Radiation can cause ionization or excitation of atoms in biological material. Ionizing radiation directly or indirectly causes damage by ionizing atoms. Directly ionizing radiation like electrons or alpha particles directly cause ionization, while indirectly ionizing radiation like X-rays produce fast moving particles that cause damage. Radiation can directly interact with targets in cells or indirectly via free radicals produced from interacting with water. Radiation damages DNA, especially double-strand breaks which can lead to chromosomal aberrations and cell death if unrepaired. Cells have several DNA repair pathways like base excision repair, nucleotide excision repair, and double-strand break repair via homologous recombination or non-homologous end joining to repair radiation