Planning and having radiotherapy

Before you start your course of radiotherapy it has to be carefully planned to make sure it is aimed accurately at the cancer. You will have one or more appointments at the hospital to plan your treatment. You can ask questions as you need to.

On your first visit to the radiotherapy department, you’ll usually have a CT (computerized tomography) scan taken of the area to be treated. This helps your doctors plan your treatment more precisely.

Instead of a CT scan you may have an MRI (magnetic resonance imaging) scan or a PET (positron emission tomography) scan. Your hospital team will tell you more about these scans.

Marks may be drawn on your skin to help the radiographer (who gives the treatment) position you accurately and show where the rays will be directed.

Your radiographer will tell you what you will happen during your radiotherapy treatment. They will help you lie on a couch in the correct position and you’ll need to lie as still as possible while you have your treatment. Your treatment will take a few minutes and is painless.

First planning visit

Your first planning visit will take 30–60 minutes. The staff in the radiotherapy department will explain what to expect. They will tell you beforehand if you need to prepare in any special way. For example, you may be asked to drink plenty of water. It‘s important for you to feel that you’re involved in your treatment, so feel free to ask as many questions as you need to.

You’ll usually have a CT (computerised tomography) scan taken of the area to be treated. This helps your doctor and physicist plan the precise area for your radiotherapy. Before your scan, you may be asked to remove some of your clothes and to wear a gown.

The CT scan takes lots of images from different angles to build up a three-dimensional picture. You may have an injection of dye into a vein when you have the CT scan. This allows particular areas of the body to be seen more clearly. You may also be asked to have a full bladder for the scan.

Instead of a CT scan, some people have an MRI (magnetic resonance imaging) scan or occasionally a PET (positron emission tomography) scan to help with planning their treatment. An MRI scan uses powerful magnetic fields to give a very detailed picture of the area that needs treating. A PET scan uses low dose radioactive glucose (a type of sugar) to measure the activity of cells in different parts of the body. Your hospital team will tell you more about these scans.

During your scan, you’ll need to lie still on a hard couch. If you feel uncomfortable when the radiographers position you on the couch, let them know so that they can make you more comfortable. This is important because, once you’re comfortable, the details of your position will be recorded. You’ll need to lie in the same position on a similar couch for your treatment.

The information from the scan is fed into a planning computer, which will be used by your radiotherapy team to work out the precise dose and area of your treatment. It can take up to two weeks to plan your treatment.

The radiographer may need to make some small marks on your skin. This is to help them position you accurately and to show where the rays will be directed. These marks must stay visible throughout your treatment, and permanent marks (like tiny tattoos) are usually used. These are extremely small, and will only be done with your permission. It may be a little uncomfortable while they are done.

Treatment sessions

At the beginning of each of your radiotherapy sessions, your radiographer will explain to you what you’ll see and hear. You may be asked to have a full bladder for each treatment. You may also be asked to take off some of your clothes and wear a gown. This is so the radiographers can see the marks on your skin that show the treatment area. They will position you carefully on the couch and make sure you’re comfortable.

Once you’re in the correct position, you will be asked to keep as still as possible. The radiographers will leave the room and you will be given your treatment, which takes a few minutes. You can talk to your radiographer, who will watch you from the next room via closed-circuit TV. The radiotherapy machine doesn’t touch you and the treatment is painless. You may hear a slight buzzing noise from the radiotherapy machine while your treatment is being given.

Once your treatment session has finished, the radiographers will come back into the room and will help you off the treatment couch. You will then be able to go home or, if you are staying in hospital, back to the ward.

Back to Radiotherapy explained

Who might I meet?

You will meet many different specialists before, during and after radiotherapy treatment.

After treatment

It can take time for your body to recover after finishing treatment. Advice and support is always available.