Radiotherapy during covid-19


treatment during Covid-19

What happens if I have suspected or confirmed COVID-19?

You may be able to continue your radiotherapy treatment even if you are confirmed or suspected to have COVID-19. This will depend on your symptoms and whether the risks of giving radiotherapy outweigh the benefits. It may be necessary to interrupt your radiotherapy to allow time for you to recover.

Is it okay to have my radiotherapy treatment at the moment?

Your oncologist will speak to you if there are any changes to your radiotherapy treatment plan. They will only stop your treatment or give you a treatment break if it is safe to do so. If you are given a treatment break, every effort will be made to ensure you complete your treatment. Please be reassured that nothing will be altered without first consulting you.

I have had radiotherapy in the past: am I at risk of becoming seriously ill from COVID-19?

If you are in a vulnerable group, the NHS will have written to you and advised you what you should and shouldn’t be doing. If you haven’t received a letter but are concerned, contact your cancer helpline service, acute oncology service, chemotherapy helpline or radiotherapy review team.

What will happen when I come to the radiotherapy department?

If possible, please come into the department on your own This is to reduce the risk of spreading COVID-19 and reduce the time you are in the department. This is for your safety and the safety of staff and other patients. If you need to attend with a carer or require additional assistance, please speak to one of the treatment team and they will be glad to help you.

Staff will be wearing Personal Protective Equipment (PPE) Don’t be alarmed if you see staff wearing PPE like face masks, gowns, gloves and eye goggles. This is for everyone’s safety and to help reduce the spread of COVID-19. You may also be asked to wear a mask and it is usual to be screened on the way in to the department, this may involve answering questions on how you are feeling and having your temperature taken. This helps to identify patients with possible COVID-19 symptoms. Please adhere to social distancing advice throughout the department  where possible.

Why has my treatment been changed/postponed?

Having radiotherapy requires you to come into hospital every day which could increase your risk of catching and/or spreading COVID-19. It is possible in some cases to reduce this risk by giving radiotherapy in fewer visits or even postponing radiotherapy where the cancer is low risk and can be monitored. These changes to treatment are considered on a case-by-case basis and are based on high-quality evidence. Your oncologist will weigh up the risks and benefits of you having radiotherapy treatment at this time and discuss these with you. Healthcare teams will also consider the impact of COVID-19 on your local health services. This may mean some treatments will be prioritised over others, where it is safe to do so. This is in line with NHS guidance. National guidelines on COVID-19 and local guidelines at your hospital are being reviewed regularly. Your radiotherapy team will discuss with you if there could be any changes that apply to you or your treatment.

What is the advice for cancer patients?

There is evidence that some cancer patients are at a higher risk of becoming seriously ill if they catch COVID-19. If you are in a vulnerable group, the NHS will have written to you and advised you what you should and shouldn’t be doing. These patient groups include those who are having or have recently had:

- chemotherapy

- curative radiotherapy for lung cancer

- immunotherapy or antibody treatments for cancer

- active treatment for blood or bone marrow cancers, such as myeloma, leukaemia or lymphoma

- a bone marrow or stem cell transplant in the last 6 months or are still taking immunosuppression drugs If you haven’t received a letter but are concerned, contact your cancer helpline service, acute oncology service, chemotherapy helpline or radiotherapy review team. You can still have radiotherapy if you are in a vulnerable group.

What if I feel unwell during my radiotherapy treatment?

If you feel unwell or if you have any side effects during radiotherapy, please make sure to tell your radiotherapy team. Please do not withhold any symptoms or side effects. It is important to share how you are feeling so that you can receive the correct care and support throughout your treatment.

Further advice regarding treatment during the COVID-19 pandemic can be found here:

General info for patients

What are the side effects of radiotherapy treatment?

This depend on many factors, for example, what part of the body is being treated, each individual receiving treatment, the amount of radiation dose prescribed, what type of radiotherapy (internal/ external, photons/electrons/protons). Some people don't experience any side effects whereas others do. Radiotherapy has an accumulative effect this means it is more common to experience side effects towards the end of the treatment course and for a short time after treatment has finished. Any possible side effects and how to manage them will be discussed in detail by the treatment team before the treatment starts and during treatment as any side effects occur. Ask any member of your treatment team if there is anything you are unsure of.

What causes side effects of radiotherapy treatment?

Side effects occur when healthy tissue near the tumour is temporarily damaged by the radiation, this causes local inflammation, the body’s normal defense reaction. Radiotherapy is carefully planned to minimise side effects as much as possible whilst giving the maximum dose to the tumour.  Most side effects are short-term and will resolve soon after treatment has finished. Occasionally side effects can be long-term but with modern radiotherapy techniques, long-term side effects are less common.

Does radiotherapy treatment hurt?

No. There is nothing to feel during the treatment. It’s very similar to having an X-Ray or CT scan taken.  It is normal to hear a buzzing noise from the machine and to see the machine move around you, but you wont feel anything when the radiotherapy is being given.

How long does radiotherapy treatment take?

Treatments usually last around 10-30 minutes, the length of time the treatment takes will depend on the body area to be treated and the type of treatment. The treatment is repeated daily (Monday to Friday) for a certain number of days depending on what type of cancer is being treated. This can be anything from a single treatment up to several weeks.

How will radiotherapy treatment affect my day-to-day life?

This can really vary from person to person. Treatment can cause specific side effects depending on the area of the body being treated and this will affect how well you are able to continue with your normal routine. For example, radiotherapy can often cause tiredness and patients may find they need more time to do everyday things. It is good for your well-being if you can continue regular routines and life as normal.

What kind of clothes should I wear for radiotherapy?

You should be able to wear anything you feel comfortable in but it is best to avoid tight-fitting clothing around the area that is being treated beasue the skin in that area may become sore. You may be asked to change into a hospital gown for treatment so wear clothes that are easy to take on and off.

Is there any risk to my family during or after radiotherapy treatment?

There is no risk to family and friends when receiving external beam radiotherapy. However, if patients are receiving internal radioactive material check with the treatment team as this can vary depending on whether they are implants that are removed or radioactive liquids or markers. The treatment team will advise patients on their specific situations and what to do.

Am I alone during radiotherapy treatment?

While the radiotherapy machine is on, the treatment team have to leave the treatment room, but they will be able to see you on camera screens from the control area. You will be monitored very closely at all times for your safety and if you are worried or need the treatment to stop for any reason you can just raise your hand and radiographers will stop treatment and check that you are okay. Many treatment facilities use intercoms as well so they can hear and speak to you during treatment.

What is SABR?

What is stereotactic ablative radiotherapy (SABR)?

SABR (also know as 'SBRT' - stereotactic body radiotherapy) is a highly focused radiotherapy treatment that gives an intense dose of radiation concentrated on a tumor, and limiting the dose to the nearby healthy organs. It uses the latest technology for image-guidance meaning tumours can be targeted with millimetre precision and the treatment can be adapted to any slight changes in real-time. Being able to give high doses also means fewer treatments and SABR/SBRT is typically done in 1-5 hospital visits. SABR can be very effective however it is not suitable in all cases. Read more about SABR on this Macmillan Cancer Support webpage

Questions for your Treatment team

Can you please explain how the radiotherapy works i.e. how does it attack the cancer and why is it the best option for my type of cancer?

What are the benefits of the treatment you are advising me to have?

What are the success rates for this treatment – nationally and for this hospital?

Will radiotherapy cure my cancer or relieve the symptoms?

Am I having external or internal radiotherapy and can you please explain why?

What are the risks, if any, of this treatment?

What are the risks if I decide not to have this treatment?

Is there an alternative treatment?

Actual treatment

How long will each individual treatment take, how many will I need per week and for how many weeks (i.e. how many treatments will I need in total?)

What will the treatment be like and how long will it take?

Can you explain exactly what will happen before and during treatment?

Is the treatment area going to be marked on my skin with ink? (i.e. should I wear ‘old’ clothes)

After treatment

How will I feel immediately after treatment?

What are the side effects of the radiotherapy treatment I am having? Is there anything I can do to alleviate/avoid them?

How will my doctor know if my treatment has worked?


What kind of clothes should I wear?

Will I need to stay in the hospital?

How will treatment affect my life e.g. regular activities, driving, relationships, exercise, and diet?

Will I need to take any special precautions e.g. stay out of the sun

When will I need follow-up appointments and for how long?

Who should I contact if I have questions or concerns, during my treatment or once my treatment has finished?