Radiotherapy

This type of cancer treatment isn’t used so often for liver cancers but there are some situations when your doctor might suggest it.

What is radiotherapy?

Radiotherapy is a treatment that uses high energy rays (radiation) directed at the cancer. Like chemo, radiotherapy kills dividing cells, so cancer cells are more sensitive to it than normal cells.

Radiotherapy is a local treatment – it only treats the area it’s directed at, rather than the whole body.

There are different types of radiotherapy and it can get a bit confusing. This page is about external radiotherapy – treatment aimed from outside the body. Internal radiotherapy for liver cancer is called SIRT or TARE .

Types of radiotherapy

With external beam radiotherapy, the rays are directed towards you from the machine in the same way as having an X-ray. The treatment doesn’t make you radioactive in any way. The beams pass through the tumour and out of the body.

Conformal radiotherapy means that the beams are expertly shaped, so they fit the tumour more exactly. That means there is less healthy body tissue in the path of the beam. So, you are less likely to have side effects, or they will be milder. Doctors sometimes use chemotherapy alongside conformal radiotherapy. The chemo makes the cancer cells more sensitive to the radiotherapy. You may hear this called chemoradiation.

You may have stereotactic radiotherapy for liver cancer. You may hear this called radiosurgery, ‘gamma knife’ or ‘cyberknife’. It’s also sometimes called stereotactic body radiotherapy (SBRT) or stereotactic ablative radiotherapy (SABR). This is a highly targeted form of radiotherapy where several beams are directed at the cancer from different directions. This allows the doctor to target the treatment really accurately, so they can use higher doses of radiation to destroy a tumour completely without damaging surrounding healthy liver tissue.

How you have external radiotherapy

There are different types of radiotherapy and you have them in different ways.

Having the treatment is a little like having an X-ray. You can’t feel it. Each treatment of conformal radiotherapy takes a few minutes. If you’re having stereotactic radiotherapy, the treatment may take longer – up to a couple of hours. Your cancer specialist will tell you exactly how many treatments you’ll have and how long they’ll take.

Firstly, you have an appointment for radiotherapy planning. This involves having a scan, which the radiotherapist uses to work out exactly where to direct the treatment. A computer programme uses the information for the scan to shape the beams to fit your tumour. This planning process usually takes a week or two.

The radiotherapist may make marks on your skin that they use to line up the machine. Sometimes they’ll make a small tattoo mark. Or they may draw markings on your skin with felt tip pen. Don’t wash them off! If they fade, they’ll redraw them.

Once your treatment is planned, you go to the hospital to have each treatment as an outpatient.

• You may have stereotactic radiotherapy in a single treatment, or sometimes 2 or 3 treatments.
• Or you may have a course of external beam radiotherapy once every 1 or 2 days, over 3 or 4 weeks.

If you’re having chemoradiation, you will have chemotherapy during your course of radiotherapy treatment. Which drug you have and how often you have it varies. Your doctor will explain what they are going to use in your case.