One of the concerns that Michael Milosevic, a radiation oncologist, hears most often from his patients is about their hair - more specifically, will they lose their hair?
No, he explains, radiation treatment for cancer does not result in hair loss. Nor will the beams burn and scar their skin, he adds, anticipating the next question.
(Chemotherapy causes hair loss and, increasingly, even those drugs do not cause that noticeable side effect.)
But the belief that radiation can cause hair loss, along with all manner of disfiguring side effects, is pervasive.
"Patients are very scared of radiation. They always wonder if it will damage normal parts of their body," Dr. Milosevic said.
As president of the Canadian Association for Radiation Oncology, he is leading a campaign to counter the myths about radiation therapy.
As well as not losing their hair or being burned, Dr. Milosevic adds, cancer patients will not glow in the dark after treatment, and they don't have to worry about the environmental impact of the machine delivering the radiation beams.
"There can't be a Chernobyl incident in a hospital because there's no nuclear reactor," he said. "The radiation for treatment is all generated electronically."
Radiation therapy is, in fact, the use of targeted X-rays, or electron beams, to kill or shrink cancer cells to stop them from growing and reproducing.
About one-third of cancer patients undergo radiation treatment -about 60,000 people a year in Canada. Increasingly, it is done in conjunction with the other principal methods of treatment - surgery and chemotherapy.
There are three main ways to use radiation therapy to treat cancer:
External use of high-energy X-rays or electron beams targeted at a specific area in the body; usually an "electron gun" is used to deliver the beam while the patient lies on a special bed;
Brachytherapy, which involves the insertion of radioactive seeds into a tumour; the process is used mostly to treat prostate and breast cancer;
Isotopes, elements that emit radioactive rays, can be infused into the body with tracer chemicals. They are used to diagnose cancer and heart disease, but in rare cases can be used as a treatment.
Raymond Power, a 71-year-old retired Loto-Québec employee, underwent brachytherapy - the insertion of 55 radioactive pellets, each the size of a grain of rice, into his cancerous prostate.
Initially he had some trepidation, but after doing a little research he determined that the radiation therapy was a much better choice for him than surgery.
"I had friends who had prostate surgery, and there was incontinence and impotence, so I wasn't keen," Mr. Power said. "I found out about brachytherapy and it sounded right."
Mr. Power had the procedure on a Thursday, went home the same day and was back at work on the Monday.
The only down side was that, at the time, his daughter was pregnant and he was told not to sit close to her for extended periods of time because of the slight risk of exposure to radiation.
But the treatment worked well, and Mr. Power is essentially cured of prostate cancer.
Dr. Milosevic, who works as a radiation oncologist at Princess Margaret Hospital in Toronto, said that a big worry of patients is that "they're going to be radioactive."
In fact, there is no lingering radiation from external beam treatment, by far the most common procedure, and very low levels with brachytherapy.
Radiation therapy has been around for more than half a century, and that also gives the impression it is old-fashioned.
"It's been around so long that people believe it's obsolete," Dr. Milosevic said. "But the reality is that it's continually evolving. The future of cancer treatment is more precise, accurate radiation, and combining it with drugs and surgery."