How is radiotherapy given?

This page explains what happens if you are having radiotherapy for pancreatic cancer.

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.

Each treatment session is called a fraction. You will usually have radiotherapy every day, Monday to Friday. Most treatment courses last three to six weeks (15-30 fractions). This will vary with the type of radiotherapy you have and the hospital where you are being treated. For example, if you have SABR you will have five fractions over one to two weeks.

If you are having palliative radiotherapy, you will usually have fewer treatment sessions (1, 5 or 10). The overall dose is usually lower which reduces the risk of side effects. You may still get some short term side effects, depending on the area being treated.

What is chemoradiotherapy?

Chemoradiotherapy is chemotherapy together with radiotherapy. 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 to begin with. You will then have a CT scan. If this shows that the cancer has not grown, you will start chemoradiotherapy.

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 five to six weeks.

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

Speak to our specialist nurses

Speak to our specialist nurses on our free Support Line if you have any questions about radiotherapy, chemoradiotherapy, or your treatment options.

Speak to our nurses
PCUK Specialist Nurse, Dianne Dobson, taking a Support Line call on the phone

Who will treat me?

The team who will plan and deliver your treatment may include these health professionals.

  • A radiologist is a doctor who reads and understands images such as X-rays, MRI and CT scans.
  • Oncologists are doctors who use radiotherapy (clinical oncologists) and chemotherapy (medical oncologists) to treat and manage cancer. They will be responsible for your treatment.
  • Atherapy or therapeutic radiographer is a technical specialist. They take X-rays and scans, help with treatment planning, and deliver the radiotherapy treatment.
  • A therapy or therapeutic radiographer is a technical specialist. They take X-rays and scans, help with treatment planning, and deliver the radiotherapy treatment.
  • Dosimetrists help create a personal radiotherapy plan. This is to make sure the cancer gets the maximum dose of radiotherapy while reducing the dose to the surrounding organs.
  • A medical physicist is a healthcare scientist who helps to work out the doses of radiotherapy and checks all aspects of your treatment plan.

They will work together to make sure your radiotherapy is delivered accurately and safely.

What happens during treatment?

Planning the radiotherapy

Before your radiotherapy starts you will normally have a planning session. This is to work out how much radiation is needed, and the exact position you will need to be in on the radiotherapy table during treatment. can take up to two hours. You will have a CT scan, and the radiographers will make tiny permanent dots (tattoos) on your skin around the area being treated. They will use the scan and the tattoos to help them get you into exactly the right position for each treatment session.

If you are having SABR, there will be further steps, such as asking you to hold your breath during the scan and treatment. 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 about what will happen.

Some people may also have an MRI scan to help with planning.

You may be asked not to eat for two hours before your planning session, but you might be given some water to drink. To make sure everything is exactly the same for treatment, you will normally have to do this before each treatment session.

After the planning session, the radiotherapy team will produce a computerised treatment plan for you. This means there will usually be a gap of two to three weeks between planning and the start of treatment. Your radiotherapy team will be able to tell you exactly how long you may need to wait.

Having treatment

The radiographers will position you on the radiotherapy table (often called a couch). They will move the radiotherapy machine (called a linear accelerator or linac) around you to different angles to check the measurements. You should try to relax and lie as still as you can.

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 can talk to them. You might feel the couch move as they adjust the position from outside the room.

Radiotherapy machines are very big and can be noisy. When your treatment is delivered the machine will move around you. It may come close to you but will not touch you. The treatment isn’t painful.

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 whole process will take about 30 minutes. 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. After radiotherapy, it’s safe to be around other people, including pregnant women and children.

Radiotherapy and chemoradiotherapy can be tiring, so having someone to drive you to hospital can be helpful, especially towards the end of treatment. You may be able to get financial help towards hospital parking or travel costs – ask your medical team.

Reviewed January 2022

Review date January 2024

Last reviewed September 2019