Radiotherapy to relieve symptoms is also known as palliative radiotherapy. Palliative radiotherapy aims to shrink cancer, slow down its growth or control symptoms. It doesn't aim to cure cancer.
Depending on the type of cancer you have, and where it has spread to, you might have external or internal radiotherapy. External radiotherapy is the use of radiation to destroy cancer cells from outside of the body. Whereas internal radiotherapy means having radiation treatment from inside the body.
When you might have palliative radiotherapy
You might have palliative radiotherapy 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 an ulcerating cancer and reduce bleeding
- treat a blood vessel blockage in the chest called superior vena cava obstruction (SVCO)
Not all cancers respond well to radiotherapy. So other treatments such as surgery, chemotherapy, hormone therapy or targeted cancer drugs may be more help.
Your specialist will talk to you about the best choice of treatment in your case.
You usually have a scan before you start radiotherapy. Your doctor uses the scan to plan your treatment.
The position that you are in for this scan is the same position that you will be in for your treatment. Let a member of the team know if you are struggling to maintain this position, as it can be more difficult to change once the scan has been completed.
During the planning session some radiotherapy departments make small permanent tattoo marks on your skin. They use these to make sure all your treatments are accurate.
You might need to have a plastic mould made to fit the treatment area. The mould keeps you still and makes sure the treatment is delivered accurately each day. If you have a mould, the treatment marks are placed on the mould, instead of the skin.
Having external radiotherapy treatment
You have your treatment in the hospital radiotherapy department, usually as an outpatient.
You might have 1 treatment or a number of treatments given over a few weeks. These treatments are sometimes known as fractions. This depends on the type of cancer. You are most likely to have a short course of a few treatments over a few days.
To have treatment you lie on a radiotherapy couch in the same position that you were in when your treatment was planned. The therapeutic radiographers help you to get into the right position and put on any moulds that you might need.
Once you are in the right position your radiographers leave you alone in the room while you have the treatment. This is so they are not exposed to radiation. They can see and hear you the whole time.
It is important that you keep still and breathe normally. Sometimes there may be a delay in starting the radiotherapy, this is due to the radiographers taking an x-ray before treatment to check your position.
It can be uncomfortable to lie very still during the treatment. This is because the radiotherapy couch can be quite hard.
Having internal radiotherapy
Internal radiotherapy to treat symptoms can be given in different ways.
Some types of internal radiotherapy involve radioactive liquids, such as Radium 223. You either have them as a capsule, drink or injection. This is also called radioisotope or radionuclide therapy.
Your radiographers will tell you if you need to stay in hospital or follow any safety procedures.
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 might have the wires taken out under general anaesthetic as this can be painful.
Your doctor might use a radioactive metal implant to treat a tumour that is blocking an airway or your food pipe (oesophagus). 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. Your doctor will try to choose treatments that have as few side effects as possible. The side effects from palliative radiotherapy aren't usually that bad but you might:
- feel tired during the treatment and for a few days or weeks afterwards
- feel sick if you have radiotherapy to the pelvic area, 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
- have an increase in pain in the treatment area for a few days or weeks afterwards
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. They can also give you medicines to help with any pain.