Find out about having chemotherapy and radiotherapy together for rectal cancer and how you have it.
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 x-rays to kill cancer cells.
Giving these treatments together can stop the cancer from coming back. Chemoradiotherapy can also shrink a cancer before surgery to make it easier to remove.
The most common chemotherapy is fluorouracil (5FU), which you have through a drip. You usually have it in a chemotherapy day unit.
Or you might have a drug called capecitabine (Xeloda) as tablets. Capecitabine is similar to fluorouracil. You take it as tablets twice a day throughout your treatment.
You might have the chemotherapy before the radiotherapy starts. You continue to have it during the radiotherapy treatment.
You might have fluorouracil in one or more of the following ways:
- through a drip (an infusion)
- as an infusion through a pump you wear 24 hours a day
- as a series of injections into a vein before radiotherapy treatment
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.
Taking capecitabine tablets
You must take tablets according to the instructions your doctor or pharmacist gives you.
Whether you have a full or empty stomach can affect how much of a drug gets into your bloodstream.
You should take the right dose, not more or less.
Never stop taking a cancer drug without talking to your specialist first.
You might have a short course of 5 radiotherapy treatments in the week before surgery if your cancer can be operated on.
You might need a longer course of treatment before surgery if you have a large tumour. The treatment may last up to 5 weeks.
You usually have this type of radiotherapy treatment over 4 to 5 weeks. You have treatment from Monday to Friday, so you have between 20 to 25 treatments in total.
Planning your treatment
Dan (radiographer): Before your treatment starts your doctor will need to work out exactly where the treatment needs to go and also which parts need to be avoided by the treatment. To have radiotherapy you lie in the same position as you did for your planning scans. We then line up the machine based on your tattoo marks. It is really important that you stay very, very still when you are having treatment it is also important to let the radiographers know right at the beginning if you are not comfortable so they can adjust your position
Radiographer: Ok all done, we’ll be back in a couple of minutes
Dan (radiographer): We leave the room and control the room from a separate room This is so we aren’t exposed to radiation. Treatment takes a few minutes and you will be able to talk to us using an intercom. We can see and hear you while you are having your treatment and will check that you are ok. When your treatment starts you won’t feel anything; you may hear the machine as it moves around you giving the treatment from different angles. Because we are aiming to give the same treatment to the same part of the body everyday then the treatment process is exactly the same everyday so you shouldn’t notice any difference. You’ll see someone from the team caring for you once a week while you are having treatment they’ll ask how you are and about any side effects.
Patient: They get you from one sitting area to another and then take you into the room where you undress to the waist and then lie down and line you up by either moving you or asking you to shuffle a little and they check the dimensions and they talk to one another and they say I am fine this side how are you ...yes fine...ok, stay where you are Jeff and that was it. There were a few little clicks and lights go on and off and you can see a green laser beam which lines up with certain things on your body uh so no, no real noise and no discomfort.
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.
The radiographers might make pen marks or small tattoos on your skin in the treatment area.
After your planning session
Your treatment starts a few days or up to 3 weeks after the planning session.
You lie under a large machine to have radiotherapy.