Proton beam therapy is an advanced form of external radiotherapy that uses high-energy proton beams instead of photon x-ray beams or electrons. Carefully measured doses of protons are delivered to the precise area needing treatment, using the latest IBA ProteusONE technology. This ensures that the delivery of proton beam therapy is highly accurate and prevents the risk of radiation reaching surrounding healthy tissue.
Radiotherapy is used to kill and destroy cancer cells. It utilises radiation in the form of high-energy x-rays, known as photons, to kill and damage the cancerous cells and prevent their growth and reproduction. It can be used as a non-surgical option to treat cancer, and it can also be used to shrink a tumour or in combination with other treatments.
The Rutherford Cancer Centres and Elekta are bringing the next generation of personalised adaptive radiotherapy technology to oncology centres across the UK, with the new MR-linac Elekta Unity now available at the Rutherford Cancer Centre North West in Liverpool.
These FAQs have been written to include some of the most frequently asked questions around being referred for radiotherapy and receiving radiotherapy treatment for cancer. If you have any queries that are not covered below or would like any further information, please do not hesitate to contact your support team or our enquiries team.
Radiotherapy (also referred to as radiation therapy) is used to treat cancers by using photons (x-rays) that are target the tumour with the purpose to interrupt the internal workings of the cancer cell’s DNA, preventing growth and duplication, and eventually leading to the death of the cell. Normal, healthy cells are affected by radiation too, but they are able to recover quickly after the treatment is finished.
Radiotherapy is delivered as a local treatment, meaning it is delivered directly to the area of the body to be treated, compared to chemotherapy and immunotherapy (known as systemic treatments) which travel through the bloodstream to the entire body.
High-energy particles or waves delivered by radiotherapy include x-rays (photons), protons, gamma rays and electrons to treat cancer. These various kinds of radiation are used in differing types of radiotherapy, such as proton beam therapy, which is another type of cancer treatment offered at Rutherford Cancer Centres.
Radiotherapy is divided into two main types of delivery; external beam radiotherapy and internal radiotherapy (brachytherapy). External beam radiotherapy uses machines, such as a linear accelerator, to deliver radiation to the targeted body site. Radiotherapy and proton beam therapy at Rutherford Cancer Centres are both types of external beam radiotherapy.
Brachytherapy is a type of internal radiotherapy which uses radiation sources that are placed internally within the body. Although inside the body, brachytherapy is still considered a local treatment and only the cancer cells and some surrounding healthy cells are affected. Brachytherapy is not currently offered at any of the Rutherford Cancer Centres.
Radiotherapy has been used to treat cancers for over 100 years and, while side effects are common, radiotherapy is safe for use and treatment machines regularly undergo precise measurement checks by qualified medical technicians to ensure they remain safe for use, as well as daily calibration checks to ensure accurate safe delivery.
Chemotherapy is a ‘full-body’ or ‘systemic’ treatment that works by treating the whole body to prevent the spread of cancerous cells. Radiation therapy or radiotherapy is a ‘targeted treatment’ that uses radiation to only treat a specific area of the body. Radiotherapy covers several methods of delivery, including conventional radiotherapy which uses photons (or x-rays) to treat cancer and advanced proton beam therapy which uses high-energy protons and precise targeting via pencil beam scanning to treat cancers and reduce side effects.
The dosimetrist works closely with the clinical oncologist to carefully plan the treatment doses for each individual patient, ensuring the highest dose can be given while reducing the severity of side effects. Doses are based on the precisely reviewed minimum and maximum doses for the specific cancer type and location in the body, which also influences the length of treatment and how the treatment is delivered.
To ensure you are in the correct positioning for treatment, once you are lying comfortably, a device is used to project a number scale onto your skin which shows the distance between you and the treatment machine. The radiographers read these numbers to confirm your positioning is correct and treatment can begin.
Another set of numbers are used to represent the position of the treatment couch and the machine; these numbers are unique to you and your treatment and ensure precise treatment in each session. Some of these numbers will be the same each day, others will not, please be assured that they can be different or the same between different treatment sessions.
Very small tattoos, or in some cases semi-permanent markings, are made on the skin to identify the precise area that radiation beams should be aimed at during each treatment session. These marks enable the radiographers to ensure the patient is positioned correctly for each treatment session and ensures higher accuracy.
Radiotherapy is delivered via a machine called a linear accelerator or a LINAC machine and uses precisely shaped, high-energy x-rays (photons) to treat cancer. The patient lies on an adjustable treatment couch and the radiotherapy is delivered through the head of the machine called the gantry, which rotates around the patient to deliver radiotherapy beams from various angles.
Yes, children with cancer can be referred for radiotherapy treatment to our centre in Newport, South Wales. The Rutherford Cancer Centre South Wales is approved to treat children 3 years and over. However, agreeing to treat a child is on a case-by-case basis depending on their individual needs.
Conventional radiotherapy (photon x-ray beam) and proton beam therapy (proton beam) can be used alongside surgery as well as other treatments, such as chemotherapy and immunotherapy. Your treatment is tailored to your individual needs, and your oncologist will advise what treatments will be best based on your diagnosis. The Rutherford Cancer Centres don’t offer surgery at its centres, but we do work alongside surgeons if surgery is needed as part of your treatment.
Cancer treatments are very carefully planned to offer the most effective treatment for the specific type, location and staging of a tumour and take into account other influencing factors such as the patient’s health and lifestyle. Alternative options are only offered when there is a greater risk of delivering a specific treatment, i.e. radiotherapy or surgery, due to a pre-existing condition or because circumstances have changed. Rutherford Cancer Centres will only offer a treatment plan that our clinical team deems to be the most effective treatment tailored to your diagnosis, whether this is a sole treatment or a combination of treatments.
After diagnosis, referral and the initial consultations with the cancer care team to determine if radiotherapy is the best treatment, you will meet with the clinical oncologist to discuss the benefits and risks of radiotherapy and confirm consent for the treatment. A CT or MRI scan or a combination of both is given to identify the size, shape and location of the tumour and then semi-permanent or permanent marks are made on the skin in the treatment area to ensure the same area is precisely targeted during each session.
Before treatment plans begin, the cancer care team will detail to the patient:
The type of radiotherapy to be given
The intended purpose of the treatment
The number of treatments planned
How often treatment is delivered
Treatments are then delivered in sessions known as ‘fractions’ that take place between Monday to Friday with breaks over the weekend. Some patients will still receive treatment over the weekend or will receive more than one treatment fraction in a single day, although this is uncommon.
During treatment, you will have regular health-checks to evaluate and manage side effects and assess the effectiveness of treatment, making changes where necessary to the treatment plan.
Full treatment plans often last between 1 to 10 weeks, and, after the treatment is finished, health checks are still carried out after treatment has been completed to manage any side effects that you may be experiencing. Some side effects may last after treatment has finished, but normally, healthy cells are able to recover quickly from radiation treatment.
Supportive care teams are still available to talk to or help with side effects, even after treatment has finished.
During the planning scans, various pieces of immobilisation equipment will be placed on the couch and around you, tailored to your individual position. The equipment will be used in the same position for each session throughout the duration of your treatment to ensure that your positioning is the same each day.
Once your planning scan is complete, very small pinpoint tattoos or semi-permanent marks will be made. These marks will be used for aligning you correctly each day so that treatment can be delivered accurately. Imaging is also performed on a daily basis to ensure the accuracy of treatment.
When receiving any kind of medical treatment, maintaining a healthy lifestyle is important as it makes it easier to manage side effects and ensures your body has the best chance of recovery during and after treatment.
Getting plenty of rest is essential to recovery and patients commonly express feeling more tired during radiotherapy treatment. Make sure to rest whenever you feel that it is required, and aim to maintain an active lifestyle, as this will help to relieve the fatigue from treatment.
The body requires a balanced diet of nutritious meals to aid with the recovery process and this can be difficult when managing side effects such as nausea. To help maintain a healthy diet, the supportive care team can provide guidance and advice around meal planning, managing site-specific side effects that interfere with eating well, and managing feelings of nausea during treatment.
The skin in the area receiving treatment can become sensitive and sore during the course of treatment, and it’s important to look after the area carefully. It is beneficial to use an SLS-free moisturiser throughout the course of treatment to reduce skin becoming dry and sore in the treatment area. The radiographers will be able to discuss suitable products with you prior to starting treatment.
Avoid using any powders, lotions, creams or shaving without first talking to the supportive care team. Instead wash the area gently with warm water and mild soap, using a soft towel to carefully pat the area dry. Try not to rub, scrub or scratch the skin and prevent irritation from clothing by wearing loose, breathable fabrics that aren’t restrictive.
It is also important to protect the skin, especially from sunlight, and the area should be covered with a hat or comfortable loose clothing while outside. The supportive care team can provide advice on suitable sun cream to use during your treatment.
Yes. While receiving any type of external beam radiotherapy, it is absolutely safe to be around others including pregnant women and children. There is no risk of radioactivity as the radiation passes through the body.
No. The radiation cannot be felt during radiotherapy treatment and there should be no pain while treatment is delivered. Some patients may experience sensitivity or reddening of the skin in the area receiving treatment after their session.
As the issues associated with coronavirus (COVID-19) continue, our number one priority at the Rutherford is the health and safety of our patients, colleagues and partners. We are committed to following all Department of Health guidance and ensuring the strict code of hygiene and other appropriate measures are in place in all Rutherford Cancer Centres. Relatives and friends are asked to wait in their cars unless it is identified that they need to accompany the patient, this is to reduce the number of people in our centres at any one time.
Yes. It is important to try and keep to a regular routine throughout treatment, although it’s not uncommon to experience fatigue during radiotherapy which can affect how active you can be. Keep to your regular activities but make sure to take it slow and easy, resting as much as possible where necessary and keeping hydrated.
Only during the delivery of the treatment will you be alone in the radiotherapy treatment room. The cancer treatment delivery team will be next door, able to see and talk to you throughout the treatment delivery. The treatment only takes a short time to deliver and then it’s possible to return to your normal daily routine afterwards.
Yes. Missing treatments can negatively influence the effectiveness of your treatment and should be avoided where possible. If circumstances arise and there is concern about missing a treatment, patients should reach out to their cancer care team to discuss options.
Your consultant oncologist takes overall responsibility for your treatment. The number of times you will see your consultant oncologist during treatment will depend on your individual treatment pathway and circumstances. They use their medical skills and experience to determine and plan the most appropriate treatment for you and ensure that you are supported during your treatment.
Your oncologist may request to see you during treatment if it’s needed, or, they may recommend that your treatment team carry out regular assessments during treatment and keep them informed about your wellbeing throughout instead. If you have any concerns during your treatment, you can always ask to see your oncologist as and when you need to.
As with any diagnosis and subsequent treatment plan, your emotional and mental health is going to be affected. The supportive care team is available to provide emotional and mental support to you whenever you need it, during or after your treatment and can provide access to additional therapies where required.
Every single person is different, from medical history and current health status to the specifics of the cancer location, type and staging. As every patient requires adjustments to their tailored cancer treatment plan, this means patients with the same diagnosis can have completely different treatment plans that are designed specifically to their individual needs.
The effectiveness of radiotherapy is dependent on a strict treatment regime that takes place over a number of weeks. Missing treatments should be avoided wherever possible but if you are feeling really unwell, the clinical oncologist can make amendments to your treatment plan for a short while and schedule additional treatments in the future.
No. Radiotherapy is an outpatient procedure, allowing you to arrive, receive treatment and go about your regular routine within an hour. Employers are legally obligated to make adjustments where necessary for their staff receiving cancer treatments.
The names of our radiotherapy teams change from centre to centre however your cancer care team will be made up of the following job roles and responsibilities:
The clinical oncologist is responsible for overseeing the entire treatment process and will work closely with the entire team to develop the best treatment plan for each individual. The clinical oncologist will monitor the progress of treatment and make adjustments to the treatment plan if necessary and work directly with the dosimetrist to ensure the right radiation dose is delivered while protecting healthy tissues.
The oncology nurse is the main point of support for patients and their families and will be on hand to provide information around side effects and how to manage them. They will be available to explain any potential changes that could occur during the treatment and will also be available after treatment is finished to provide advice and supportive care as needed.
Therapy radiographers are responsible for administering the daily dose of radiation according to the treatment plan determined by the clinical oncologist. They will also update the patient’s daily records after each session and regularly check over the treatment machines to ensure they are safe and ready for use.
Working directly with the clinical oncologist, medical physicists assist in tailoring complex treatments to patients. They are also the main role responsible for the safety of treatment machines, regularly working with the therapy radiologists to maintain and safety check machines, including taking precise measurements of the radiation beam.
Working alongside the clinical oncologist and medical physicists, dosimetrists are responsible for calculating the correct radiation dose for each individual treatment session. With the help of state-of-the-art software, dosimetrists draft several different treatment plans to identify the most effective course of treatment that ensures the least impact on surrounding healthy cells.
Mould Room Technicians
During the delivery of radiotherapy treatment, the positioning of the patient is extremely important and some treatment sessions will require the use of special masks to help with remaining in position comfortably. Radiotherapy shields are also used when additional protection is required for healthy tissues in the treatment area by inserting the shields into the radiotherapy machine to shape the radiation rays closely to the form of the tumour. These shields and masks are built bespoke by a dedicated team of Mould Room technicians.
Radiotherapy is delivered by therapy radiographers on the cancer care team in line with the treatment plan developed by the clinical oncologist. They are also responsible for updating patient treatment records daily.
Your radiotherapy treatment team should know about any implants, such as pacemakers and ICDs and be informed of any illnesses or existing conditions that you are aware of, prior to receiving treatment. The team should also be updated throughout your treatment to any changes in health or conditions, or if there is any chance that you may be pregnant at any point during treatment.
During the treatment session, you will be asked to lie on the treatment couch where the team will help to get you into a comfortable position and confirm you are in the correct position to receive treatment. At this time, the treatment table or machine may adjust and move around you until it is in the right place.
Once happy with your positioning, the radiographers will make some final specific movements and checks, and then imaging and treatment can begin. The radiographers will leave the room to the control area next door, but please don’t be worried – they will be watching you at all times and can speak to you through the intercom throughout the treatment, if this makes you more comfortable. If you require assistance at any point, you can let the team know and they can immediately pause treatment to assist you.
As your treatment is delivered, the dosage and positioning are carefully monitored and your progress is accurately recorded.
The treatment itself only takes a few minutes. You won’t see or feel anything, but you may hear a buzzing sound. The machine may rotate around you multiple times to deliver the radiation from different angles. Once treatment is complete, the radiographers will re-enter the room and help you off the couch, and you will be free to go.
Each radiotherapy session shouldn’t take longer than an hour in the centre, however, you are welcome to bring personal entertainment, including books, mp3 player or tablets. We offer free Wi-Fi across all of our centres.
If at any time before, during or after your treatment you would like to talk to someone, you can reach out to your supportive care team who can provide assistance or access to additional therapies where required.
There are no waiting lists for Rutherford Cancer Centres, however, we do need to collect:
Before a consultation date can be offered from the patient’s current health care provider and this can sometimes cause a delay. Once the necessary documents are received and a consultant has confirmed availability, an appointment will be arranged as soon as possible.
Should a patient need to be seen urgently, we can arrange for a consultant within our network to provide a telephone or video consultation.
A key part of our tailored cancer care packages is ensuring that you and your family receive all-important supportive care and your supportive care team are available for you at any time during and after your treatment. Where required, your supportive care team can arrange access to additional supportive therapies and provide compassion and expert guidance on managing side effects and maintaining a healthy lifestyle during your treatment.
While Rutherford Cancer Centres do not provide housing facilities or accommodation, we are located in areas with ample accommodation available, including hotels and guest houses, that we can recommend should you want to stay near the centre.
All our cancer treatments are delivered as outpatient procedures and patients will not be expected to stay overnight in the centre. If you are travelling to us and need help with booking accommodation while having treatment, we are able to take care of this for you at an additional cost.
Radiotherapy treatments are available at all of our centres, including Rutherford Cancer Centre South Wales, Rutherford Cancer Centre Thames Valley, Rutherford Cancer Centre North East and Rutherford Cancer Centre North West.
Conventional radiotherapy is not currently available to NHS patients through the Rutherford Cancer Centre network. However, we are able to treat NHS patients for proton beam therapy, where commissioned to do so. This may change over time, so it’s always best to contact your nearest Rutherford centre to find out more.
Patients are not able to self-refer for treatment and should seek a referral from their consultant oncologist, providing they are registered to work with Rutherford Cancer Centres. A full list of consultants working with us can be found here.
A snapshot of the typical patient pathway can be found on our referral page. If you would like further information regarding the referral process at Rutherford Cancer Centres, please reach out to us on 0800 210 0402.
If you need to make any changes to the time or date of your appointment, please contact Rutherford Cancer Centres on 0800 210 0402 and our team will try to arrange a more suitable time and date. Alternatively, you can call the specific at which you are receiving your treatment: