Radiotherapy

Radiotherapy uses high-energy particles (ionising radiation) such as X-rays, gamma rays, protons or electron beams to damage the DNA of cancer cells, preventing them from growing and dividing. When enough damage is done to the cell DNA, these cancer cells die and are removed from the body.

As it can take time for cancer cells to get damaged enough to die, you’ll need multiple rounds of radiotherapy, although the amount you have depends on the course of treatment set by your consultant.

If you’re undergoing radiotherapy to relieve symptoms, you could have anything from a single treatment to two weeks of treatment. On the other hand, radiotherapy with the aim of curing cancer can last anywhere between one to seven weeks.

There are two main types of radiotherapy:

• External radiotherapy (external beam radiation therapy) 
• Internal radiotherapy

Your consultant will recommend the most appropriate type of radiotherapy for you depending on the following factors:

• Your type of cancer
• Where your cancer is in your body
• Your stage of your cancer
• Your general health
• If you’re undergoing any other cancer treatments

External beam radiation therapy (EBRT)

External beam radiation therapy (EBRT) is the most common type of radiotherapy, where a machine is used to carefully direct radiation beams at the cancer site and surrounding area.
The treatment is very precise and aims to destroy cancer cells while minimising harm to the surrounding healthy cells.

External beam radiation therapy is usually given as a course of outpatient treatment sessions over several days or weeks. It doesn’t make you radioactive and you can have contact with other people, including children and pregnant women, while undergoing treatment.

Internal radiotherapy

Internal radiotherapy involves being given a source of radiation inside your body. This can be done in several ways.

Brachytherapy

Brachytherapy describes radiotherapy where radioactive implants being placed inside your body, in or near the tumour.

There are three types of brachytherapy:

• High-dose-rate (HDR) implants that are left in place for a few minutes at a time
• Low-dose-rate (LDR) implants that remain in place for up to seven days
• Permanent implants that stay in your body for the rest of your life

Brachytherapy is most commonly used to treat prostate, breast, cervical, eye, and head and neck cancers.

Radionuclide (radioisotope) therapy

Radionuclide therapy is a type of radiation that you can take in the form of a capsule or drink, or can have injected into a vein.

Radioisotopes target and destroy cancer cells while minimising damage to healthy cells, and is mostly used to treat thyroid cancer

Selective internal radiation therapy (SIRT)

Selective internal radiation therapy is a type of internal radiotherapy used to treat liver cancer.

During treatment, tiny radioactive beads are injected into your bloodstream and travel to the small blood vessels in and around your liver tumour, where they remain permanently. These beads emit radiation, damaging the cancer cells in your liver.

Intrabeam radiotherapy

Intrabeam radiotherapy is a type of intraoperative radiotherapy that can be used to treat early-stage breast cancer, and is typically performed at the same time as breast cancer surgery. 

The cost of radiotherapy depends on your individual circumstances. At the time of your appointment your consultant will discuss all options with you and ensure all your questions are answered.

Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. However, any pre-surgery diagnostic tests and your consultant's outpatient appointment consultation fee are charged separately.

Our flexible payment options help you spread the cost of your payment across a time period that suits you.

One of the main benefits of radiotherapy is that it’s highly effective at targeting and destroying cancer cells. By damaging the DNA of these harmful cells, radiotherapy can be used to cure small tumours and early-stage cancers and reduce the likelihood of your cancer coming back.

Radiotherapy can also be used to relieve cancer symptoms such as pain and difficulty breathing, improving comfort and quality of life where a cure is not possible.

Though healthy cells may be damaged while you undergo treatment, this is usually minimal, and most cells can repair themselves once the treatment is complete.

In some cases, radiotherapy can provide an alternative to surgery and may make other cancer treatments, such as surgery or chemotherapy, more effective.

At your first consultation, you will be seen by a consultant oncologist, a doctor specialising in treating cancer.

Your consultant will ask you about your symptoms, diagnosis, general health and medical history. They may ask to see the results of any previous tests or scans you have had or arrange them on the day.

Your first appointment is important as it’s where you’ll meet your consultant, the doctor responsible for your care. Your consultant will take time to get to know you, discuss your expectations for treatment and encourage you to ask any questions you may have.

At Circle Health Group, we want you to be as well-informed and comfortable as possible during your radiotherapy treatment, so please discuss any questions or concerns with your consultant during your appointment.

You may want to ask about:

• The type of cancer you have and how advanced it is 
• Possible treatments 
• The aim of your treatment 
• Possible side effects of treatment
• How likely it is that treatment will be successful

At the end of your appointment, your consultant will decide if radiotherapy is a suitable treatment for you based on your diagnosis, the type, stage and location of your cancer and your general health.

Your consultant will tell you everything you need to do to prepare for radiotherapy, and instructions on how to prepare will be included in your appointment letter. If there’s anything you’re not sure about, or if you have any questions, please contact the hospital for advice.

Before you receive radiation therapy, a multi-disciplinary team of experts will work together to create an individualised treatment plan tailored to your needs. During this planning stage of your treatment, your healthcare team will use special treatment planning software to work out the exact dose of radiation you need and precisely where it will be delivered while minimising damage to healthy cells.

The planning stage of your treatment can take around two to three weeks to complete.

Your planning appointment normally takes between 15 minutes and two hours and usually involves having a CT scan to examine your tumour and the area around it in detail.

Depending on the type and location of your cancer, your appointment may also include:

• An injection or a drink containing a dye to show up certain parts of your body on the scan 
• Having a full or empty bladder
• Medication such as an enema to empty your bowels before the scan 
• Attaching wires to scars or around lumps
• Fasting before the scan so that you have an empty stomach
• Small tattoo marks on your skin to pinpoint the area to be treated 
• A mould to keep a part of your body still during your treatment 

Before starting your treatment

It can be difficult to know how undergoing radiotherapy will affect you, but you can help prepare for your treatment by being as well-informed as possible and aiming to be in the best possible health before starting your treatment.

Your consultant and other members of your healthcare team will explain everything to you before you start your radiotherapy, and be on hand to support you and answer any questions you have throughout your treatment.

Some things you can do to prepare for your radiotherapy treatment include:

• Plan for your treatment sessions such as arranging childcare, adjusting your work schedule and planning how you will get to and from your appointments 
• Arrange for someone to help with household tasks such as shopping, cooking and housework while you are undergoing treatment
• Optimise your general health by eating a healthy, nutritious diet, drinking plenty of water, stopping smoking, limiting alcohol, practising relaxation techniques and taking regular exercise 
• Have a dental check-up: if you have head or neck cancer, it’s a good idea to have your teeth and gums checked before starting radiotherapy treatment 
• Reach out for support from family, friends, health professionals and support groups

Radiotherapy and fertility

Some types of radiotherapy, such as total body irradiation (TBI) or radiotherapy targeted at the pituitary gland or reproductive organs, can affect your fertility.

If you plan on having children in the future, talk to your consultant about the possible effects on your fertility before starting radiotherapy.

Radiotherapy and pregnancy 

If you were assigned female at birth and are aged between 12 and 55, you must take precautions to ensure you don’t become pregnant at any time while you are having radiotherapy.

Radiotherapy during pregnancy may cause miscarriage or result in birth abnormalities. If you think you may be pregnant during your radiotherapy treatment, tell a member of your healthcare team immediately. You may need to have a pregnancy test to ensure you are not pregnant before starting your treatment.

In some cases, such as if your radiotherapy is urgent and involves a part of your body that is not close to your womb, your consultant may recommend having radiotherapy during pregnancy.

You should avoid getting pregnant during radiotherapy treatment and for a period after your treatment ends.

Other medications

Before starting your radiotherapy treatment, tell your consultant about any medications you take regularly, including over-the-counter medicines, vitamins, herbs, supplements and skin creams. Some medicines can affect how radiation therapy works and may increase the risk of side effects such as skin reactions.

Medical implants

Tell your consultant if you have any medical implants such as a joint replacement, pacemaker, or cochlear implant before starting your radiotherapy treatment.

Signing a consent form 

Before your radiotherapy treatment, you’ll need to sign a consent form to say that you agree to treatment and are aware of what it entails, the possible risks and potential complications.

What happens during your radiotherapy depends on the type of radiotherapy you are having.

External beam radiation therapy

External beam radiation therapy is normally an outpatient procedure, meaning in most cases, you’ll be able to go home once your treatment session has finished.

During your treatment, you’ll be positioned on a treatment couch while a machine directs high-energy radiation, usually in the form of X-rays, at the cancer site and a small area of surrounding tissue. External beam radiation therapy is painless, and a session normally lasts for about ten minutes.

The frequency of your radiotherapy sessions and how long you need to have them depends on your treatment plan, the type of cancer you have and the aim of treatment. Most people have radiotherapy sessions Monday to Friday with a break at the weekend, although this may vary.

Palliative radiotherapy to relieve symptoms may consist of a single session or a short course of treatment over a week or two, whereas curative radiotherapy is usually given over four to seven weeks.

Internal radiotherapy 

What happens during internal radiotherapy depends on the type of treatment you’re having:

• Brachytherapy: Radioactive implants are placed inside your body, normally through a thin, flexible tube called a catheter 
• Radionuclide (radioisotope) therapy: You will be given your radiotherapy via a drink, capsule or injection into a vein 
• Selective internal radiation therapy (SIRT): Radioactive beads are injected into your liver via a catheter

After radiotherapy, it can take a while to recover and start to feel back to normal. Side effects of radiotherapy usually start to improve around two weeks after your treatment has finished, but it can be a few weeks to a few months before you feel fully recovered.

When you can return to work and other daily activities, such as driving, depends on how you feel and the side effects you may experience. As tiredness is a common side effect of radiotherapy, it may help to gradually resume normal activities following your treatment.

You can help your body recover from radiotherapy by:

• Getting enough rest. It’s common to feel more tired than usual after radiotherapy, so give your body time to heal by resting as much as you need to 
• Practicing relaxation techniques and reducing stress
• Drinking plenty of fluids, and avoid caffeine and alcohol for a few weeks after treatment
• Following a healthy, nutritious diet
• Taking regular light exercise, such as walking, swimming, yoga and Pilates
• Attending all your follow-up appointments with your consultant to monitor your progress and deal with any complications or side effects

Precautions after radiotherapy treatment 

Depending on the type of radiotherapy you had, you may need to take some precautions to protect yourself and others after your treatment.

Protecting your skin

After external beam radiation therapy, your skin can become sensitive in the treated area, and you will need to take measures to protect your skin during and after your treatment.

This may include:

• Washing the treated area daily with warm water and a mild, low-pH cleanser 
• Applying moisturiser every day as directed by your healthcare team 
• Avoiding shaving the treated area 
• Avoiding harsh products or those that contain fragrance such as makeup, skincare products, perfumes and deodorant 
• Wearing loose clothing
• Not scratching, rubbing, or scrubbing your skin 
• Avoiding contact with extreme heat or cold 
• Not applying anything sticky to your skin such as plasters or patches 
• Wearing a sunscreen with an SPF 50 or above and avoiding exposing your skin to sunlight for at least a year after your treatment ends

Protecting others after radiotherapy

After some types of internal radiotherapy, you may need to take some precautions to avoid exposing others to radiation, depending on the type and amount of radiation you received during your treatment.

Your consultant may instruct you to do the following to protect others after your radiotherapy:

• Spend time in isolation in a private room during your treatment and for a period of time afterwards
• Have visitors stay a short distance away from you when they visit
• Avoid contact with pregnant women and children
• Follow guidance on dealing with bodily fluids, contaminated waste and laundry

While radiotherapy is effective at killing cancer cells, it also affects healthy cells in the treated area, causing a range of side effects.

Most side effects improve within a few weeks of completing treatment, but some side effects can last longer.  Your consultant will explain all the possible side effects before you start your treatment and discuss ways you can help manage them.

Possible side effects of radiotherapy include:

• Fatigue 
• Nausea and vomiting 
• Skin problems such as dryness, redness, puffiness, itching, swelling, blistering, peeling or darkening of your skin 
• Diarrhoea 
• Headache 
• Blurred vision 
• Memory or concentration problems 
• Dry/sore mouth
• Difficulty swallowing (dysphagia) 
• Hair loss in the treated area
• Swelling of the body tissues (lymphoedema) 
• Loss of appetite

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about radiotherapy, book your appointment online or call a member of our team today.

Radiotherapy - Cancer Research UK 
Radiotherapy - NHS
Radiation therapy to treat cancer - National Cancer Institute 
Radiotherapy - Macmillan Cancer Support