Cancer Treatments Radiotherapy

Overview

Radiotherapy (also called radiation therapy) is a cancer treatment that uses carefully targeted high-energy rays, such as X-rays, to destroy cancer cells. It damages the genetic material inside cancer cells, making it harder for them to divide and grow. Radiotherapy can be used on its own or together with other treatments like surgery, chemotherapy, or hormone therapy.

Yes. Around half of all people being treated for cancer will have radiotherapy at some point. It is one of the most common and effective cancer treatments available.

Radiotherapy is used for people of all ages, from children to older adults. Whether you receive it depends on the type, size, location, and stage of the cancer, as well as your overall health and treatment goals.

Symptoms

Common symptoms

• Fatigue or a general feeling of tiredness that may last after treatment ends
• Skin redness, dryness, or tenderness in the treated area
• Hair loss only in the exact area being treated
• Local swelling or changes in the skin texture

Symptoms in children

• Growth changes in the area where radiation is given, potentially affecting bones or organs
• Dental issues if the head or neck is treated
• Tiredness and emotional ups and downs during and after treatment

Symptoms in older adults

• More pronounced fatigue that may take longer to lift
• Possible worsening of existing health conditions such as heart or lung disease
• Temporary memory fuzziness or trouble concentrating if the brain is treated

Causes

Main causes

• Cancer itself arises from complex changes in a cell's DNA, often linked to a mix of genetics, environment, and lifestyle.
• Radiotherapy is recommended when the cancer type is known to respond well to radiation, or when it is the best way to attack the tumour in a specific location.
• It may be used to shrink a tumour before surgery, to destroy any remaining cells after surgery, or to relieve symptoms when a cure is not possible.

Risk factors

• Previous radiotherapy in the same part of the body increases the risk of local side effects.
• Certain inherited conditions that make skin cells more sensitive to radiation.
• Taking some other medicines during treatment can raise the risk of skin or tissue reactions.

When to see a doctor

See a doctor urgently if:

• Call your radiotherapy team or local emergency number if you develop a high fever, severe breathing problems, or intense pain that does not go away.
• Seek same-day advice if the treated skin becomes very painful, blistered, or broken.
• Contact your care team if you are unable to eat or drink enough to stay hydrated.

Book a routine appointment if:

• Tell your doctor or nurse about any new or worsening side effects, even if they seem small.
• It is normal to have regular check-ups during and after treatment to monitor how you are recovering.

Diagnosis

Radiotherapy is not used to diagnose cancer; you normally receive a diagnosis first. To plan radiotherapy, your team performs a dedicated planning process using scans and sometimes small temporary marks on your skin.

Tests that may be done

• CT scan to map the exact shape and position of the tumour
• MRI scan for detailed images of nearby tissues
• Blood tests to check your general health before starting treatment

What to expect at your appointment

You will usually attend a 'planning session' where a specialised team positions you on a table and takes scans. They may add tiny skin marks (often tattoos) to guide each daily treatment. The treatment itself feels like having an X-ray; you do not feel anything while the radiation is on.

Treatment

Radiotherapy is a mainstay of cancer treatment. It can be delivered from outside the body (external beam radiotherapy) or from inside using a small source placed near the tumour (brachytherapy). Your doctor will tailor the timing and dose to your specific situation, often over a number of weeks.

Self-care at home

• Rest when you are tired, but try to stay gently active with short walks.
• Wash the treated skin with lukewarm water and a mild cleanser, and pat it dry — avoid rubbing.
• Wear loose clothing made of soft cotton in the treated area.
• Keep following a balanced diet and drink plenty of fluids unless your team advises otherwise.

Medical treatments

The medical team will manage your radiation dosing and schedule. You may also receive supportive medicines, such as anti-nausea or pain relief, but always take these exactly as your doctor directs. Radiotherapy is often combined with other treatments like chemotherapy, immunotherapy, or hormone therapy — your oncology team will explain the plan.

When is surgery considered?

Radiotherapy can be used before surgery to shrink a tumour, during surgery to target a specific area, or after surgery to destroy any remaining cancer cells. It is a complementary treatment, not a replacement, when surgery is needed.

Living with this condition

You can usually carry on with work, school, or hobbies during radiotherapy, though you may need to adjust your pace. Try to keep a routine and allow short rest breaks during busy days.

Lifestyle tips

• Avoid exposing the treated skin to the sun, saunas, or very hot water.
• Stop smoking, as smoking can slow healing and worsen side effects.
• Keep a log of your energy levels and side effects to share with your care team.

Diet and exercise

Eat a balanced diet with plenty of fruits, vegetables, and protein to help your body repair itself. Gentle exercise like walking, yoga, or stretching can reduce fatigue and improve mood, but listen to your body and rest when needed.

Mental health and emotional wellbeing

Feeling anxious, sad, or overwhelmed is common during cancer treatment. It is important to acknowledge these feelings and seek support. Radiotherapy itself is painless and often feels like a routine, which can make it easier emotionally than many people expect.

Prevention

Radiotherapy is used to treat cancer, not to prevent it. However, living a healthy lifestyle — avoiding tobacco, limiting alcohol, staying physically active, and eating well — can lower your overall risk of developing some cancers in the future.

Vaccines

Some vaccines, such as the HPV vaccine, help protect against cancers caused by certain viruses. Ask your healthcare provider if a vaccine is recommended for you or your children.

Screening programmes

Screening tests for breast, bowel, cervical, and other cancers can catch problems early, when treatment is often simpler and more effective. Follow the screening advice for your age and risk factors.

Complications

If left untreated

• If cancer is left untreated, it may continue to grow and spread to other parts of the body.
• Delaying radiotherapy can reduce the chance of it being curative, or may allow the cancer to become more advanced.
• Untreated cancer can cause symptoms such as pain, weight loss, or organ dysfunction.

Long-term outlook

Radiotherapy has helped millions of people, both as a cure and to relieve symptoms caused by cancer. Success rates depend on the type and stage of the cancer, but outcomes have improved significantly in recent decades. Even when a full cure is not possible, radiotherapy can dramatically improve quality of life and give people more valuable time with their loved ones.

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