Radiation therapy is used to treat cancer in the human body. As part of a medical radiation oncology team, radiation therapists use machines called linear accelerators to administer radiation treatment to patients. Linear accelerators are most commonly used in a procedure called external beam therapy, which projects high-energy X rays at targeted cancer cells. As the X rays collide with human tissue, they produce highly energized ions that can shrink and eliminate cancerous tumors. Radiation therapy is sometimes used as the sole treatment for cancer, but it is usually used in conjunction with chemotherapy or surgery.
Before treatment can begin, the oncology team has to develop a treatment plan. To create this plan, the radiation therapist must first use an X-ray imaging machine or computer tomography (CT) scan to pinpoint the location of the tumor. Then, a radiation oncologist (a physician who specializes in therapeutic radiology) and a radiation physicist (a worker who calibrates the linear accelerator) determine the best way to administer treatment. The therapist completes the plan by positioning the patient and adjusting the linear accelerator to the specifications developed by the team, recording the details so that these conditions can be replicated during treatment. The therapist later explains the treatment plan to the patient and answers any questions that the patient may have.
The next step in the process is treatment. To begin each treatment session, the radiation therapist uses the guidelines developed during the planning phase to position the patient and adjust the linear accelerator. Then, from a separate room that is protected from the X-ray radiation, the therapist operates the linear accelerator and monitors the patient's condition through a TV monitor and an intercom system. Treatment can take anywhere from 10 to 30 minutes.
During the treatment phase, the radiation therapist monitors the patient's physical condition to determine whether the patient is having any adverse reactions to the treatment. The therapist must also be aware of the patient's emotional well-being. Because many patients are under stress and are emotionally fragile, it is important for the therapist to maintain a positive attitude and provide emotional support.
Radiation therapists keep detailed records of their patients' treatments. These records include information such as the dose of radiation used for each treatment, the total amount of radiation used to date, the area treated, and the patient's reactions. Radiation oncologists and dosimetrists (technicians who calculate the dose of radiation that will be used for treatment) review these records to ensure that the treatment plan is working, to monitor the amount of radiation exposure that the patient has received, and to keep side effects to a minimum. Therapists also may assist dosimetrists with routine aspects of dosimetry, the process used to calculate radiation dosages.
Work Environment
Radiation therapists held about 17,700 jobs in 2020. The largest employers of radiation therapists were as follows:
- Hospitals; state, local, and private - 65%
- Offices of physicians - 24%
- Outpatient care centers - 6%
Radiation therapists stand for long periods and may need to lift or turn patients.
Injuries and illnesses
Because radiation therapists work with radiation and radioactive materials, they should be aware of the risks involved and must follow safety procedures. These procedures require therapists to be in a different room while administering radiation to a patient and to wear a film badge dosimeter to track their exposure.
Work Schedules
Most radiation therapists work full time. They have a regular work schedule because radiation therapy procedures are usually planned in advance.
Education & Training Required
Employers usually require applicants to complete an associate or a bachelor's degree program in radiation therapy, which can be completed at schools offering this course. Radiation therapy programs include core courses on radiation therapy procedures and the scientific theories behind them. In addition, such programs often include courses on human anatomy and physiology, physics, algebra, precalculus, writing, public speaking, computer science, and research methodology. In 2009, there were 102 radiation therapy programs in the U.S. that were accredited by the American Registry of Radiologic Technologists (ARRT).
Certifications Needed
In 2009, 33 States required radiation therapists to be licensed by a State accrediting board. Licensing requirements vary by State, but many States require applicants to pass the ARRT certification examination. Further information is available from individual State licensing offices.
Other Skills Required
Some States, as well as many employers, require radiation therapists to be certified by ARRT. To become ARRT-certified, an applicant must complete an accredited radiation therapy program, adhere to ARRT ethical standards, and pass the ARRT certification examination. The examination covers radiation protection and quality assurance, clinical concepts in radiation oncology, treatment planning, treatment delivery, and patient care and education. Candidates also must demonstrate competency in several clinical practices including patient care activities; simulation procedures; dosimetry calculations; fabrication of beam modification devices; low-volume, high-risk procedures; and the application of radiation.
ARRT certification is valid for 1 year, after which therapists must renew their certification. Requirements for renewal include abiding by the ARRT ethical standards, paying annual dues, and satisfying continuing education requirements. Continuing education requirements must be met every 2 years and include either the completion of 24 course credits related to radiation therapy or the attainment of ARRT certification in a discipline other than radiation therapy. Certification renewal, however, may not be required by all States or employers that require initial certification.
All radiation therapists need good communication skills because their work involves a great deal of interaction with patients. Individuals interested in becoming radiation therapists should be psychologically capable of working with cancer patients. They should be caring and empathetic because they work with patients who are ill and under stress. They should be able to keep accurate, detailed records. They also should be physically fit because they work on their feet for long periods and lift and move disabled patients.
How to Advance
Experienced radiation therapists may advance to manage radiation therapy programs in treatment centers or other healthcare facilities. Managers generally continue to treat patients while taking on management responsibilities. Other advancement opportunities include teaching, technical sales, and research. With additional training and certification, therapists also can become dosimetrists, who use complex mathematical formulas to calculate proper radiation doses.
Job Outlook
Employment of radiation therapists is projected to grow 9 percent from 2020 to 2030, about as fast as the average for all occupations.
About 1,100 openings for radiation therapists are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.
Employment
The incidence of cancer increases as people age, so an aging population may increase demand for radiation therapists. Continued advancements in the detection of cancer and the development of more sophisticated treatment techniques may also lead to greater demand for radiation therapy.
Earnings
The median annual wage for radiation therapists was $82,790 in May 2021. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $61,030, and the highest 10 percent earned more than $128,550.
In May 2021, the median annual wages for radiation therapists in the top industries in which they worked were as follows:
- Outpatient care centers - $121,140
- Offices of physicians - $82,540
- Hospitals; state, local, and private - $81,050
Most radiation therapists work full time. They have a regular work schedule because radiation therapy procedures are usually planned in advance.
