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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
Find out how we produce our information|
Radiotherapy| treats cancer by using high-energy rays to destroy the cancer cells, while doing as little harm as possible to normal cells. Radiotherapy is directed at specific parts of the body and may be given externally or, more rarely, internally.
External radiotherapy may be given before or after surgery|. It may also be given at the same time as chemotherapy|. This is known as chemoradiation.
The treatment is given in the hospital radiotherapy department as short daily sessions from Monday to Friday, with a rest at the weekend. The length of your treatment will depend on the type and size of the cancer. Your doctor will discuss your treatment with you.
Planning is a very important part of radiotherapy and makes sure that it is as effective as possible. On your first visit to the radiotherapy department you’ll be asked to have a CT scan| or lie under a machine called a simulator, which takes x-rays of the area to be treated. The treatment is planned by a cancer specialist (clinical oncologist) and may take a few visits.
The radiographer (the person who gives you your treatment) will make small marks on your skin, to show where the rays are to be directed. During the course of treatment this area should be kept as dry as possible to prevent the skin becoming red and sore. Your radiographer will explain how to look after the area being treated.
Before each session of radiotherapy, the radiographer will position you carefully on the couch and make sure that you are comfortable. The treatment only takes a few minutes. You’ll be left alone in the room but can talk to the radiographer, who will watch you from the next room. Radiotherapy is not painful, but you do have to lie still for a few minutes during treatment. The treatment will not make you radioactive, and it’s perfectly safe for you to be with other people, including children, afterwards.
Radiotherapy can cause general side effects such as feeling sick (nausea)| and tiredness|, but it is also likely to make the inside of your oesophagus inflamed, causing short-term soreness when you swallow. These side effects can be mild or more troublesome, depending on the strength of the radiotherapy dose and the length of your treatment.
It’s not unusual to feel worse before you start to feel better. Some people can find this a very difficult time and they may feel low or even depressed| for a while. The clinical oncologist can advise you about what to expect.
Radiotherapy can make your throat very sore towards the end of the treatment, and you may not be able to swallow properly| for a while. Your doctor can prescribe medicines to help.
Some people have a feeding tube put into their stomach (known as a PEG tube) before the radiotherapy starts. Your doctor can advise you whether this is necessary. PEG stands for percutaneous endoscopic gastrostomy and is carried out under local anaesthetic.
A flexible tube with a light at the end (endoscope) is passed down the throat and oesophagus into the stomach, to find a suitable area to insert the tube. A cut is then made in the skin and muscle over the stomach and a tube passed through a cut made in the stomach itself. The tube is usually held in place with a rubber or silicon disk (flange). Liquid feeds can be given through the tube.
Our section on nutritional support| discusses PEG tubes and feeding in detail.
If the radiotherapy is given to the upper end of the oesophagus, it may reduce the amount of saliva your salivary glands produce. This effect may be temporary, but occasionally can be permanent. This may make your mouth dry, which can make eating difficult. We have a section on coping with a dry mouth|, which we can send you.
Feeling sick (nausea)| can usually be treated by anti-sickness drugs (anti-emetics), which your doctor can prescribe.
If you don't feel like eating, you can replace meals with nutritious, high-calorie drinks, which you can get from most chemists. Our section on diet and cancer| has some helpful hints on how to eat well. You can discuss any problems with your doctor.
When radiotherapy is used to treat the oesophagus, men may find that some of the hair on their chest may fall out.
As radiotherapy can make you tired|, you should try to get as much rest as you can, especially if you have to travel a long way for treatment each day.
All these side effects should disappear gradually once your course of treatment is over, but it is important to let your doctor know if they continue.
This is given by inserting a radioactive source into the oesophagus, which gives a high dose of radiotherapy to the tumour. As the radiation dose doesn’t travel far, surrounding organs are not affected. The source is left there for between 30 minutes and a couple of days, depending on the amount of radiation that is needed. In this way, more focused treatment is given to the inside of the oesophagus in a short time, rather than a course of external radiation given to a wider area over a longer time.
There are two ways of giving internal radiotherapy:
Your doctor can explain more about this treatment. As with external radiotherapy, internal radiotherapy causes temporary soreness when you swallow, which may develop a few days after treatment and last for a few days. Your doctor will recommend liquid medicines to help.
If you have to stay in hospital for a few days while the radioactive source is in place, your family or close friends will only be able to visit you for short periods each day.
It’s not advisable to allow children or pregnant women to visit while you are having this type of radiotherapy. The hospital staff will advise you on who can visit.
Our section on radiotherapy| describes this process in more detail.
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.