What does radiotherapy involve?

What are the different types of radiotherapy?

There are different types of radiotherapy used for pancreatic cancer in the UK. They all aim to focus the radiation on the cancer and limit the amount of radiation to surrounding organs and healthy tissues. The radiotherapy team will decide which is the best and safest treatment for you.

• Intensity modulated radiotherapy (IMRT) uses at least five radiation beams arranged at different angles so that the tumour gets the maximum amount of radiation.
• Volumetric modulated arc radiotherapy (VMAT) is a type of IMRT that uses one continuous beam to deliver radiotherapy as it moves around your body.

• Stereotactic ablative body radiotherapy (SABR) or stereotactic body radiotherapy (SBRT) delivers higher doses of radiation in a shorter time and over fewer sessions than IMRT or VMAT. SABR is an option for locally advanced cancer, usually after at least three months of chemotherapy.
• 3D conformal radiotherapy also shapes the radiation beam to the cancer. It may be used for palliative radiotherapy.

How is radiotherapy for pancreatic cancer given?

Radiotherapy treatment will vary depending on your pancreatic cancer diagnosis and the type of radiotherapy you are having. You will go to the hospital for each treatment but you won’t need to stay overnight.

How long will my radiotherapy treatment last?

Each treatment session is called a fraction. How long treatment lasts will vary with the type of radiotherapy you have and the hospital where you are being treated.

• You will usually have radiotherapy every day, Monday to Friday.
• Most treatment courses last three to six weeks (15-30 fractions).
• If you have SABR you will have five fractions spaced out, typically every other day, over one to two weeks.
• If you are having palliative radiotherapy, you will usually have fewer treatment sessions (1, 5 or 10) over one to three weeks. The overall dose is usually lower. This can reduce the risk of side effects.

How is radiotherapy combined with chemotherapy?

Sometimes radiotherapy is used with chemotherapy. This is called chemoradiotherapy. The chemotherapy may make the cancer cells more sensitive to the radiotherapy, making it more effective.

You will usually have chemotherapy on its own for three to six months. You will then have a CT scan. If this shows that the cancer has not grown, you will start chemoradiotherapy.

What chemotherapy drugs are used with radiotherapy?

The chemotherapy drug most often used with radiotherapy is capecitabine, which is a tablet that you can take at home. You will have radiotherapy and capecitabine every day from Monday to Friday, for three to six weeks.

Occasionally a chemotherapy drug called gemcitabine is used. This is an infusion into a vein that you have at the hospital as an outpatient. You will usually have radiotherapy every day from Monday to Friday for three weeks, together with one infusion of gemcitabine each week.

Ask your oncologist if chemoradiotherapy is a suitable treatment for you, and if it’s available in your hospital. You could also ask about clinical trials using chemoradiotherapy.

What should I expect when coming for treatment?

Planning the radiotherapy

Before your radiotherapy starts you will normally have a planning session.

• You may be asked not to eat for two hours before your planning session, but you might be asked to drink some water during your appointment. You will normally have to do the same before each treatment session.
• You will have a CT scan to work out the best position for you to lie in on the radiotherapy table during treatment. Some people may also have an MRI scan to help with planning.
• The radiographers will then make tiny permanent dots (tattoos) on your skin around the area being treated. These help make sure they get you into exactly the right position for each treatment session.

Different hospitals do things slightly differently and your oncologist and the radiotherapy team will discuss the process in detail with you. Ask them any questions you have.

After the planning session, the radiotherapy team will produce a treatment plan for you. There will usually be a gap of two to three weeks between planning and the start of treatment.

Having treatment

• The radiotherapy machine is called a linear accelerator or linac.
• The radiographers will position you on the radiotherapy table (often called a couch) using the tattoos. You might feel the couch move as the radiographers adjust the position from outside the room. They may move the radiotherapy machine around you to different angles to check the measurements.
• With most standard radiotherapy machines, you will have a scan before the treatment is delivered. This is to help make sure the radiotherapy is delivered accurately, but it won’t check how well the treatment is working.
• The radiographers will leave the room to deliver your treatment but will watch you using cameras. They can talk to you over an intercom and you may be able to talk to them.
• You should try to relax and lie as still as you can. The machine will not touch you and the treatment isn’t painful.

The whole process will take about 30 minutes, but this may vary. For SABR it will be longer – 45 minutes to more than an hour. The treatment itself only takes a few minutes. You can go home as soon as each treatment session is finished.

Radiotherapy and chemoradiotherapy can be tiring, so having someone to drive you to hospital can be helpful, especially towards the end of treatment. After radiotherapy, it’s safe to be around other people, including pregnant women and children.

What check-ups will I have after my radiotherapy treatment has finished?

If you had radiotherapy for locally advanced or borderline resectable cancer , you will have a check-up appointment with your oncologist. This will usually be 4-6 weeks after you finish radiotherapy treatment, though this may vary. This is often called a follow-up appointment.

You can use the check-up appointment to discuss any questions or concerns. It’s a good idea to write down any questions you have before the appointment. We have some suggested questions you could ask.

Having a CT scan after radiotherapy

Radiotherapy may continue to affect the cancer after your treatment has finished. You will have a CT scan about 12 weeks after radiotherapy, to check how well the treatment has worked. If you have had SABR, you may have a CT scan 6-12 weeks after having treatment.

Care after palliative radiotherapy

If you have had palliative radiotherapy to control symptoms, you will continue to see your oncologist or palliative care team (specialists in managing symptoms). They will check how well the radiotherapy has worked, whether you need any more radiotherapy, and help manage any other symptoms.

Updated January 2026

Review date January 2029