Having radiotherapy for advanced bowel cancer

Radiotherapy uses high energy waves similar to x-rays to kill bowel cancer cells. It can shrink the cancer, relieve symptoms, and help you feel more comfortable. Radiotherapy to relieve symptoms is also called palliative radiotherapy. 

This page is about radiotherapy for advanced bowel cancer. Advanced bowel cancer is cancer that started in either the back passage (rectum) or large bowel (colon) and has spread to another part of the body.

You don’t usually have radiotherapy for colon cancer if it hasn’t spread. But you might have it as part of your treatment for rectal cancer that hasn't spread.

Where you have radiotherapy

You have treatment in the hospital radiotherapy department. You might have:

  • just one treatment
  • treatment every weekday for up to 2 weeks

You need to travel to the hospital each time you have treatment. Some hospitals have rooms nearby where you can stay in if you have a long way to travel.

You go to the radiotherapy department from your ward if you are staying in hospital.

The radiotherapy room

Radiotherapy machines are very big and could make you feel nervous when you see them for the first time. The machine might be fixed in one position or able to rotate around your body to give treatment from different directions. The machine doesn't touch you at any point.

Before your first treatment, your therapy radiographers Open a glossary item will explain what you will see and hear. In some departments the treatment rooms have docks for you to plug in music players. So you can listen to your own music while you have treatment.

Photo of a linear accelerator

Before your treatment

Your radiographers help you get into position on the treatment couch. You might have a type of firm cushion to help you keep still.

The room is darkened and the radiographers line you up in the radiotherapy machine using laser lights. You will hear them saying measurements to each other to get you in the right position. 

Then they leave you alone in the room for a few minutes.

During the treatment

You need to lie very still on your back. Your radiographers might take images (x-rays or scans) before your treatment to make sure that you're in the right position. The machine makes whirring and beeping sounds. You won’t feel anything when you have the treatment.

Your radiographers can see and hear you on a CCTV screen in the next room. They can talk to you over an intercom and might ask you to hold your breath or take shallow breaths at times. You can also talk to them through the intercom or raise your hand if you need to stop or if you're uncomfortable.

You won't be radioactive

Radiotherapy doesn't make you radioactive. It's safe to be with other people throughout your course of treatment.

Travelling to radiotherapy appointments

You might have to travel a long way each day for your radiotherapy, depending on where your nearest cancer centre is. This can make you very tired, especially if you have side effects from the treatment.

You can ask the therapy radiographers Open a glossary item for an appointment time to suit you. They will do their best, but some departments might be very busy. Some radiotherapy departments are open from 7am till 9pm.

Car parking can be difficult at hospitals. You can ask the radiotherapy staff if they can give you a hospital parking permit for free parking or advice on discounted parking. They may be able to give you tips on free places to park nearby.

The radiotherapy staff may be able to arrange transport if you have no other way to get to the hospital. Your radiotherapy doctor would have to agree. This is because it is only for people that would struggle using public transport and have no access to a car. 

Some people are able to claim back a refund for healthcare travel costs. This is based on the type of appointment and whether you claim certain benefits. Ask the radiotherapy staff for more information about this.

Some hospitals have their own drivers and local charities might offer hospital transport. So do ask if any help is available in your area.

Side effects

Radiotherapy for advanced bowel cancer can make you tired. It can also make the skin in the treatment area go red and feel sore.

Specialised radiotherapy for cancer cells in the liver

Bowel cancer can sometimes spread to the liver. If this happens, your doctor might recommend a specialised type of radiotherapy treatment. There are 2 types:

Stereotactic radiotherapy

You might have this treatment if your bowel cancer has spread only to the liver and you can't have surgery.

A radiotherapy machine aims radiation at the cancer from different directions. This gives high doses of radiation to the cancer cells but only a small amount to the normal tissue around them. 

Selective internal radiotherapy (SIRT) 

For this treatment, your doctor puts tiny radioactive beads into the main artery that takes blood into the liver. The beads give off high doses of radiation to the cancer cells but cause little damage to the surrounding healthy tissue.

This treatment will be available in England on the NHS from April 2019. You might need to travel to a specialist centre to have it.

Last reviewed: 
12 Nov 2018
  • Metastatic Colorectal Cancer: ESMO Clinical Practice Guidelines 
    E Cutsem and others
    Annals of Oncology, 2014. Volume 25, Pages ii1-iii9

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