External radiotherapy for advanced cancer

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

External beam radiotherapy directs radiotherapy beams at the cancer from a machine. This is different to internal radiotherapy which means giving radiotherapy to the cancer from inside the body.

This page is about external beam radiotherapy.

Where do you have it?

You have external radiotherapy in a hospital radiotherapy department. You usually have it as an outpatient. 

For advanced cancer, you might have one treatment a day for a few days, or you may have a few treatments with a few days break between each.

Some hospitals have rooms near the hospital you can stay in if you have a long way to travel.

You go to the radiotherapy department from your ward if you’re already 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 treatment

The radiographers help you to get into position on the treatment couch.

They line up the radiotherapy machine, using marks on your skin.

You might need to raise your arms above your head.

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

During the treatment

You need to lie very still. 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

This type of radiotherapy won't make you radioactive. It's safe to be around other people, including pregnant women and children.

Travelling to radiotherapy appointments

You might have to travel a long way each day for your radiotherapy. This depends 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. Ask the radiotherapy staff if you are able to get free parking or 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. It is only for people who would struggle to use 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 to the oesophagus can make you tired and make your mouth and throat sore. You may also have difficulty eating.

Last reviewed: 
18 Oct 2019
  • Guidelines for the management of oesophageal and gastric cancer. British Society of Gastroenterology (BSG), 2011.

  • Oesophago-gastric cancer: assessment and management in adults  [NG83]
    National Institute for Health and Clinical Excellence (NICE)
    Published January 2018

  • Current management of oesophageal cancer
    N Rashid and others
    British Journal of Medical practicioners 2015 Volume 8, Issue 1, page 804

  • Oesophageal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
    F. Lordick and others
    Ann Oncol. 2016 27 Suppl 6: v50-v57

  • Oesophageal cancer
    J Lagergren and others
    The Lancet Vol 390, November 25th 2017

    .

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