Radiotherapy treats cancer by using high-energy rays (radiation) which destroy the cancer cells, while doing as little harm as possible to normal cells. It only affects cells in the part of the body to which it is given. It is given in the radiotherapy department at the hospital.
Radiotherapy can be given from an external machine (similar to an x-ray machine) and is then known as external radiotherapy. Sometimes internal radiotherapy is used. Internal radiotherapy can be given either by placing radioactive (translation in brackets) material known as a source, close to, or inside, the tumour, or by giving a radioactive liquid. The radioactive liquid is either given as a drink or as an injection into a vein. Your treatment will be planned by a clinical oncologist or radiotherapist: a doctor that specialises in radiotherapy treatment. The doctor will be able to discuss the treatment with you and answer any questions you may have. The treatment will be given by a radiographer.
Planning your treatment
Some treatments are very simple, but others may need careful planning beforehand. If your type of treatment does need some preparation this may mean having some x-rays or scans. It may also mean that you may have a session lying under a large machine called a simulator. The simulator takes special x-rays or scans of the area to be treated. Treatment planning is a very important part of radiotherapy and it may take several visits over a week or two before the planning is complete. It is a good idea to take someone with you who speaks both your language and English, when you first go for radiotherapy. Interpreters may also be available if you need one. If you are having external radiotherapy, marks will be made on your skin to show the radiographer where the rays are to be directed. The marks will be made using inks that will show up on your skin. Some of these marks may be permanent. If you would prefer not to have permanent marks, please discuss this with your radiotherapist.
External radiotherapy is normally given as a series of short daily treatments. High energy xrays are directed from a machine at the area of the cancer. The treatments are usually given from Monday to Friday, with a rest at the weekend. The number of treatments will depend on the type and size of the cancer but the whole course of treatment for early cancer may last a few weeks. Each treatment takes from 10 to 15 minutes. Your doctor will discuss the treatment and possible side effects with you. Sometimes, if radiotherapy is being used to ease an unpleasant symptom, like pain, you may need only one treatment with a single visit as an out-patient. Before each session of radiotherapy the radiographer will position you carefully on the couch and make sure that you are comfortable. During your treatment you will be left alone in the room, but you will be able to talk to the radiographer who will be watching you carefully from the next room. To maintain your dignity, you may want to be covered by a sheet or a robe. Please discuss this with the doctor or radiographer before you start treatment.
Radiotherapy is not painful but you do have to lie still for a few minutes while your treatment is being given. The treatment will not make you radioactive and it is perfectly safe for you to be with other people, including children, after your treatment. Your skin may become sore in the area being treated. Perfumed soaps, creams or deodorants may irritate the skin and should not be used during the treatment. It is a good idea to ask the radiographer or nurse about any products or oils that you may normally use to wash the area being treated with radiotherapy, as some may not be recommended. Some useful tips are also provided under ‘Coping with radiotherapy’ later in this factsheet.
Internal radiotherapy can be given by putting radioactive material into the tumour itself and this is known as brachytherapy. Sometimes the treatment is given by putting wires into the tumour. These are then removed after a few days. Sometimes the radioactive metal is left in the tumour permanently. The radioactivity decreases quickly and you can carry on a normal life during this time.
Another type of brachytherapy uses small, hollow, plastic tubes that are inserted into the tumour during an operation. If the tumour is in the womb, cervix or vagina the plastic tubes will be placed into the vagina. The tubes are then attached to a machine called a Selectron, which feeds tiny radioactive metal balls into the tubes to deliver the radiotherapy to the area. After the treatment, the radioactive balls go back into the machine and the hollow tubes are removed. If you have any concerns or worries about having radiotherapy in this way, please discuss them with your doctor before agreeing to have treatment. Sometimes internal radiotherapy is given as a liquid drink, or as a fluid given into the vein. Your specialist will discuss your particular treatment with you. When you have internal radiotherapy, you may need to stay in hospital for a few days until the radioactive material has been removed from your body, or until the radioactive liquid has
gone from your body. Due to the possibility of other people being exposed unnecessarily to the radiation, you may need to be looked after in a single room and certain safety measures may need to be followed. Staff and relatives may only spend a limited time with you, and pregnant women or children will not be allowed to visit. The safety measures and visiting restrictions might make you feel very isolated, frightened and depressed at a time when you might want people around you. If you have these feelings it is important that you let the staff looking after you know. It might also be helpful to take in things to keep you occupied whilst you are in isolation, such as reading material or tapes to listen to. The isolation only lasts while the radioactive metal is in place, or the radioactivity from the liquid is still present. Once the radioactive material has been removed or the liquid has gone from your body, you are no longer radioactive and it is perfectly safe to be with other people.