Chemotherapy vs. Radiation: Uses, Benefits, Side Effects, & More

Chemotherapy and radiation are types of cancer treatment. While chemotherapy kills cancer cells systemically (throughout the whole body), radiation targets cancer in a specific area of the body.

Some people may need only one of the two treatments, while others may need both chemotherapy and radiation. Although each effectively treats cancer, chemo and radiation work very differently.

This article covers the differences between chemotherapy and radiation.

What to Know About Chemotherapy

Chemotherapy (chemo) refers to the use of drugs (medications) to treat cancer, and it is one of the most common treatments. There are many types of chemo because they work differently in the body. Depending on the type of cancer and its stage (how advanced it is), chemotherapy is used to either cure, control, or shrink the disease.

How Does It Work?

Cancer occurs when one cell begins to divide and replicate uncontrollably. These rapidly dividing cells form tumors in the body.

Traditional chemotherapy travels through the bloodstream and destroys all rapidly dividing cells, healthy and unhealthy. Newer agents, sometimes called targeted therapies, can attack specific molecules that cancer cells use to grow and divide.

Some cancers require several chemo medications to fight cancer more effectively and prevent the disease from returning.

Chemotherapy Delivery

Chemo is administered in frequencies referred to as cycles. The length of each cycle depends on the chemo regimen being used. Some cycles are weekly, while others may be monthly.

Chemotherapy is usually given in the following ways:

• Intravenous (IV): Chemo is delivered directly to the bloodstream through a peripheral intravenous catheter (PIVC) or central venous access device (CVAD).
• Oral: Some chemo medications come in a pill or liquid you swallow.
• Injection: Chemo can be injected into your skin or muscle with a syringe.
• Topical: Chemo can also be applied to the top of your skin as a cream or gel.

Chemo given directly into the spinal canal is called intrathecal chemo. This helps treat certain cancers that may travel to the brain. Chemo can also be given directly into the abdominal cavity, bladder, or the space in your chest.

Depending on the cancer type and stage, you may need to have chemo delivered in several routes.

Side Effects

Since chemo destroys rapidly dividing healthy cells in addition to cancer cells, there are side effects to these medications. Hair, skin, mouth, gastrointestinal, reproductive, bone marrow, and nerve cells are typical fast-splitting cells affected by chemo. Additionally, people undergoing chemo are at high risk for serious infections.

Here are common side effects of chemo:

• Neutropenic fever/infection
• Nausea/vomiting
• Hair loss
• Mouth sores
• Taste changes
• Skin and nail changes (peeling, dry, discoloration)
• Bowel changes (constipation/diarrhea)
• Peripheral neuropathy (nerve pain)
• Low white and red blood cell count
• Infertility

There are pharmacologic (medications) and non-pharmacologic ways to lessen or treat the side effects of chemo. If chemotherapy symptoms affect your quality of life, speak to your oncology nurse (a nurse specializing in cancer) or oncologist immediately. You don't need to suffer just because you're on chemo.

Prices & Where to Get It

Intravenous and injectable chemotherapies are given in a hospital or outpatient clinic. A pharmacist mixes and prepares these medications, and an oncology nurse administers them. Oral and topical chemo are purchased through a specialty pharmacy and can be administered at home.

The price of chemotherapy varies based on which medications are used and where you receive your treatment. In addition to health insurance, many drug companies offer discounts or free drug programs.

If you're diagnosed with cancer, make an appointment with your clinic's oncology social worker and financial advocate for assistance with available programs.

What to Know About Radiation

Radiation delivers high-energy waves or particles to the site of cancer. The radiation particles destroy the DNA of cells so they can no longer grow and divide. About 50% of people with cancer will receive radiation. Like chemo, radiation is used to cure, control, or shrink cancer tumors.

Radiation Delivery

Radiation is delivered in the following three ways:

• External radiation: While lying on a table, a machine directs the radiation beam to a specific body area. The device is programmed explicitly to each person's unique cancer site.
• Internal radiation (brachytherapy): Radiation can also be placed inside the body by a radioactive device called an implant.
• Systemic radiation: Radioactive medications can be given by IV or orally and circulate in the bloodstream to deliver radiation.

The radiation dose is determined by cancer type, size, and location.

Side Effects

Radiation also damages healthy cells, leading to side effects. The side effects from radiation treatment depend on what body part is being treated and may include:

• Hair loss (all areas)
• Sunburn/sore skin (all areas)
• Skin changes (all areas)
• Fatigue (all areas)
• Abnormal bloodwork (all areas)
• Headache/blurry vision (brain)
• Sore throat/difficulty swallowing (throat, esophagus)
• Mouth sores/taste changes (mouth, throat)
• Nausea/vomiting (stomach, abdomen, esophagus)
• Malnutrition (mouth, throat, esophagus, stomach)
• Cough/shortness of breath (chest, esophagus)
• Bowel changes (abdomen, pelvis)
• Sexual and fertility problems (pelvis, rectum)

Pain can be a common side effect of radiation, depending on the affected body area. Therefore, it's important to tell your oncology nurse or radiation oncologist (a doctor that specializes in radiation therapy) if your pain is not tolerable.

Prices & Where to Get It

Radiation is delivered in the hospital or an outpatient oncology clinic. As with chemo, prices vary depending on the dose and length of radiation needed. Before starting treatment, speak with the oncology social worker or financial advocate to help find resources.

Which Treatment Is Best for You?

The National Comprehensive Cancer Network (NCCN) provides guidelines for your oncology team to follow. Together with the recommendations of your oncologist, a treatment plan that best fits your needs will be created. Factors that determine what treatment you're eligible for include the following:

• Type and stage of cancer
  
• Genetics/molecular makeup of the cancer
• Your past and current state of health
• Quality of life issues

In addition, you may qualify for a clinical trial and receive cutting-edge medication at a low cost.

Can Chemotherapy and Radiation Be Used Together?

Chemo and radiation can be given separately or together. Some treatment regimens require chemo and radiation to be given together because the combination can be more effective in killing cancer cells. In addition, certain types of chemotherapy help radiation work better.

Coping With the Side Effects

The side effects of chemo and radiation depend on many factors. You will need support during your cancer journey. Many oncology facilities have support services that include a dietician, masseuse, yoga instructor, social worker, financial advocate, and nurse navigator who help find ways to relieve the physical and emotional side effects of chemo and radiation.

When cancer treatment has been completed, you will need ongoing support, as some side effects can be lifelong. Participation in a survivorship program is vital for your continuing health and wellness after cancer treatment.

Summary

Chemotherapy and radiation are effective ways to treat cancer. While chemo treats cancer everywhere in the body, radiation targets cancer in a specific body area. Chemo and radiation can be given separately or together. Cancer treatment is expensive, but an oncology social worker and financial advocate may be able to help lower the costs. Since chemo and radiation destroy healthy cells in addition to cancer cells, there are side effects to each treatment modality.

A Word From Verywell

If you or a loved one has been diagnosed with cancer, meeting with a social worker and financial advocate can be helpful before treatment starts. The financial obligations that come with cancer treatment can be overwhelming. Learning what your health insurance will cover and the expected copays can alleviate anxiety. An oncology social worker can help connect you with grants and scholarships, while the financial advocate can explain your coverage or help you obtain coverage. Accepting help upfront can make your cancer journey less stressful.