Radiotherapy for ovarian cancer

Radiotherapy uses high energy x-rays to destroy ovarian cancer cells. 

You usually have external beam radiotherapy for ovarian cancer. External beam radiotherapy directs radiotherapy beams at the cancer from a machine outside of the body.

Planning radiotherapy

The radiotherapy team plan your external radiotherapy before you start treatment. This means working out the dose of radiotherapy you need and exactly where you need it.

Your planning appointment takes up to 2 hours.

You usually have a planning CT scan in the radiotherapy department.

The scan shows the cancer and the area around it. You might have other types of scans or x-rays to help your treatment team plan your radiotherapy. The plan they create is just for you.

Before the scan

You will need to prepare your bladder and bowels for the planning scan and treatment. You will get information about this before your scan. Following this advice can help reduce long term side effects to your bladder and bowels.

Before the scan you need to empty your bowels. Your radiographer might give you an ​enema​ to help you empty your bowels. You will also need to drink a certain amount of water before you have the scan. They will tell you how much. 

You may need to prepare your bowels and bladder in the same way before each treatment. This helps to improve the accuracy of the treatment and reduce the possible side effects.

Your radiographer will ask you to put on a hospital gown. When you’re ready, the radiographers help you to position yourself on the scanning couch. This is the same type of bed that you lie on for your treatment sessions.

You need to lie very still. You might have a type of firm cushion called a vacbag to help as you may be in this position for a little while. Let the radiographers know if you are uncomfortable. 

Injection of dye

You might need an injection of ​contrast medium​ through a small thin tube (cannula) in your arm. 

Before you have the contrast medium, the radiographer asks you about any medical conditions or allergies. Some people are allergic to the dye.

For some people the dye might: 

• make you feel hot and flushed for a minute or two

• give you a metallic taste in your mouth, but this will not last long 

• make you feel like you’re passing urine but you aren’t. This feeling usually passes quickly

Having the scan

Once you're in position the radiographers move the couch up and through the scanner. They then leave the room and the scan starts.

The scan takes about 20 minutes. You won't feel anything. The radiographers can see you from the CT control area where they operate the scanner. 

Ink and tattoo marks

The radiographers make pin point sized tattoo marks on your skin. They use these marks to line you up into the same position every day. The tattoos make sure they treat exactly the same area for all of your treatments. They may also draw marks around the tattoos with a permanent ink pen, so that they are clear to see when the lights are low.

The radiotherapy staff tell you how to look after the markings. The pen marks might start to rub off in time, but the tattoos won’t. Tell your radiographer if that happens. Don't try to redraw them yourself. 

After the scan

The radiographers will then help you off the CT scanner couch and you can get changed back into your clothes. You stay in the department for about 15 to 30 minutes if you had an injection of the dye. This is in case it makes you feel unwell, which is rare.

The radiographer removes the tube from the vein in your arm before you go home. 

You should be able to go home or back to work. You can eat and drink normally.

After your planning session

You might have to wait a few days or up to 3 weeks before you start treatment.

During this time the physicists and your radiotherapy doctor (clinical oncologist) decide the final details of your radiotherapy plan. They make sure that the area of the cancer will receive a high dose and nearby areas receive a low dose. This reduces the side effects you might get during and after treatment.

Having radiotherapy

Radiotherapy machines are very big and could make you feel nervous when you see them for the first time. The machine might be fixed in one position. Or it might rotate around your body to give treatment from different directions. The machine doesn't touch you at any point.

Before your first treatment, your ​radiographers​ will explain what you will see and hear. In some departments, the treatment rooms have docks for you to plug in music players. So you can listen to your own music while you have treatment.

Before your treatment

Before each treatment you need to empty your bowels. Your radiographer might give you an enema to help you. 

You will also need to drink a certain amount of water before treatment. They will tell you how much, and when to drink it. 

During the treatment

You need to lie very still. Your radiographers might take images (x-rays or scans) before your treatment. This is to make sure that you're in the right position. The machine makes whirring and beeping sounds. You won’t feel anything when you have the treatment.

Your radiographers can see and hear you on a CCTV screen in the next room. They can talk to you over an intercom and might ask you to hold your breath or take shallow breaths at times. You can also talk to them through the intercom or raise your hand if you need to stop or if you're uncomfortable.

Side effects of radiotherapy

Radiotherapy for ovarian cancer can cause diarrhoea and sickness, inflamed bladder and tiredness.

These side effects usually start a few days after the radiotherapy begins. They might gradually get worse during your treatment or after treatment ends. You usually start to get better 1 to 2 weeks after you finish treatment.

The side effects are usually less severe if your treatment is for a short period of time. And more severe if treatment is longer, for example over a few weeks.

Tiredness and weakness

You might feel tired during your treatment. It tends to get worse as the treatment goes on. You might also feel weak and lack energy. Rest when you need to.

Tiredness can carry on for some weeks after the treatment has ended. But it usually improves gradually.

Various things can help you to reduce tiredness and cope with it, such as exercise. Some research has shown that taking gentle exercise can give you more energy. It's important to balance exercise with resting.

Get tips on coping with tiredness

Feeling or being sick

You might feel sick at times. This can start a few hours after treatment and last for a few days. Anti sickness injections and tablets can help. Tell your doctor or nurse if you feel sick. You might need to try different anti sickness medicines to find one that works.

Contact your doctor or nurse straight away if you’ve been sick more than once in a day.

Tips:

• Avoid eating or preparing food when you feel sick.

• Avoid foods that are fried, fatty, or have a strong smell.

• Drink plenty of liquid to stop you from getting dehydrated.

• Relaxation techniques help control sickness for some people.

• Ginger can help – try it as crystallised stem ginger, ginger tea or ginger ale.

• Fizzy drinks help some people when they’re feeling sick.

Find out about was of controlling sickness

Diarrhoea

Radiotherapy to the tummy (abdomen) or pelvic area can cause diarrhoea. Your poo (stool) may be very watery. You might need to poo more often or need to go the toilet more urgently.

Your healthcare team can give you medicine to slow down your bowel can help to reduce diarrhoea. Drink at least 2.5 litres of fluid a day to help keep you hydrated. Let your doctor or nurse know straight away if the diarrhoea is severe or getting worse.

Ask your nurse about soothing creams to apply around your back passage (anus). The skin in that area can get very sore.

Find out about coping with diarrhoea

Inflamed bladder (radiation cystitis)

Radiotherapy can make the lining of the bladder inflamed. This is called radiation cystitis. 

It can make you very uncomfortable. You might have bladder pain or a burning feeling when you pee. It may feel as though you need to pee all the time, even though you know you’ve only just been. Try to drink plenty of fluids because this will help.

Speak to your healthcare team if you have pain or feel you need to pee more often.

Read more about side effects after pelvic or abdominal radiotherapy