Radiation can be one of the scariest words you hear after a cancer diagnosis. In this episode of What I Wish I Knew, host and cancer survivor McKenna Avery shares what it felt like to finish 33 rounds of proton radiation, including the emotional “last day” moment, and the three things she wishes she knew sooner: that proton therapy can be an option, the power of visualization during treatment, and why consistent moisturizing matters.

Dr. Dan sits down with radiation oncologist Dr. James Urbanski (UC San Diego) for a grounded, patient-first explanation of radiation therapy and the real-world decision-making behind it. They break down the goals of treatment (symptom relief, life prolongation, post-surgery “cleanup,” and curative intent), why some cancers are treated with radiation to preserve function (including larynx/voice box, cervix, and anal cancers), and how the field has advanced with better imaging, tighter accuracy, and faster planning.

You’ll also hear a clear, non-hype comparison of proton therapy vs conventional X-ray (photon) radiation, including the Bragg peak, why “best” depends on the situation, and how technique differs from modality (3D conformal, IMRT/IMPT, SBRT, SRS). Dr. Urbanski walks through what planning day looks like (CT imaging, immobilization devices, contrast considerations, and behind-the-scenes safety checks), what side effects can look like across body areas (including skin reactions and why proton skin reactions may be more pronounced), how clinicians think about re-irradiation, and where immunotherapy may or may not fit alongside radiation. The conversation also touches on cost, insurance authorization realities, access gaps, and what patients should listen for when deciding if a care team feels trustworthy and thorough. This conversation is for patients, survivors, caregivers, and clinicians seeking clarity, not marketing. Educational only, not medical advice.

Episode Chapters:

00:00:00 - Cold Open: Progress, Immunity, and Hope

00:00:29 - Welcome + McKenna’s Proton Radiation Story

00:01:06 - Three Things McKenna Wishes She Knew About Proton Therapy

00:02:03 - Meet Dr. James Urbanski

00:02:51 - From Ships to Cancer Care: Dr. Urbanski’s Path

00:05:31 - Radiation Therapy Basics Explained

00:07:22 - The Goals of Radiation Treatment

00:09:00 - When Radiation Replaces Surgery

00:10:48 - How Radiation Therapy Has Evolved

00:13:30 - When Patients Want to “Go Natural”

00:18:25 - Radiation Myths, Safety, and Trust

00:21:46 - What Is Proton Therapy?

00:26:41 - Who Proton Therapy Helps Most

00:32:39 - Cost, Coverage, and Insurance for Proton Therapy

00:40:27 - Proton Therapy Hype vs Reality

00:42:39 - SBRT, SRS, and Modern Radiation Techniques

00:50:30 - Immunotherapy and Radiation Used Together

01:01:54 - What Happens on Radiation Planning Day

01:06:15 - AI and Machine Learning in Radiation Planning

01:11:52 - What Treatment Looks Like Behind the Scenes

01:21:03 - Radiation Side Effects: Short-Term and Long-Term

01:24:25 - Re-Irradiation: When and Why It’s Considered

01:31:28 - Diet, Exercise, and Mind-Body Support During Treatment

01:38:46 - The Future of Radiation: New Particles, New Questions

01:43:23 - Access, Geography, and Proton Center Availability

01:48:18 - Questions Every Patient Should Ask

01:50:40 - Resilience, Meaning, and Joy in the Work

Disclaimer:

This episode is for general educational purposes and reflects personal experiences and professional perspectives. It is not medical advice and is not a substitute for individualized diagnosis or treatment planning. Always consult your oncology team for guidance specific to your situation. If you think you may be experiencing an urgent medical issue, seek immediate care.