Internal radiotherapy for advanced cancer

Find out about what happens when you have radiotherapy from inside the foodpipe and about possible side effects.

Internal radiotherapy means giving radiotherapy to the cancer from inside. It is called brachytherapy. You have the treatment in the radiotherapy department. It takes a few hours.

The treatment gives a high dose of radiation to the cancer but very little to surrounding tissues. It can shrink the cancer, relieve symptoms and help you feel more comfortable. It might slow the growth of the cancer and it can reduce pain.

It can also help you swallow more easily.

Planning the treatment

The radiotherapy team carefully plans your treatment. They work out exactly where the cancer is in the food pipe and how much radiation you need to treat it. Your planning appointment takes from 1 to 2 hours.

Your nurse gently puts a soft, flexible tube called a nasogastric tube up your nose. It goes down into your food pipe. They might spray your throat beforehand to numb it.

You have a planning CT scan in the radiotherapy department. The scan shows the cancer and the area around it.

CT Scan.jpg

What happens

The radiotherapy staff take you on a trolley to the brachytherapy treatment room. They connect the nasogastric tube to the treatment machine using a narrow tube.

The staff leave the room. From outside the room they operate the treatment machine. A small radioactive ball called a source passes from the machine into the nasogastric tube. The source stops in the area of the cancer to give a dose of radiotherapy.

Diagram-showing-internal-radiotherapy-with-radioactive-source-through-a-NGT-tube.png

The treatment takes between 10 and 15 minutes. It doesn’t hurt but the tube can be uncomfortable. You need to lie still.

The staff can see you on a CCTV screen. They are in the next room and can hear you. So you can tell them if you need anything.

After treatment

The staff come back into the room and gently remove the nasogastric tube. You can go home.

If you had an anaesthetic spray to numb your throat you mustn’t eat or drink anything for 4 hours. The staff will give you further instructions as necessary.

You might have just one treatment or another treatment after a week or so.

Side effects

You might have some soreness when you swallow for up to 2 weeks. Your nurse or doctor will give you painkillers to reduce the soreness. Let them know if the pain gets worse or lasts for longer than 2 weeks.

Narrowing of the food pipe

Your food pipe might become narrower and less stretchy over some months or years. This is called an oesophageal stricture. It can make it difficult for you to swallow.

Your doctor can stretch the food pipe slightly. They call this oesophageal dilatation. You have a medicine to make you sleepy (sedation). Your doctor puts a tube called an endoscope down your throat. It stretches the food pipe so you can swallow more easily again. You might need to have this repeated if the narrowing happens again.

Dilatation treatment-illustration
Last reviewed: 
05 May 2016
  • Guidelines for the management of oesophageal and gastric cancer. British Society of Gastroenterology (BSG), 2011.

  • Management of oesophageal and gastric cancer. Scottish Intercollegiate Guidelines Network (SIGN), June 2006.

  • Oesophageal cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow up. M Stahl, C Mariette, K Haustermans and others. Annals of Oncology. 2013. 24 (supplement 6) vi51-vi56.

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