Surgery Is Done — Why Not Radiotherapy Today?

After cancer surgery, many patients ask me:

“Doctor, the surgery is over. If I need radiotherapy, why can’t we start today?”

Because after surgery, your body first needs time to heal.

Surgery does not only remove the tumour. It also creates a wound, both outside and inside the body. In the days after surgery, tissues are repairing themselves. There may still be swelling, stitches, drains, bruising, fluid collection or tenderness.

If radiotherapy is started before the operated area has recovered sufficiently, it may interfere with this healing process.

Starting too early can increase the risk of problems such as:

• Delayed wound healing

• Wound opening

• Infection

• Persistent swelling

• Fluid collection or seroma

• More severe skin reaction

• Poor healing of deeper tissues

• Difficulty tolerating treatment comfortably

This is why I usually want to see that your surgical wound is healing well before beginning radiotherapy.

At the same time, we also need your final histopathology report.

This report tells us important details such as:

• Whether the tumour was completely removed

• Whether the surgical margins are clear

• Whether lymph nodes contain cancer

• Whether there are high-risk features

• Whether radiotherapy is required

• Which areas need to be treated

These details can change the radiation plan.

Radiotherapy also needs preparation. It is not simply a machine that is switched on after surgery.

You may need a planning CT scan, proper positioning and immobilisation. I then identify the area that needs treatment and nearby normal organs that should be protected. The radiation dose and treatment plan are calculated and checked before the first session.

So the time between surgery and radiotherapy is doing two important things:

Your body is healing, and your radiotherapy is being planned properly.

However, this does not mean radiotherapy should be postponed indefinitely. Once the wound has healed adequately and the required reports are available, treatment should begin within the appropriate time for your type of cancer.

The exact timing is different for every patient and depends on the type of cancer, the surgery performed, wound healing, pathology findings, complications and whether chemotherapy is also required.

So if I ask you to wait for a short period after surgery, it usually does not mean your cancer treatment has stopped.

It means we are trying to start radiotherapy safely, accurately and at the right time.

The goal is not to start radiation as early as possible.
The goal is to start it when your body is ready and the treatment plan is correct.