Pancreatic Cancer
Radiotherapy and chemoradiotherapy for pancreatic cancer
Chemoradiation or chemoradiotherapy is where chemotherapy is combined with radiotherapy to treat cancer. Both treatments destroy cancer cells. Radiotherapy uses high-energy rays and chemotherapy uses drugs. You may be treated just with chemotherapy or just with radiotherapy. Use of chemotherapy is a lot more common for pancreatic cancer than radiotherapy.
Combining the two treatments can work better than using one by itself. Chemotherapy can make cancer cells more likely to be affected by the radiotherapy.
One or both may be used:
- Before surgery to try to shrink or slow the growth of the cancer.
- After surgery to try to stop the cancer coming back.
- To slow down the growth of the cancer if surgery isn't possible.
- To help to relieve symptoms such as pain.
(CyberKnife) stereotactic ablative radiotherapy might also be used.
Elaine had surgery followed by radiotherapy. Her doctor had ‘persuaded’ her to have the treatment to try to stop the cancer coming back.
Other we spoke to who'd had radiotherapy had also had chemotherapy at the same time. One man had it to try to shrink his tumour in order to make surgery possible. Others had it after surgery to try to stop it coming back. A few people were unable to have surgery so had chemoradiation to slow the growth of the cancer.
People had different chemotherapy drugs.
Steve had neo-adjuvant chemoradiotherapy. His doctors wanted to shrink his tumour, hoping to make potentially curative surgery possible.
Steve had neo-adjuvant chemoradiotherapy. His doctors wanted to shrink his tumour, hoping to make potentially curative surgery possible.
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So in a very short space of time, just a matter of a week or so I was able to speak with the oncologist who recommended a treatment of, it’s actually called cisplatin, which is a chemotherapy drug which is administered through a drip and that was done, and it happens over the course of a whole day, you go into a day ward and you have the cisplatin through an infusion. And also an oral chemotherapy drug, one that I would have, I think it was three times a day with a meal, you’d swallow this big tablet. And at the same time each weekday I would go for radiotherapy. So that regime was outlined and that was over I think it was five or six weeks, this regime would take place.
So around yes six weeks after returning to the
After her surgery Alison had adjuvant chemotherapy. Then she had adjuvant chemoradiotherapy. She described what having radiotherapy was like.
After her surgery Alison had adjuvant chemotherapy. Then she had adjuvant chemoradiotherapy. She described what having radiotherapy was like.
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I’d gone six months, so we’re now into March. And I had a month off, and we went away on holiday. And came back from that and I was referred to a consultant clinical oncologist. And he prescribed for me roughly six weeks’ worth of chemoradiotherapy. Now that involved having a, a drug called 5FU in a pump which was attached to what’s called a Groshong line, which is a c-, a central line that, that goes into your chest and it delivers the chemotherapy on a 24/7 basis. So you’ve got the pump with you continually. And that was changed once a week in clinic. So, which actually I decided to do myself, because I couldn’t be bothered [laugh] to go back up to the, to the, the clinic to do, and I was given all the kit to do that in a sterile environment. But, yes, and, and included in that was daily sessions of radiotherapy, which are, which are actually done at the NHS unit locally, but as a private patient.
What was the radiotherapy like?
It wasn’t painful at all. Beforehand I had to go in for some scans, so that they can perfectly align where they were going to focus the beam. And I had to have some mini tattoos put on me. And the radiotherapy went in three sides, so the middle and then the two sides. And I’ve got three nice little dots to show them where they were going to line the machine up. So it’s, it’s not quite a, a dragon or a butterfly or anything like that. And it, you certainly don’t notice it now. But the process itself, it was only for ten minutes but I had, I had to lie very, very still. And it’s amazing, when you’re trying to lie still you think about not moving and you can’t wait to move. And it’s, it’s really difficult. And, you know, it, it, it doesn’t hurt at all. And you just hear sort of the zapping and the clunking of the machine and, as it’s rotating around you. And that I found worse than the chemotherapy regime I’d been on. The side effects of that were mainly exhaustion.
Anthony's wife, Martine, had inoperable pancreatic cancer. After the diagnosis she started chemoradiotherapy. Anthony described what it involved.
Anthony's wife, Martine, had inoperable pancreatic cancer. After the diagnosis she started chemoradiotherapy. Anthony described what it involved.
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I think after that things moved fairly fast in that we were handed over to, from the surgeon to a radiologist, oncologist. And they said straightaway, “We’re going to move you to two things, you’re going to start a course of chemotherapy”, I think there’s a, there’s a drug that’s always used for, and called gemcitabine, “and also you’ll go onto radiotherapy”.
And then we learnt all about the process of having planning, I think it’s called, where she had to go and have these little marks, little tattoos put on her. First when the word tattoo was used, we had visions of great big marks on her body, which she was a bit worried about, but they were only just dots actually.
And then she went for the planning and she had these tattoo marks so that when she was lying on the, the big machine with the radiotherapy, whatever it is, the gun, they knew exactly where to focus it so it was straight on the tumour, on the pancreas.
And she never felt anything, during the sessions of radiotherapy. As the radiotherapy went on she got tireder and tireder, but how much was from the radiotherapy and how much was from the chemotherapy, we don’t know because it was joint.
People usually have radiotherapy as an outpatient. Treatment is painless, but Michael said he found the massive machine “rather intimidating”. Peter found it difficult to lie still on the table because it was uncomfortable as he had become very thin. He also felt disorientated after treatment.
Richard had inoperable cancer. He had chemoradiotherapy. He described what it was like to have radiotherapy.
Richard had inoperable cancer. He had chemoradiotherapy. He described what it was like to have radiotherapy.
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And so with radiotherapy, the way in which that worked was again every Monday morning I would go in and receive a small dose of gemcitabine, in the hospital intravenously.
Then each day I had, from Monday to Friday, I had to attend the hospital for my radiotherapy. In preparation I had a special scan done which located the tumour precisely, and worked out the as it were the various angles in which it was going to be attacked by the x-rays. And my body was marked in various critical positions which became like the daily target so that when I lay on the x-ray machine I was able to be lined up precisely to the millimetre, exactly to, to receive my radiotherapy.
And I had five weeks and three days, so I had 28 individual treatments. And each treatment only lasts about five minutes, but you in, in order to get the treatment you had to get undressed, and then get dressed. And I have to say it was very well organised. I was rarely kept waiting for more than ten/fifteen minutes, and sometimes I would sort of arrive on time for my appointment and almost go straight in. So I certainly couldn’t complain about my, my treatment at all there.
People experienced various side effects. It was not always clear which were from the chemotherapy and which were from the radiotherapy.
Last reviewed November 2020.
Last updated November 2020.
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