Radiotherapy for symptoms or palliative treatment aims to shrink a cancer, slow down its growth, or control symptoms.
What palliative radiotherapy is
Radiotherapy uses high energy rays to treat cancer. Radiotherapy to control symptoms is called palliative treatment. It aims to shrink a cancer, slow down its growth, or control symptoms. It doesn't aim to cure the cancer. Doctors use palliative radiotherapy to help shrink an advanced cancer. Or they can use it to control symptoms and give a better quality of life.
Depending on the type of cancer you have, and where it has spread to, you may have external radiotherapy or internal radiotherapy.
External beam radiotherapy works very well for treating cancer cells in one area of the body or several distinct areas. This type of radiotherapy uses high energy rays, which only treat the area of the body they are aimed at. You can have external radiotherapy to more than one area at the same time.
There are several different types of internal radiotherapy treatment.
You might have a small injection of a radioactive substance to treat widespread cancer in the bones.
Or you might have a radioactive metal implant put inside your body, very close to the cancer. This treatment can shrink a cancer that is causing a blockage, for example in the food pipe (oesophagus).
When palliative radiotherapy is used
Palliative radiotherapy is used for various reasons such as to:
- relieve bone pain
- treat pressure on the spinal cord (spinal cord compression)
- shrink a tumour to relieve pressure or a blockage
- treat symptoms of cancer in the brain
- treat symptoms of cancer in the lungs
- control ulcerating tumours and reduce bleeding
- treat a blood vessel blockage in the neck called superior vena cava obstruction (SVCO)
Palliative radiotherapy is not suitable for all types of cancer. It depends on the particular type you have.
Not all cancers respond well to radiotherapy. So other treatments such as surgery, chemotherapy, hormone therapy or biological therapy may be more help.
You will need to talk to your own specialist to find out the best choice of treatment in your case.
Having external palliative radiotherapy
You have your treatment in the hospital radiotherapy department. You may just have 1 or 2 treatments or up to 10 treatments given over 2 weeks.
This depends on the type of cancer. You are most likely to have a short course of a few treatments over a few days.
Planning the radiotherapy
You have a specialised CT planning scan.
You may also have other scans, such as MRI scans or PET scans. This allows the treatment team to plan the radiotherapy treatment area very precisely.
During the planning session, the radiographers might make marks on your skin. They use these to make sure the same area is treated at each session.
You might also need to have a plastic mould made to keep you still during the treatment sessions.
You might have to wait a day or a few days until your first radiotherapy treatment.
Having external radiotherapy treatment
To have the treatment you lie on a radiotherapy couch. The radiographers will help you to get into the right position and put on any moulds that you may need.
Once you are in the right position the staff leave you alone in the room. This is so they are not exposed to the radiation. You will be alone for a few minutes. The radiographers watch you carefully on a closed circuit television screen.
You can't feel the radiotherapy. It doesn’t hurt but you may find it uncomfortable to lie very still during the treatment. The radiotherapy couch can be quite hard. You can ask your doctor or specialist nurse if you can take a painkiller half an hour beforehand if you think it might help.
Having internal radiotherapy
Internal radiotherapy to treat symptoms can be given in different ways.
You have some types of internal palliative radiotherapy as a radioactive capsule or drink in the nuclear medicine department. You are then usually allowed to go home. The staff in the department tell you if you need to follow any safety precautions. You may need to avoid being close to children or pregnant women for a few days after the treatment.
Giving radiotherapy in this way is called brachytherapy. Doctors put very thin radioactive wires into your body close to the cancer. They do this while you are under a general anaesthetic in the operating room. You may have an X-ray afterwards to make sure that the wires are in the right position.
While you have the wires in your body, you stay in a separate room. Staff and visitors will need to follow internal radiotherapy safety procedures until the wires are removed. This is usually after 3 to 4 days but may be up to a week depending on which part of your body is being treated. You may have the wires taken out under general anaesthetic as this can be painful.
Your doctor may use an internal metal implant to treat a tumour that is blocking an airway or your food pipe. Under local or general anaesthetic they put a tube called an endoscope down your throat. Or you may have a tube called a nasogastric tube up your nose. Using a scan, the doctor positions the end of the tube next to the tumour.
The tube connects to an internal radiotherapy machine which lets out a radioactive metal ball. The ball travels through the tube and releases radiation to treat the tumour. It's left there for a few minutes. The ball then goes back into the radiotherapy machine and the doctor removes the tube from your nose or throat.
This treatment gives a high dose of radiotherapy directly to the cancer. Very little radiation reaches the surrounding healthy tissues.
Side effects of radiotherapy for symptoms
Palliative radiotherapy aims to make you feel better. So your cancer specialist will try to choose treatments that have as few side effects as possible. Most people have few side effects but you might:
- have some damage to normal cells around the cancer
- feel increasingly tired during the treatment and for a few days or weeks afterwards
- feel sick if you have radiotherapy to the pelvic area, stomach, tummy (abdomen) or brain
- have soreness when you swallow after radiotherapy to the lung, the head and neck area, or the top of the spine
To help control sickness, your doctor can give you anti sickness medicines (anti emetics). You may find that taking an anti sickness tablet an hour before your treatment helps.