Radiotherapy treatment uses high-energy waves to destroy cancer cells. These can either be administered externally or internally.

How is radiotherapy administered?

External radiotherapy
This method uses a machine similar to an X-ray to administer high intensity waves (usually x-rays) from outside the body. The procedure only takes a few moments, and is completely non-invasive. Usually this treatment is given over numerous sessions, with a small dose of radiation each time, which helps minimise any side-effects or damage to surrounding healthy tissue. Courses of external radiotherapy may be short or long, depending on the size and extent of your tumour.

Internal radiotherapy
This is a more specialised technique, which involves inserting radioactive sources into the body, close to the tumour(s) to deliver a high dose of radiation directly to the relevant area. This type of treatment is sometimes known as brachytherapy, and is usually delivered over only one or two sessions

How will Radiotherapy form part of my treatment?
Radiotherapy may be offered at various stages of your treatment course.

Neo-adjuvant is the use of radiotherapy prior to an operation, in order to shrink the tumour(s) in order that there’s a better chance of it being successfully removed. Normally this is carried out several weeks before the planned operation, as the radiation will continue to shrink the tumour after the last dose of radiotherapy has been administered.

Adjuvant radiotherapy is given after surgery to destroy any microscopic cancer cells that may remain following an operation, or to target any cancer cells that have spread to adjacent lymph nodes. It is also sometimes used post-operation to help prevent the cancer from returning.

Palliative radiotherapy is given at a low dose, over a longer period when surgery is not an option; in order to relieve symptoms, slow the spread of the disease, and to prolong life.

Chemo-radiation is the use of both chemotherapy and radiotherapy treatments combined. The chemotherapy drugs make the cancerous cells more susceptible to radiation, making this a particularly effective treatment. This treatment is usually used in the treatment of rectal and anal cancers.

What other types of treatment are available?
Radiotherapy can also be used in highly specialised techniques to target parts of the body which are usually inoperable – such as the brain. These can only be carried out an a few specialist centres around the UK, but your consultant will advise you on locations and accessibility should you require this type of treatment.

Will I experience any side-effects?
The side-effects of radiotherapy will depend on the length and intensity of your treatment, and may also vary widely from person to person. Although the radiation is targeted specifically at the cancerous area, sometimes surrounding tissues and organs are also affected by the radiation.Prior to undergoing any treatment, your consultant should discuss with you what the possible side-effects are, and ways in which you can minimise these.

People can also get late effects from the treatment sometimes up to 5 years down the line.

Bowel issues
Mild side effects may include temporary discomfort in the bowel region, pain during bowel movements, a change in your normal bowel habit, or passing blood or mucus from the rectum.
In some cases, radiotherapy can cause thickening of the bowel, which may result in less control over bowel movements, increased frequency and urgency of bowel movements, and in some cases, incontinence.
Most of these symptoms should get better within a few weeks or months of your treatment ending. However in some cases, patients have later developed these types of side effects years after receiving the treatment. If you are struggling to cope with any long term side-effects, then speak to your GP or radiotherapy consultant, who will be able to advise coping strategies.

Urinary problems
In addition to bowel-related symptoms, radiotherapy may also cause bladder and urinary problems, which could develop at any time after receiving the treatment. Symptoms may include leaking of urine, increased frequency and urgency when passing urine, discomfort while passing urine, or incomplete emptying of the bladder. Again, these symptoms are usually manageable in the short term, but if symptoms persist then consult your GP or radiotherapy consultant

Skin inflammation
Radiotherapy can also cause inflammation, redness, burning, or flaking of the skin around the area where the radiation was administered. Usually creams and dressings can be used to treat these areas but, so speak to your radiographer if you are having any problems. Check with your specialist team before using a cream on your skin as only specific creams can be used.

Sexual issues
Unfortunately, after receiving radiotherapy treatment, some patients have reported sexual issues such as erectile dysfunction in males, and vaginal dryness in females.