What is Radiotherapy?
Radiotherapy is a cancer treatment using high doses of radiation.
Cancer can happen to anyone, and one in every two people is predicted to develop cancer at some point in their life. Footnote [1] This might sound scary, but with modern medicine, doctors have many treatments available to treat it. One of these treatments is radiotherapy.
Radiotherapy treatment uses high doses of ionising radiation to kill cancer cells. The decision to treat with radiotherapy depends on factors such as: the type of cancer, the size and location of the tumour, how aggressive the cancer is, and your general health. Footnote [2]
It’s often used alongside other cancer treatments such as chemotherapy (anti-cancer medications) and surgery, to destroy cancer cells with the aim of curing cancer, slowing its growth, or stopping it from returning.
If your cancer is the type that isn’t curable, radiotherapy may be given to help control your symptoms and improve your quality of life.
Before commencing treatment, your specialist will discuss your treatment plan, the aim of the treatment and the associated risks to ensure you understand your options before deciding to consent to treatment.
Types of radiotherapy
There are two main types of radiotherapy:
External beam radiotherapy
External Beam Radiotherapy delivers treatment from a machine outside of the body. The treatment is directed at the tumour, using high energy photons to destroy cancer cells, shrink the size of tumours, relieve symptoms, and prevent cancer cells from spreading.
Different techniques are available to deliver external beam radiotherapy:
- IGRT: Image Guided Radiotherapy is the technique of gathering multiple images, for example using a MRI scanner, from multiple angles to capture the position of the tumour ready for radiotherapy treatment. IGRT can also be useful when a tumour is in an area that moves freely: for example, the MRIdian technique uses MRI to target radiotherapy in real time at the area needing treatment.
- IMRT: Intensity Modulated Radiotherapy shapes the radiotherapy beams to the shape of the tumour, reducing the amount of radiation affecting healthy organs and therefore reducing side effects.
- VMAT: Volumetric Modulated Arc Therapy radiotherapy is a form of IMRT in which the radiotherapy machine rotates around the body in an arc shape, continuously delivering beams of radiation at the tumour.
- Tomotherapy is another form of IMRT using a CT scanner that rotates spirally around a patient lying still on the treatment couch.
- Proton beam therapy is a type of radiotherapy using protons rather than photons to target the tumours of specific types of cancer.
External beam radiotherapy is delivered using a number of ‘fractions’ depending on the dose required and the technique use, which is determined and discussed during treatment planning.
Throughout treatment you’ll need to lie still on the bed/ table. The machines are moved into place by the radiographer who then leaves the room and instructions are provided through a two-way intercom. The machines are large and can be quite noisy, but you won’t feel any pain during treatment.
External beam radiotherapy treatment can take few minutes or possibly up to an hour depending upon the treatment required, but you should be able to go home afterwards.
Internal radiotherapy
Internal radiotherapy delivers treatment from inside the body using a radioactive implant placed close to the cancer. The technique used depends on the type of cancer, tumour size, how aggressive the cancer cells are, and your general health. Your specialist will discuss this with you to ensure you understand your treatment plan.
- Brachytherapy for prostate cancer: Small radioactive seeds are placed within the prostate which disperse low-dose radiation over the course of a few months. The seeds stay in place and are not removed. Alternatively, your oncologist might propose high-dose radiation day-case treatment, with removal of the radioactive seeds immediately afterwards.
- Brachytherapy for gynaecological cancers: High dose radiation is delivered through hollow tubes inserted into either the womb or cervix. The tubes connect to a machine that when switched on sends radioactive pellets into the tubes which deliver radiation to the tumour. At the end of treatment, the tube and pellets are removed, so you can go home.
- Intra operative radiotherapy: This involves giving radiotherapy treatment in the operating theatre immediately after surgical removal of the tumour. An applicator is placed at the site of the removed tumour and radiation is passed through it at the appropriate dosage. The application is then removed, and the surgery is completed.
- SIRT (Selective Internal Radiotherapy): This is brachytherapy used to treat liver tumours. Radioactive beads are inserted into one of the arteries supplying the liver. They travel to the liver and stop in small capillaries, where they release radioactive particles. This procedure is carried out in two steps: the first step involves assessing the arteries to check if one is suitable for use. The second step is the delivery of treatment. The beads emit radiation over a couple of weeks and are left in the body.
- Radioactive Iodine: This treatment can be used for thyroid cancer and is administered in the form of a drink or tablet. When the treatment has been ingested, the thyroid gland absorbs the iodine, destroying the cancer cells. Because of the high radiation dose, treatment is administered as an inpatient within a single room and monitored. When your radiation has fallen to a safe level, which might take up to a week, you can go home. You will be given advice about avoiding close contact with pregnant women and young children for a period afterwards.
Your specialist will explain your treatment in detail, ensuring that you understand and can provide informed consent.
Radiotherapy planning
Before you start radiotherapy treatment, it requires careful planning. This involves using imaging scans to determine: the most appropriate radiotherapy technique, taking account of your cancer type, stage, and locations; the precise area to be treated; the correct dose of radiation; the number of treatments (fractions) needed; and the optimal body position during treatment.
Radiotherapy planning also takes your general health condition into account. During external radiotherapy planning you may also have skin markings (tattoo marks) to allow the radiotherapy machine to be lined up correctly for accurate treatment. A mask or a mould may be necessary if you are having radiotherapy to your head or neck to help keep you still during treatment.
Side effects of radiotherapy
Radiotherapy affects everyone differently, it all depends on what part of your body is being treated, the type of radiotherapy treatment, and the dosage.
One of the main side effects is tiredness. This might only be mild and for a short period, but if you feel tired it’s important to rest.
Other side effects can include:
Hair loss
This usually affects just the area being treated, so if you’re having radiotherapy to your head, you may lose your hair. If another area of your body is being treated, you’ll lose a patch of body hair there.
Nausea (feeling sick) and diarrhoea
You may feel sick during, or after your treatment. If you tell your doctor you should be able to be prescribed some anti-sickness medication.
You’re more likely to feel sick, vomit, or have diarrhoea if the treatment is on or near your stomach, bowel or your brain.
Sore skin
A week or two after your treatment begins you may notice your skin is sore, itchy, dry or a different colour. This usually settles down a few weeks in, but you’ll need to be careful and look after your skin while it’s sore. Be careful not to use fragranced perfumes, soaps or lotions as these can irritate the skin. It’s also important to protect your skin from the sun during and after your treatment period. Damage to the lymph vessels under the skin can cause tissue swelling (lymphoedema).
Sore mouth and throat
You may have a sore mouth and difficulty swallowing if you’re having radiotherapy to your head, neck or upper body.
This can start a couple of weeks into your treatment, and you may get a dry mouth, mouth ulcers, a reduced sense of taste and a sensitivity to hot and cold foods. Painkillers and mouth washes and a bland diet can help manage these side effects.
Sex and fertility issues
Radiotherapy to your lower tummy, pelvic area, or groin may affect your sex life and fertility. Because there’s a risk of infertility you may wish to discuss storing eggs or sperm before treatment.
Radiotherapy v chemotherapy
Radiotherapy (ionising radiation treatment) and chemotherapy (anti-cancer drugs) are two different treatments used to treat cancer by destroying cancer cells. They can be used separately, or both at the same time.
Long-term risks of radiotherapy
Sometimes side effects of radiotherapy can develop months, even years after treatment. These include changes to skin, hair, lymph vessels, joints and other tissues of the body. It’s difficult for your care team to predict exactly how you’ll feel and for how long, but they can help and support you by giving you advice on how best to manage these side effects.
You could use your cover to pay for radiotherapy
You could claim for your radiotherapy treatment using your health insurance cover. First, you’ll need to get a referral from your specialist. Then make a claim through MyAviva, online or over the phone.
If we confirm your claim is eligible, we’ll pay for the treatment directly subject to policy terms and conditions. Just be sure to tell us if you need more tests or treatment, or if your hospital or specialist changes.
It’s good to have one less thing to worry about. It takes Aviva.
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