Radiation oncology is often a key component in the fight against cancer. Radiation therapy targets malignant cells with controlled doses of high-energy radiation, destroying cancer or slowing its growth without harming healthy nearby cells.
When is radiation used?
When is radiation used?Depending on the type of cancer, radiation may be the sole or primary treatment strategy, or your care team may recommend radiation therapy alongside chemotherapy, immunotherapy, or surgery.
Radiation therapy can help shrink tumors before surgery or kill remaining tumor cells after surgery. Since it is a precise and targeted treatment, radiation therapy may be appropriate when tumors are located near vital organs in order to protect healthy, non-tumor tissue. It is also used to treat non-cancerous diseases such as acoustic neuroma, trigeminal neuralgia, tremors, heterotopic ossification, keloid, Depuytren's contracture, and osteoarthritis.
Our radiation oncologists work as part of a multidisciplinary team, collaborating closely with surgeons, medical oncologists, and other specialists to ensure your care is fully coordinated.
Radiation therapy may be delivered externally using advanced machines that direct radiation at the tumor, or internally through techniques such as brachytherapy, where radioactive material is placed inside the body near the cancer.
What to expect at your first radiation therapy visit
What to expectYour first visit with a radiation oncology team is designed to answer your questions, confirm whether radiation therapy is appropriate, and begin building a personalized treatment plan. Here’s how the process typically unfolds:
Consultation and Medical Review
During your initial appointment, you’ll meet with a radiation oncologist who will review your diagnosis and overall health. This conversation often includes:
- Your cancer stage and type
- Your treatment goals
- Potential benefits and risks of radiation therapy
- How radiation fits with other treatments like chemotherapy or surgery
Imaging Review and Additional Testing
Your doctor will carefully review existing imaging (such as CT, MRI, or PET scans). In some cases, additional imaging may be ordered to better define the tumor and surrounding anatomy, ensuring the highest level of precision.
Simulation (Treatment Mapping)
If radiation therapy is recommended, the next step is a planning session called a “simulation.” You’ll be positioned exactly as you will be during treatment, sometimes with custom supports or molds to help you stay still. Typically, a CT scan will be done to map the treatment area. This step is critical for delivering radiation accurately and minimizing exposure to healthy tissue. The CT scan may include the use of oral or IV contrast. A 4D CT scan may be done to see how a tumor moves as the patient is breathing.
Treatment Planning
After simulation, your multidisciplinary care team creates a comprehensive care plan tailored to your unique disease and genetic profile.They will calculate your exact radiation dose and the best angles and delivery method. This planning process can take several days.
From the very first screening through recovery, our goal is to provide you with the safest and most effective therapy, delivered quickly to cure your cancer and maximize your quality of life.
Treatment Schedule
Once your plan is finalized, you’ll begin treatment. Depending on your condition, radiation may be delivered daily over several weeks, or in fewer, higher-dose sessions. Sessions are typically outpatient visits, and they are usually quick. The radiation therapy itself takes about 15 to 30 minutes, though setup may take longer.
Follow-Up and Ongoing Care
Throughout treatment, you’ll have regular check-ins with your care team to monitor progress and manage any side effects. After completing radiation therapy, follow-up visits and imaging help assess how well the treatment worked and guide next steps in your care.
Types of radiation therapy at NewYork-Presbyterian
TypesAt NewYork-Presbyterian, we are continually committed to incorporating the latest evidence-based radiation treatment technologies into your care. Many of our doctors are international leaders on the advancement of these technologies to improve treatment outcomes. We offer:
Adaptive radiation therapy and advanced imaging to make changes to your personalized radiation treatment daily, adapting to your tumor's size and the movement of nearby organs.
Ethos™ Adaptive Radiation Linear Accelerator, which leverages artificial intelligence to provide adaptive radiation treatments in less than 30 minutes per treatment for cancers of the anus, bladder, cervix, head and neck, endometrium, esophagus, pancreas, lung, kidney, adrenal gland, liver, prostate and rectum.
Gamma Knife Esprit and stereotactic radiosurgery, a noninvasive system that targets multiple areas of the brain simultaneously without the need for a head frame.
Intraoperative radiation therapy (IORT), radiation therapy that is administered during surgery directly in the operating room to treat cancers of the eye, breast, abdomen and pelvis.
Hypofractionated radiation therapy to deliver faster, shorter courses of therapy. This type of therapy is available for many cancers such as breast, prostate and rectal.
Specialized breast cancer radiation therapies, including prone radiation therapy, which reduces radiation exposure to the heart and lungs, deep-inspiratory breath hold, which further helps to reduce radiation exposure to the heart and lungs, and partial breast irradiation.
MRI-guided external beam and brachytherapy to treat gynecologic and other types of cancers.
Other types of radiation therapy that we offer include:
- CT Simulation and Treatment Planning
- Image-Guided Radiotherapy (IGRT)
- Intensity-Modulated Radiotherapy (IMRT) , including volumetric arc therapy (VMAT) - RapidArc
- Prostate Seed Implants
- 3D conformal radiation
- 4D CT treatment planning and delivery
- Stereotactic body radiotherapy (SBRT)
- Stereotactic radiosurgery (SRS)
- Total body irradiation (TBI) before bone marrow transplant
- Total lymphoid (nodal) irradiation (TLI) for transplant rejection
- Total skin electrons (TSE) for mycosis fungoides (a type of skin lymphoma)
- Radioactive eye plaques for melanoma
- Multiple radiation immunotherapy trials
- Proton therapy
- GammaTile brachytherapy
- Focused ultrasound trial for pediatric and adult brain cancers
Side effects
Side effectsWhile side effects vary by treatment area, the most common side effect of radiation therapy is fatigue. Your radiation oncologist will talk to you about possible side effects from treatment, as wel as ways to prevent and reduce side effects. It’s also common to experience skin changes such as redness, dryness, itching, blistering, or hair loss in the targeted area.
The goal at NewYork-Presbyterian is to treat the whole individual, not just the cancer. We'll create a treatment plan specific to your unique disease and genetic profile. In addition to our radiation oncologists, multidisciplinary care, and tumor boards, our compassionate nurses, patient navigators, and staff are here to support you.
If necessary, we can connect you with other experts including dietitians, physical therapists, and speech pathologists to help manage radiation oncology side effects. For children, child life specialists are also available.
Our radiation therapy locations
LocationsAt NewYork-Presbyterian, our radiation oncology centers are experienced in providing radiation therapy for children, adolescents, and adults.
Our world-class radiation oncologists review each case as one team. We have several convenient locations throughout the region: find one closest to home here.
Find a doctor
Find a doctorThe radiation oncology teams at our two top-tier cancer centers, the Herbert Irving Comprehensive Cancer Center of New York-Presbyterian/Columbia University Irving Medical Center and the Weill Cornell Medicine Meyer Cancer Center, have formed a dynamic partnership to bring patients the highest quality, most compassionate and personalized care.
These exceptional physician-scientists are advancing the field with groundbreaking research on the benefits of radiation treatment for cancer with approaches that regard the unique genetics of a patient's tumor and spare as much nearby tissue as possible.
This content has been reviewed by the following medical editors.
Awards & Recognition
Dr. Lisa Kachnic, Chair of the Department of Radiation Oncology and Chu H. Chang Professor at the Columbia University Vagelos College of Physicians and Surgeons and radiation oncologist-in-chief at NewYork-Presbyterian/Columbia, is the past president of the American Board of Radiology, the American Board of Medical Specialties governing organization of all board-certified radiologists, radiation oncologists and medical physicists in the United States. She is the director of the National Cancer Institute’s Community Oncology Research Program at HICCC and is an international leader in radiation care for patients with anal and rectal cancer.
Dr. Sally Amundson, Associate Professor in the Department of Radiation Oncology at the Columbia University Vagelos College of Physicians and Surgeons and a senior scientist in the Department's Center for Radiological Research, is the current president of the Radiation Research Society, the largest and oldest Radiation Research Society, worldwide.
The Center for Radiological Research has been awarded a five year $27M grant from the National Institutes of Health to investigate biomarkers of prior radiation exposure, as well as a $2.5M equipment grant from the National Cancer Institute (NCI) for a charged-particle accelerator booster, to study a new approach for treating brain tumors and pancreatic tumors with heavy charged particles. Following on from this award, the CRR has been awarded two further NCI grants totaling $4.5M to perform pre-clinical studies with this new machine.
The Herbert Irving Comprehensive Cancer Center (HICCC) at NewYork-Presbyterian/Columbia University Irving Medical Center and Weill Cornell Medicine Meyer Cancer Center in partnership with NewYork-Presbyterian are both recognized with accreditation by the American College of Radiology (ACR), which provides a third-party, impartial peer review and evaluation of patient care.