Having external radiotherapy for cervical cancer
Radiotherapy uses high energy x-rays to treat cervical cancer cells. You have the treatment in the hospital radiotherapy department.
When you might have radiotherapy
Radiotherapy with chemotherapy (chemoradiotherapy)
You are most likely to have chemoradiotherapy treatment if your cervical cancer is:
- stage 1B2 or bigger, up to a stage 4A
- you have had surgery, and cancer cells were found in the lymph nodes close to the cervix
You usually have chemotherapy once a week throughout a 5 week radiotherapy course.
Following chemoradiotherapy, you usually have internal radiotherapy (brachytherapy).
Radiotherapy after surgery
Some people might have radiotherapy after a hysterectomy. Your doctor might suggest this if:
- the border around the tumour contains cancer cells (positive margins)
- there are cancer cells in the lymph nodes
- the cancer has grown deep into the tissues around the cervix
You usually have treatment over 5 weeks.
Radiotherapy to control symptoms
Radiotherapy can:
- shrink the cancer
- relieve symptoms such as pain or bleeding
- help you feel more comfortable
You usually only have a short course. It might include:
- one or two treatments
- 5 treatments over a week
- 10 treatments over 2 weeks
You very rarely have more than 10 treatments.
Types of radiotherapy
You usually have a type of external radiotherapy called intensity modulated radiotherapy (IMRT).
You might also have internal radiotherapy. Internal radiotherapy gives radiotherapy to the cancer from inside the body. This is also called brachytherapy.
The radiotherapy room
Radiotherapy machines are very big and could make you feel nervous when you see them for the first time. The machine might be fixed in one position. Or it might rotate around your body to give treatment from different directions. The machine doesn't touch you at any point.
Before your first treatment, your 
will explain what you will see and hear. In some departments, the treatment rooms have docks for you to plug in music players. So you can listen to your own music while you have treatment.
Before each treatment
Before each treatment you might be asked to drink a certain amount of water. This is so your bladder is roughly the same size every day. If you need to do this then the procedure will be carefully explained to you when you have your planning scan.
You might also be asked to empty your bowels before each treatment. Not everyone has to do this.
The radiographers help you to get onto the treatment couch. You might need to raise your arms over your head.
The radiographers line up the radiotherapy machine using the marks on your body. Once you are in the right position, they leave the room.
During the treatment
You need to lie very still. Your radiographers might take images (x-rays or scans) before your treatment to make sure that you're in the right position. The machine makes whirring and beeping sounds. You won’t feel anything when you have the treatment.
Your radiographers can see and hear you on a CCTV screen in the next room. They can talk to you over an intercom and might ask you to hold your breath or take shallow breaths at times. You can also talk to them through the intercom or raise your hand if you need to stop or if you're uncomfortable.
Dan (radiographer): Before your treatment starts your doctor will need to work out exactly where the treatment needs to go and also which parts need to be avoided by the treatment. To have radiotherapy you lie in the same position as you did for your planning scans. We then line up the machine based on your tattoo marks. It is really important that you stay very, very still when you are having treatment it is also important to let the radiographers know right at the beginning if you are not comfortable so they can adjust your position
Radiographer: Ok all done, we’ll be back in a couple of minutes
Dan (radiographer): We leave the room and control the room from a separate room This is so we aren’t exposed to radiation. Treatment takes a few minutes and you will be able to talk to us using an intercom. We can see and hear you while you are having your treatment and will check that you are ok. When your treatment starts you won’t feel anything; you may hear the machine as it moves around you giving the treatment from different angles. Because we are aiming to give the same treatment to the same part of the body everyday then the treatment process is exactly the same everyday so you shouldn’t notice any difference. You’ll see someone from the team caring for you once a week while you are having treatment they’ll ask how you are and about any side effects.
Patient: They get you from one sitting area to another and then take you into the room where you undress to the waist and then lie down and line you up by either moving you or asking you to shuffle a little and they check the dimensions and they talk to one another and they say I am fine this side how are you ...yes fine...ok, stay where you are Jeff and that was it. There were a few little clicks and lights go on and off and you can see a green laser beam which line sup with certain things on your body uh so no, no real noise and no discomfort.
You won't be radioactive
This type of radiotherapy won't make you radioactive. It's safe to be around other people, including pregnant women and children.
Travelling to radiotherapy appointments
You might have to travel a long way each day for your radiotherapy. This depends on where your nearest cancer centre is. This can make you very tired, especially if you have side effects from the treatment.
You can ask your radiographers for an appointment time to suit you. They will do their best, but some departments might be very busy. Some radiotherapy departments are open from 7 am till 9 pm.
Car parking can be difficult at hospitals. Ask the radiotherapy staff if you are able to get free parking or discounted parking. They may be able to give you tips on free places to park nearby.
Hospital transport may be available if you have no other way to get to the hospital. But it might not always be at convenient times. It is usually for people who struggle to use public transport or have any other illnesses or disabilities. You might need to arrange hospital transport yourself.
Some people are able to claim back a refund for healthcare travel costs. This is based on the type of appointment and whether you claim certain benefits. Ask the radiotherapy staff for more information about this and hospital transport.
Some hospitals have their own drivers and local charities might offer hospital transport. So do ask if any help is available in your area.
Side effects
Radiotherapy for cervical cancer can cause side effects. This includes diarrhoea and bladder inflammation.
Let the radiographers know if you have any problems or side effects so they can give you advice or arrange for you to see a doctor.
