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Find out about having chemotherapy and radiotherapy together for anal cancer, how you have it and the possible side effects.

What it is

Chemoradiotherapy means having chemotherapy and radiotherapy treatment together.

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in the bloodstream.

Radiotherapy uses high energy waves similar to x-rays to kill cancer cells.


You usually have treatment in the chemotherapy day unit or you might need to stay in hospital for a day or more.

Your exact treatment plan will depend on what your treatment team thinks is best for you. The most common treatment is a combination of the drugs mitomycin C and fluorouracil (5FU). You have the chemotherapy over 4 to 5 days. You usually have 2 cycles. The second treatment is 4 weeks after the first.

A nurse puts a small tube into one of your veins and connects it to the drip or you might need a central line. This is a long plastic tube that gives the drug into a large vein, either in your chest or in your arm. It stays in while you’re having treatment, which might be for a few months.

You might need to stay in hospital while you have your chemotherapy treatments. But some hospitals give people a portable pump to take home that gives the fluorouracil. The pump is attached to a PICC line (a long tube that goes into a vein in your arm).

Instead of having fluorouracil through a vein, you might have a tablet form called capecitabine. Then you can have most of your treatment at home.

Radiotherapy treatment

On the first day of chemotherapy you also have your first radiotherapy treatment. You’ll continue to have radiotherapy every weekday, from Monday to Friday for 5 to 6 weeks. As long as you are well enough you have your radiotherapy as an outpatient. So you need to travel to hospital each weekday for about 6 weeks.

Planning your treatment

Before you begin treatment, the radiotherapy team work out how much radiation you need. They divide it into a number of smaller treatments. They call each treatment a fraction. 

After your planning session

Your treatment starts a few days or up to 3 weeks after the planning session. 

Having treatment

You lie under a large machine to have radiotherapy.

Side effects

You will have side effects from your treatment. These can be more severe than either radiotherapy or chemotherapy on their own.

You can feel very tired, and might have frequent diarrhoea. Most people have soreness around their anus and groin, and the skin becomes red. Your skin might peel and break down. This can be painful, particularly when you open your bowels. Tell your nurse or doctor if this happens. They can give you painkillers and tell you about how to look after your skin. 

Use only creams or dressings on your skin that your nurse or doctor recommends.

Last reviewed: 
07 Jun 2016
  • Anal cancer: ESMO-ESSO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up
    R. Glynne-Jones and others.
    Annals of Oncology 2014. 25 (Supplement 3)

  • Principles and practice of oncology (10th edition)
    De Vita VT, Lawrence TS and Rosenberg SA
    Lipponcott, Wiliams, Wilkins, 2015

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