This leaflet provides information regarding the use of external beam radiotherapy in treating cancer, including details of the procedure and side effects that you may experience.

Although you may have heard about radiotherapy from friends, relatives and/or other patients, it is important to remember that their experience may not be the same as yours. In all cases, a doctor will explain your radiotherapy treatment to you and answer any questions you may have.

We are here to help, so if you would like further information or have any particular concerns, please do not hesitate to ask a radiographer or a member of the radiotherapy review specialist team.

In most cases, a friend, relative or carer may accompany you to your appointments. This will depend on any infection control guidelines currently in place. Please ask your doctor or a member of the radiotherapy team if this is possible.

What is radiotherapy?

Radiotherapy uses precise, carefully measured doses of high energy x-rays to treat cancer. Cancer cells are more sensitive to radiation than normal cells and the aim of treatment is for the xrays to either destroy cancer cells or stop them from growing. This happens whilst avoiding and protecting the normal cells as much as possible.

Radiation also damages normal cells in or around the area being treated which causes side effects, but these will usually recover and heal after treatment.

Why use radiotherapy to treat cancer?

Radiotherapy may be given to treat and attempt to cure cancer as an alternative to surgery; for example, when surgery to remove the cancerous tumour is not possible for medical reasons.

Radiotherapy can also be used in order to shrink the tumour prior to or after surgery to keep the tumour from coming back. Radiation can also be used on its own for cancers that are very sensitive to this type of treatment. It may also be the preferred form of treatment which limits the harm to nearby healthy cells.

Prescribed doses of radiation may range from a single session of radiotherapy to longer courses of treatment that can last several months. The length of your treatment will depend on the kind of treatment you need and your general health.

Radiotherapy may also be used to relieve symptoms of cancer when it has spread outside the original site of the tumour into other parts of the body. This will usually be a shorter course of treatment that can help to control symptoms and minimise side effects.

Chemotherapy

Some patients may receive a course of chemotherapy prior to or during radiotherapy. This is to help make the cancer cells more sensitive to radiation. Both treatments are administered as outpatient procedures.

Chemotherapy may increase your risk of experiencing side effects, particularly infection and bleeding, and so will not be recommended for all patients. We will give you specific information leaflets on chemotherapy if it is part of your treatment plan.

Your radiotherapy planning appointment

Prior to your radiotherapy treatment starting, you will need to attend the radiotherapy department for a CT planning scan. This scan is different to the previous ones you may have had, as it will be used to design and tailor your radiotherapy treatment to your specific needs.

The planning CT scan itself will only take five to 10 minutes. The rest of the appointment time is for getting you in the correct position. Remember that the position you are scanned in will be the exact position you will be in for all of your treatments, so please tell us if you feel that you may struggle with this.

Sometimes you will need an injection of dye alongside your planning CT scan to assist in seeing things clearly on the scan. A specific information leaflet is available if you require this.

At the end of the planning scan, a number of permanent ink markings, usually three but sometimes more or less, are made on your skin using a pinprick of ink. These are to ensure that you are accurately repositioned for your treatment each day.

Your radiotherapy treatment appointments

Treatment will usually start a few weeks after your planning appointment. Each session takes about 15-20 minutes.

The radiographer will carefully position you on the couch in the exact position you were in for your planning appointment. They will use the permanent marks to align you correctly during treatment.

The machine will move around you. Once your radiographers are satisfied that all of your pre-treatment checks have been made, they will leave the room to switch the machine on. It is important that you keep still at all times and follow the radiographer’s instructions during the radiotherapy treatment.

Each treatment lasts a few minutes, during which you will be alone in the room. The radiographers will observe your treatment and if necessary, will be able to talk to you from the next room. You will not see or feel anything when the machine switches on, but you will hear the machine buzzing. The machine will come close to you but it will not touch you.

We may perform an additional scan on some or all of your treatment appointments, to check the accuracy of your positioning.

This treatment will not cause you to be radioactive and it is safe to remain in normal contact with other people, including small children and pregnant people, afterwards.

Side effects of radiotherapy treatment

You may develop side effects as you go through your treatment. Some side effects are short term or known as acute side effects. Most side effects begin at least one week after starting treatment, so for some shorter treatment courses this may be after you have completed your treatment.

Short term side effects will typically worsen gradually for two to three weeks after you finish your treatment and take a further two to three weeks to reduce. This may not be the case during your treatment but if you are concerned about any side affects you are experiencing, speak to a member of your medical team.

For information on the possible side effects specific to your treatment, please review the information sheet provided to you and consult the radiotherapy consent form filled in by your doctor. If you do not yet have a copy of this, you may request one at any of your radiotherapy appointments.

Please always let the radiotherapy team know of any side effect that is worrying you. The radiotherapy review specialist will see you regularly during your treatment and will ask you about any side affects you may be experiencing. They can also offer advice and on how to cope with the effects of your treatment, and arrange any additional tests to help with this.

Can I continue to work during my treatment?

If you feel well enough to do so, you can continue working as normal during your treatment. However, some patients prefer to take a period of leave from their workplace during this time. If you are unsure how your treatment will affect you, speak to your doctor.

Travelling to and parking at the Royal Free Hospital

As parking at the Royal Free Hospital and the surrounding area are limited, we strongly encourage that you travel to your appointment using public transport if possible. Parking at the Royal Free Hospital is free for patients having radiotherapy treatment, parking in allocated spaces only. These are available in front of the main hospital entrance on Pond Street.

You will need to display a radiotherapy parking permit in your car, which we will issue you during your first visit.

View information on concessionary parking

Please provide the radiotherapy receptionist with your car registration number on arrival to avoid being issued a parking fine.

Free parking is only available for patients attending their treatment appointments and is not available for out-patient clinic appointments.

Will I be eligible for hospital transport?

Patient transport is a service provided for patients who are unable to attend hospital appointments by public transport or any other means (including private minicab) due to their medical condition.

Patients or a relative must book their own transport to and from the hospital if they are travelling from home.

View information on how to book non-emergency patient transport.

Support available at The Royal Free Hospital

If you require support either during or after your radiotherapy treatment, there are a number of support services available. If you would like to know more about these, please ask a member of the radiotherapy team or one of your specialist nurses.

Macmillan cancer support

Macmillan cancer support is available to cancer patients and their families. The service provides confidential and expert advice on a range of topics that you may find helpful during your treatment.

Macmillan offers a wide range of information booklets in a variety of languages for practical tips on treatment side effects, symptoms and survivorship as well as referrals to other support groups and specialist services. The Macmillan cancer support information centres are available to you as part of your treatment visit.

The information centres can be found at:

Chase Farm Hospital

  • Location: Ground floor of the main building.
  • Opening times: Monday to Friday, 10am to 4pm.
  • Tel: 020 8375 2247.
  • Email: rf-tr.BarnetCancerInfo@nhs.net.

Barnet Hospital

  • Location: inside the main entrance on level one.
  • Opening times: Monday, Tuesdays, Thursdays, and Friday. Closed Wednesdays.
  • Tel: 020 8216 4142
  • Email: rf-tr.BarnetCancerInfo@nhs.net.

Royal Free Hospital

  • inside the oncology out-patients department on the ground floor). Tuesdays-Fridays 10am to 4pm

  • Telephone: 020 7794 0500 extension 31337

  • Email :rf.cancerinfo@nhs.net.

Maggie’s at the Royal Free Hospital

Maggie's offers practical emotional and social support for anyone with cancer, their family and friends.

Complementary therapies

A range of complementary therapy treatments, including massage and aromatherapy, are available for cancer patients at the Royal Free Hospital. For more information, please ask a member of the radiotherapy team.

Counselling

If you believe that you would benefit from speaking to a specialist counsellor during your treatment, please ask a member of the radiotherapy team, your radiotherapy doctor or one of your nurse specialists.

Alternatively, you can telephone the radiotherapy and oncology counselling team on 020 7472 6739.