External beam radiotherapy uses high energy x-rays to kill cancer cells.

When you might have radiotherapy

For borderline resectable or locally advanced pancreatic cancer

You may have radiotherapy with chemotherapy (chemoradiotherapy) for pancreatic cancer that is borderline resectable or locally advanced. This means the cancer has just started to grow outside the pancreas into nearby organs or is very close to major blood vessels.

Having chemotherapy with radiotherapy makes the cancer cells more sensitive to the radiotherapy. So it helps the radiotherapy to work better. You may have this treatment as part of a clinical trial.

The aim of treatment is to shrink and control the cancer and help with symptoms. For some people the treatment may shrink the cancer enough to make surgery possible.

For advanced pancreatic cancer

If the cancer has spread to other parts of the body, such as the lungs (advanced or metastatic pancreatic cancer), you might have radiotherapy to control the cancer and reduce symptoms such as pain.

Stereotactic body radiotherapy (SBRT)

You might have a type of external radiotherapy called stereotactic body radiotherapy (SBRT). This gives radiotherapy from many different positions around the body. The cancer receives high doses of radiation but the surrounding tissues only get a low dose. This lowers the risk of side effects. 

Planning radiotherapy

Before you begin your treatment, the radiotherapy team carefully plan your external beam radiotherapy. This means working out how much radiation you need to treat the cancer and exactly where you need it. 

Your planning appointment may take from 15 minutes up to a couple of hours.

You usually have a planning CT scan in the radiotherapy department.

The scan shows the cancer and the area around it. You might have other types of scans or x-rays to help your treatment team plan your radiotherapy. The plan they create is just for you.

Photo of a CT scanner

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 each treatment session

The radiographers help you to get onto the treatment couch. You might need to raise your arms over your head.

The radiographers line up the radiotherapy machine using the marks on your body. Once you are in the right position, they leave the room.

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

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, 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 treatment can make you feel very tired. You may need to rest more than usual but gentle exercise can raise your energy levels.

You might also feel sick or have diarrhoea. Let your doctor or nurse know if you have this. They can give you medicines to help.

Your skin might become red or darker in the treatment area. Your nurse can give you creams to soothe it. The hair in that area might also fall out. 

These effects usually get better within a few weeks of finishing treatment. Tell your nurse, doctor or radiographer if you have any problems so that they can help you.

Last reviewed: 
04 Dec 2020
Next review due: 
04 Dec 2023
  • Pancreatic cancer in adults: diagnosis and management
    National Institute for Health and Care Excellence (NICE), February 2018

  • Cancer of the Pancreas: European Society Medical Oncology Clinical Practice Guidelines
    M Ducreux and others
    Annals of Oncology, 2015, Volume 26, Supplement 5, v56 - v68

  • Cancer: Principles and Practice of Oncology (11th edition)
    VT DeVita, TS Lawrence, SA Rosenberg
    Wolters Kluwer, 2019

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