Radiotherapy for pancreatic cancer

What is radiotherapy?

Radiotherapy uses radiation to destroy cancer cells.

A machine called a linear accelerator is usually used to deliver radiotherapy for pancreatic cancer. This directs beams of radiation at the cancer from outside the body, destroying the cancer cells.

If you have pancreatic cancer, you may have radiotherapy on its own, or together with chemotherapy. This is called chemoradiotherapy.

Who can have radiotherapy?

Radiotherapy is used in different ways, depending on your diagnosis. It may be used after, and occasionally before, surgery to remove the cancer.

• Borderline resectable pancreatic cancer is cancer that has grown very close to the major blood vessels near the pancreas. Chemotherapy together with radiotherapy (chemoradiotherapy), or more rarely, radiotherapy on its own may be suitable for some people with borderline resectable cancer. The aim is to shrink the cancer enough to make it possible to remove it with surgery.
• Locally advanced pancreatic cancer is cancer that has spread to the large blood vessels near the pancreas, or the stomach, spleen or large bowel. If you have locally advanced cancer, you may be offered chemoradiotherapy. Chemoradiotherapy may help control the cancer and slow down its growth. Another option may be a type of radiotherapy called SABR (stereotactic ablative body radiotherapy), which is very precise radiotherapy that delivers higher doses of radiation in a shorter time.
• If you have cancer that has spread to other parts of the body (advanced or metastatic cancer) it can cause pain. You may be able to have radiotherapy to help the pain. This is called palliative radiotherapy.

How will I have radiotherapy?

You will normally have a planning session before your radiotherapy starts, so that the radiotherapy team can make a treatment plan for you. You will have a scan, and the radiographers will make tiny permanent dots (tattoos) on your skin. They will use these dots to get you into exactly the right position for each treatment session.

You will usually go to the hospital Monday to Friday for your radiotherapy. Treatment normally lasts three to six weeks, although this varies. The treatment session may take up to 30 minutes each time.

The radiographers will position you on the radiotherapy table (often called a couch). The radiotherapy machine will move around you during treatment, but won’t touch you.

You will usually have scans or X-rays taken while you are having radiotherapy to check that you are in the right position during treatment. You can go home as soon as each treatment session has finished.

Read more about how radiotherapy is given.

How will I have chemoradiotherapy?

If you are having chemoradiotherapy, you will usually have chemotherapy on its own for three to six months to begin with. You will then have a CT scan. If this shows that the cancer has not grown, you will have radiotherapy and chemotherapy every day from Monday to Friday, for five to six weeks.

The chemotherapy drug most often used with radiotherapy is capecitabine, which is taken as a tablet.

Are there any side effects?

Radiotherapy and chemoradiotherapy can cause some short and longer-term side effects but these are often mild. Side effects include:

• fatigue (extreme tiredness)
• feeling and being sick (nausea and vomiting)
• runny poo (diarrhoea)
• skin changes.

If you have chemoradiotherapy, you may also get side effects from the chemotherapy.

Your medical team will carefully plan your treatment to reduce the risk of any side effects, and there are ways to manage side effects.

Published September 2019

To be reviewed September 2021

This information is currently under review.