Most times, radiation doesn’t change a cell to be cancerous. Almost every time you get hit by a piece of ionizing radiation, the cell that gets hit doesn’t turn cancerous, it just dies. The issue is in that 1% of the time that it does turn cancerous, and that only needs to happen once.
Radiation therapy though, kills those cells, and if they turn more cancerous, then it doesn’t really matter, they’re already cancer. It doesn’t hit other parts of the body, like “cancer causing” radiation.
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