There are over 15,000 radiation therapists in the United States. This occupation is expected to experience a much higher than average growth over the next decade, at 27%.

Radiation therapists are members of a medical radiation oncology team. Other team members include a radiation oncologist and a radiation physicist who calibrates the linear accelerator, the machine used to deliver radiation treatment. The radiation therapist then delivers treatment, usually through external beam therapy that targets cancer cells with intense x-rays. Some cancer treatments combine radiation therapy with surgery and/or chemotherapy. On occasion, it is the sole treatment.

In order to determine a treatment plan, a radiation therapist images a tumor using x-ray or CT scanning. The team decides the best method of approach. These specifications must be recorded so they can be repeated during the course of treatment. At the start of each session, the radiation therapist revisits the plan created by the team to determine how to position the patient and fine-tune the linear accelerator. The radiation therapist moves to a protected room, activates the linear accelerator, and attends to the patient’s condition via a monitor and intercom system. It is important for the radiation therapist to establish trust and a sense of security. The level of stress many patients are experiencing makes them feel vulnerable; asking how they are doing and making adjustments accordingly helps to humanize the experience. Radiation therapists notate the radiation dose, the total radiation to date, the treatment area, and patient reaction. These records will be reviewed by radiation oncologists and dosimetrists to determine the dose for the next treatment.

Radiation therapists work in clean, well–lit, and ventilated hospitals and clinics. The job requires some strength and stamina, as patients need assistance getting on and off the table. Therapists spend most of their shift standing or walking. Most work a set schedule of 40 hours per week. In some cases, a radiation therapist might be required to be on call in case of emergency. It is extremely important that therapists remain conscious at all times of how they are handling radioactive materials. Standard safety requirements and the use of protective aprons and other gear help them to limit over-exposure.

Radiation therapists must hold an associate or bachelor’s degree or be certified in radiation therapy. While not all states require licensing, nearly all employers require certification. Alternatively, an associate or bachelor’s degree in radiography (the study of radiological imaging), together with the completion of a one-year certificate program is acceptable. While in school, radiation therapists study courses on procedures involved with radiation therapy, as well as the scientific theories upon which the procedures are based. The study of anatomy and physiology, algebra and pre-calculus, physics, computer science, and research methodology are also required. The American Registry of Radiologic Technologists (ARRT) names just over 100 accredited radiation therapy programs in the United States. Most states require that applicants have passed the ARRT certification examination. The examination assesses the candidate’s knowledge of radiation protection, concepts in radiation oncology, treatment plans and delivery, patient care and education. In addition, patient care, dosimetry calculations, beam modification, and radiation application are covered. The ARRT certification must be renewed annually. Every two years, 24 continuing education course credits or gaining ARRT certification in a related field is required.
Additional skills and abilities that contribute to a good radiation therapist include empathy, good communicative skills, the emotional fortitude needed to work with cancer patients, attention to detail, and the necessary degree of physical fitness.

With time and experience, a radiation therapist can advance to a managerial position. Alternatively, a radiation therapist may decide to advance by teaching, entering technical sales, or becoming involved in research. Further training and certification will raise the occupational level to that of a dosimetrist. who determines correct radiation doses.

The median annual pay for radiation therapists is around $73,000. Those in the middle of the pay range earn between about $60,000 and $88,000. Those in the bottom 10% in terms of pay earn less than $48,000, while those in the top 10% earn around $105,000.