External beam radiotherapy
External radiotherapy is normally given as a series of short, daily treatments in the radiotherapy department using equipment similar to a large x-ray machine.
Treatment is individually planned, and even people with the same type of cancer may have different types of radiotherapy treatment.
The following information is only guide, as the details of treatment will vary from person to person.
A course of curative (radical) treatment may last 2-7 weeks. The treatments are usually given once a day, with a rest at the weekend. Each treatment is called a fraction. Giving the treatment in fractions ensures that less damage is done to normal cells than to cancer cells. The damage to normal cells is mainly temporary, but this is what causes the side effects of radiotherapy.
Some people may have more than one treatment daily or treatment every day for two weeks, including the weekends. Sometimes treatment may only be given on three days each week - for example, Mondays, Wednesdays and Fridays.
Usually, each radiotherapy treatment takes about 10-15 minutes. Most of this time is spent getting you in position and doing checks. The treatment itself usually only lasts a few minutes.
Palliative treatment (for symptom control) may involve only one or two sessions of treatment, but it can be up to 10 sessions.
There are several different types of radiotherapy machines that work in different ways. Radiotherapy treatment for most cancers, apart from skin cancers, is given by machines called linear accelerators, which are often called LinAcs.
The radiotherapy machine doesn’t normally touch you, although for some types of cancer it may press against your skin. If you have a specific type of radiotherapy called electron treatment, a small applicator that touches a small area of skin may be used.
The treatment itself is painless, although it may gradually cause some uncomfortable side effects.
External radiotherapy doesn’t make you radioactive. It’s perfectly safe for you to be with other people, including children, throughout your treatment.
Having your treatment
Before your first treatment, the radiographers will explain to you what you will see and hear. It’s normal to feel anxious about having your treatment, but as you get to know the staff and understand what’s going on, it should become easier.
The sight of large radiotherapy machines can be frightening, especially for children. Don’t be afraid to talk to the staff about any fears or worries - they are there to help you, and the more you understand your treatment, the more relaxed you will be.
The radiographers will position you carefully on the table and adjust its height and position. Because it’s so important that you’re in the right position, the radiographers may take a little while getting you ready. They may call this ‘setting up’.
The room may be in semi-darkness while this is happening.
The table you are lying on will be quite hard. Let the radiographer know if it’s uncomfortable, as they can often make you feel more comfortable by putting foam pads or pillows underneath you. It’s important that you’re comfortable because you have to lie as still as possible during the treatment.
Once you’re in the correct position, the radiographers will need to leave you alone in the room. This is to prevent them from being exposed to any unnecessary radiation. Don’t worry if they seem to rush out of the room once they have positioned you - this is just to keep your treatment time as short as possible.
Some treatment rooms have CD players so you can listen to music to help you relax while having your treatment.
During the treatment you will be alone for a few minutes, but there will be an intercom so you can talk to the radiographers. They will be watching you carefully from the next room, either through a window or on a television screen. To protect your privacy, nobody else will be able to see you. If you have any problems, you can raise your hand to attract the radiographer’s attention and they will come in to help you.
Most curative (radical) radiotherapy involves having treatment from several different directions. While you’re lying still, the machine will move into the new position. Usually the radiographers will be in the treatment room with you when this happens. Once the machine has been repositioned the radiographers will make sure you are still in the right position before the treatment continues.
Once your treatment session has finished, the radiotherapy staff will come back into the room and help you get ready to go home or back to the ward.