Art therapy in the course of cancer radiation therapy can be considered as one of the complementary interventions in psycho-oncology, because radiation therapy, although it is one of the important pillars of cancer treatment, is associated with a period of anxiety, constant waiting, fatigue, worry about complications, physical changes, and disruption in daily activities for many patients. The experience of radiation therapy is usually done in the form of numerous and relatively regular sessions, and this repetition can create the possibility of gradual adjustment on the one hand, and on the other hand, it can cause the formation of anticipatory anxiety and increase sensitivity to physical symptoms for some patients. The theoretical basis of the use of art therapy in this situation is based on the interaction between emotional, cognitive, perceptual, and physiological processes, and its main assumption is that creative interventions can reduce part of the psychological burden of treatment and strengthen the patient's capacity for adaptation. Art therapy, through activities such as painting, drawing, collage, illustration, music, and other artistic activities, provides the opportunity to express experiences that are sometimes difficult for the patient to express directly. Radiation therapy anxiety may not be limited to fear of the disease itself, but may include concerns about the effectiveness of treatment, possible complications, changes in body appearance, pain, fatigue, the future, and the possibility of recurrence. By creating a structured and controllable environment, artistic activity can direct the patient's attention from a constant focus on the threat to a meaningful and manageable activity. This shift in attention can be one of the possible mechanisms of reducing anxiety, as the patient engages in a process that requires observation, choice, concentration, and decision-making for a certain period of time. From a psychological perspective, the feeling of control is very important because the illness and cancer treatment may create an experience of uncertainty and reduced control over the body and the future. Art allows the patient to choose, change, stop, and shape the outcome in their own personal way, at least within the scope of a specific activity, and this experience of active participation can foster a sense of agency. On the other hand, art therapy can serve as a platform for identifying and processing emotions associated with radiation therapy. The patient may express their fear, anger, sadness, or concern in the form of color, form, image, or artistic metaphor, and then discuss the personal meaning of the work with the therapist's help. In this process, art is not merely the final product, but the process of creating the work itself is important and can help organize the inner experience. One of the important areas in this regard is the perception of physical symptoms. Patients undergoing radiation therapy may experience symptoms such as fatigue, skin irritation, pain, local discomfort, changes in appetite, or other complications, and the degree of discomfort caused by these symptoms is not only dependent on their physiological severity, but also on the patient's anxiety, selective attention, expectation, and cognitive interpretation. Art therapy cannot eliminate the medical cause of these symptoms, but it may affect how we experience and process them. Reducing anxiety and reducing the constant focus on symptoms can help change perceptions of discomfort severity in some patients, although this effect should be investigated with valid measures and under controlled conditions. In this context, it is necessary to distinguish between "symptom reduction" and "symptom-induced perception or discomfort" because art therapy should not be considered as a substitute for medical treatment of radiation therapy complications. Research evidence on art interventions in cancer patients has shown that art activities and creative interventions have been associated with a reduction in anxiety and psychological distress and improved some aspects of quality of life in some studies, but the results of the studies are not the same in terms of the type of intervention, the population studied, the duration of treatment, and the severity of the effect. Therefore, it cannot be concluded based on the available evidence that art therapy is equally effective in all patients undergoing radiation therapy. Differences in the type of cancer, location of radiation therapy, stage of disease, severity of complications, physical condition, individual characteristics, and social support can alter the response to the intervention. In clinical application, art therapy can be administered before a radiation therapy session, during waiting, after treatment, or in between sessions, and its form should be in harmony with the patient's condition. For a patient who is severely fatigued, short, sedentary art activity may be more appropriate, while a person with greater physical ability may benefit from more complex creative activities. In the design of the intervention, attention should also be paid to the therapeutic environment; the radiation therapy space may be a reminder for the patient of the illness and treatment, and creating a calm, predictable, and supportive environment can be important alongside artistic activity. In addition to the creative process, group art therapy can also provide the ground for communicating with other patients and reduce feelings of isolation. Observing other people's experiences may reduce the feeling of being different and allow for the exchange of coping strategies, but group participation should not be mandatory for patients who need more privacy or rest. In terms of quality of life, the main goal of the intervention is to reduce the impact of illness and treatment on daily functioning, social relationships, mood, sense of meaning, and satisfaction with life. If art therapy reduces anxiety but does not cause any changes in functioning, social participation, or quality of life, clinical interpretation of its effect should be done with caution. Therefore, the evaluation of outcomes should be multidimensional and include indicators such as fatigue, sleep, pain, social functioning, psychological distress, and quality of life, in addition to anxiety. In this context, the psycho-oncologist and art therapist can work with the oncology team to assess the patient's mental and physical state and choose appropriate activity. This collaboration is especially important in patients with severe or complex symptoms, as some symptoms may require specialized medical or psychological intervention. From a neuropsychological perspective, active engagement with artistic activity can engage networks related to attention, emotion processing, cognitive control, and the reward system, creating an experience different from a constant focus on threat, but attributing specific clinical changes to a single neural pathway requires rigorous empirical evidence. The creative process may also provide some patients with a sense of meaning, identity, and personal continuity, especially when the individual feels that the illness has affected a large part of their life. Creating a work of art can be an opportunity to document the experience of radiation therapy and make it part of a person's life narrative, without the patient having to describe their experience as merely positive or promising. An important limitation in this area is the significant heterogeneity of art therapy protocols. Differences in the type of art activity, number of sessions, duration of each session, therapist training, and measurement tools make it difficult to compare studies. Limited sample size, lack of active control group, short follow-up period, and clinical differences between patients are also limitations. In addition, part of the observed effect may be due to social attention and support, and separating it from the specific effect of the art activity requires more rigorous research designs. Another challenge is the risk of simplifying the relationship between anxiety and physical symptoms, as the symptoms caused by radiation therapy are of medical origin and should not be attributed to psychological factors. Art therapy should therefore be placed as a complementary intervention and medical management of complications should remain a key part of care. Future research could investigate the effect of innovative interventions at different stages of radiotherapy by designing controlled trials and using larger samples, and take into account the differences in patients' responses based on the type of cancer, the location of radiotherapy and the severity of symptoms. The simultaneous use of validated measures of anxiety and quality of life with indicators of symptom perception can provide a more accurate picture of the outcomes of the intervention, and longitudinal studies can also determine whether psychological changes remain sustained after radiotherapy ends. Overall, art therapy can be used in the course of radiation therapy as a complementary and human-centered intervention to support emotion regulation, reduce distress, shift of attention, strengthen a sense of agency, and promote some dimension of quality of life. The value of this approach lies in that it considers the patient's experience beyond tumor control and physical complications and also considers the individual's emotional, cognitive, and semantic experience. Despite the clinical capacity of this intervention, its effectiveness should be evaluated based on credible evidence, the patient's individual characteristics, and his/her medical conditions, and art therapy should be used in coordination with the treatment team and not as a substitute for standard radiation therapy.