In most hospitals, a number of different professionals are involved in providing treatment. This is known as a multidisciplinary team. A clinical oncologist (a doctor who specialises in cancer care using radiotherapy) will oversee the treatment. The radiotherapy equipment is operated by a therapy radiographer, a healthcare professional trained in using X-rays for treatment. A radiologist will help with diagnosis and assessing the response to treatment. A nurse specialist is often your key contact during treatment and will be available to offer help and support.
You may see other health professionals including a physiotherapist, dietician and pharmacist. Behind the scenes, medical physicists are responsible for calculating safe and effective doses of radiation.
There are two main types of radiotherapy treatment: external beam radiotherapy and internal radiotherapy.
External beam radiotherapy
External beam radiotherapy is delivered by a machine known as a linear accelerator. It produces a high-powered beam of radiation, which is often X-rays. The dose of X-rays is at least 40 times greater than for taking an X-ray picture.
The course of treatment will be planned by a clinical oncologist. He or she will a plan your treatment by taking into account the size of the cancer, its likely sensitivity to radiation and the sensitivity of the surrounding tissues. He or she will also take into account your general health and fitness, and will discuss possible short and long-term side effects that you may need to prepare for.
The number and duration of the radiotherapy sessions depends on the type of cancer and where it's located in your body. A superficial skin cancer may need only a few treatments, whereas a cancer deeper in the body may need longer treatment. It may also depend on whether you are having treatment to cure the cancer or treatment to reduce symptoms.
The total amount of radiation you will need is measured in Grays (abbreviated to Gy). The overall dose is given in daily doses called 'fractions'. For each fraction of radiotherapy you will be asked to sit or lie down in a fixed position.
The radiotherapy equipment can be positioned with great accuracy to target the beam of radiation exactly on the right spot. This may involve lying down while the machine rotates around you, or you may be asked to sit in a chair while the beam is directed at a tumour that is near the surface of your skin. The machine won't actually touch you at any point, but it can be quite noisy, with whirring and buzzing sounds. There is an intercom so you can communicate with the radiographer at all times.
Radiotherapy won't make you become radioactive during or after the treatment because no radiation-producing material gets inside the body. You will be able to carry on with many of your normal daily activities. However, you may feel tired during and after your treatment so it's a good idea to ask friends and family for help if you need it.