Chemoradiotherapy

What is chemoradiotherapy?

Chemoradiotherapy (also called chemoradiation) means having chemotherapy at the same time as radiotherapy. The chemotherapy drugs act as 'radiosensitisers', making cancer cells more vulnerable to the radiation, so the two together can work better than either treatment on its own.

It is used for a number of cancers, commonly cancers of the anus, cervix, head and neck, lung, oesophagus (gullet), bladder and rectum, among others. It may be the main treatment given with the aim of cure, or it may be used before surgery to shrink a cancer (neoadjuvant) or after surgery to lower the chance of it coming back (adjuvant). The plan is decided by a multidisciplinary team (MDT).

The trade-off is that combining the treatments usually makes side effects stronger than having either alone. Because of this, chemoradiotherapy is not suitable for everyone, and your team will weigh up your general health and fitness before recommending it.

Whether the aim is to cure the cancer or to control it and protect quality of life depends on your diagnosis and stage. No cancer treatment can guarantee a cure, and your clinical oncologist should be clear and honest with you about the realistic aim and what the treatment involves.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Chemoradiotherapy compared with radiotherapy alone

The combination is more intensive. The right choice depends on the cancer type, the aim of treatment and how well you are likely to cope, and is decided with your team.

Preparing for your treatment

• Talk through why chemoradiotherapy is being recommended, whether the aim is to cure or to control the cancer, and what the alternatives would mean.
• Have any fitness, blood, heart, kidney or dental checks your team arranges, as some are needed before head and neck or other treatments.
• Ask how the chemotherapy will be given (tablets or drip) and whether you will need a line fitted.
• Plan practical support: travel for daily radiotherapy over several weeks, time off work, and help at home during and after treatment.
• Discuss fertility before starting if this matters to you, as treatment can affect fertility depending on the area and drugs.
• Ask about managing eating and weight, especially for head, neck or gullet treatment, and whether you will see a dietitian.
• Bring a list of all your medicines and any questions, and consider bringing someone with you.

What happens

Before starting, you have planning for the radiotherapy, including a planning CT scan in your treatment position, and any tests needed to check you are fit for the chemotherapy.

The radiotherapy is usually given as short daily treatments on weekdays over several weeks. You lie still while the machine delivers the radiation; you do not feel it. The chemotherapy is given during this time, either as tablets taken on treatment days or as drips on set days, sometimes through a line in your arm or chest.

You are reviewed regularly during the course so the team can manage side effects, which build up over the weeks and depend on the area treated and the drugs used. Some people need extra support such as anti-sickness medicines, pain relief, mouth care or help with eating.

After the course finishes, the treatment keeps acting on the cancer for weeks to months. Side effects often peak shortly after treatment ends and then settle. Follow-up appointments are arranged to manage recovery and to assess how the cancer has responded.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Comfort, sedation or contrast choices

If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.

The key point is that combining chemotherapy and radiotherapy makes side effects stronger and can affect your blood counts, so infections and other problems need to be taken seriously and reported quickly. Ask your team which specific early and late effects are likely for your cancer, how they will support you through the course, and what signs mean you must contact them urgently. Whether the aim is cure or symptom control should be clear.

Published figures to discuss

Side-effect and outcome rates depend heavily on the cancer type, stage, the drugs and dose used, the area treated and your general health, so a single set of figures would be misleading. Combining chemotherapy and radiotherapy reliably increases side effects compared with either alone, and effects on blood counts make infection a particular concern. Because robust numbers that apply to every person do not exist for 'chemoradiotherapy' as a whole, we describe the pattern and the importance of urgent help for infection rather than invent precise percentages. Ask your team for figures specific to your cancer and plan.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

Chemoradiotherapy is an intensive treatment rather than an operation, but it takes a real toll. Side effects build up during the course and often peak just after it ends, then settle over weeks. The cancer's response is judged later at planned follow-up.

• Tiredness that lasts for weeks after treatment ends
• Sore skin in the treated area, and a sore mouth or throat, settling over weeks
• Reduced appetite, weight changes and altered taste that improve gradually
• Bowel or bladder symptoms after pelvic treatment, easing over time
• No immediate change in the cancer, because treatment keeps acting over weeks to months

Aftercare

• Take all prescribed medicines, including anti-sickness, pain relief, mouth care and any antibiotics, exactly as directed.
• Look after the treated skin as advised, avoiding harsh products and sun exposure.
• Eat and drink as well as you can, and accept dietitian or feeding support if offered.
• Watch for signs of infection and keep the emergency contact details your team gave you to hand.
• Rest when you need to, but keep gentle activity going to help recovery and fatigue.
• Attend all follow-up appointments and blood tests, even when you feel well.
• Tell your team about any new or worsening symptoms between appointments.

• Emergency contact card and advice on infection signs kept to hand
• Travel and support arranged for daily treatment over several weeks
• Prescribed medicines (anti-sickness, pain relief, mouth care) collected
• Dietitian or eating support organised if needed
• Time off work and help at home arranged
• Follow-up appointments and blood tests booked
• Fertility discussion completed before starting, if relevant

⚠ Get urgent help if…

• A high temperature, shivering, or feeling very unwell — this can mean a serious infection when blood counts are low and needs urgent assessment
• Being unable to eat or drink, or severe pain swallowing, leading to dehydration
• Severe diarrhoea, vomiting or abdominal pain
• Unusual bruising, bleeding, or a rash with feeling unwell
• Breathlessness, chest pain or a fast heartbeat
• New or worsening neurological symptoms during treatment near the brain or spine
• Any symptom your team has told you to report straight away

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result is the cancer responding to treatment, but chemoradiotherapy works gradually, so the response is judged at planned follow-up over weeks to months, using examinations, scans or other tests as appropriate to your cancer. Where it is given before or after surgery, it is one part of a wider plan.

No cancer treatment can guarantee a cure or that a cancer will never return, even when chemoradiotherapy is given with the aim of cure. Where the aim is to control the cancer, the goal is to manage it and protect quality of life. Your clinical oncologist should be honest about what the treatment is realistically expected to achieve for you.

How durable the result is depends on the cancer type and stage and the whole treatment plan, not on chemoradiotherapy alone. Some cancers can be controlled long term, while in other situations it is part of a broader plan or is used to control the cancer. Long-term follow-up matters because both recurrence and late side effects can appear months or years later.

Related tests, treatments or support

Chemoradiotherapy is itself a combination, and it may sit within a wider plan that includes surgery before or afterwards, or further drug treatment. The mix is decided by your multidisciplinary team based on your cancer type, stage and fitness. Because combining treatments increases side effects, the plan should carefully balance the expected benefit against the burden.

Follow-up & long-term care

After treatment you stay under your oncology team's care. Follow-up appointments and tests check how the cancer has responded, support your recovery, manage side effects and watch for late effects. You should be told who to contact between appointments and given clear emergency advice, and any private care should be coordinated with your NHS team and GP.

• Attending long-term follow-up so recurrence and late effects are picked up early
• Ongoing dental, swallowing, bowel, bladder or other site-specific care as advised
• Reporting new or persistent symptoms promptly
• Continuing any rehabilitation, dietitian or speech and language support recommended

Repeat, follow-on and what comes next

• Treatment may be paused, reduced or changed if side effects become severe.
• Further treatment — surgery, more drug treatment or other radiotherapy — may be needed depending on the response.
• The response is judged at follow-up over weeks to months, not immediately.
• Late side effects may need their own management months or years later.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• Clear written emergency advice on infection signs, with a 24-hour contact route.
• Active management of side effects, including mouth care, skin care, pain relief and anti-sickness medicines.
• Dietitian, speech and language or rehabilitation support where relevant.
• A scheduled follow-up plan to assess the response and watch for late effects.
• Coordination between any private team, your NHS oncology team and your GP.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• The clinical oncologist's, medical oncologist's and team's fees for planning and giving treatment
• The number of radiotherapy sessions and the chemotherapy drugs and regimen used
• Whether a line is needed for chemotherapy, and any associated procedures
• Blood tests, scans, planning and supportive medicines
• Management of side effects, including any hospital stays
• Follow-up appointments, scans and rehabilitation or dietitian support

• The specialist and facility fees for the full radiotherapy and chemotherapy course
• The chemotherapy drugs, any line, and supportive medicines
• Blood tests, planning scans and imaging
• What is included for managing side effects, including possible hospital stays
• Follow-up appointments, scans and who provides them
• What happens, and what it costs, if treatment changes or a complication occurs

On the NHS? Chemoradiotherapy is commonly available on the NHS when clinically indicated; private care is mainly used for speed or choice of specialist and should be coordinated with your NHS team.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• Is the aim of my chemoradiotherapy to cure the cancer, to shrink it before surgery, or to control it?
• Which specific side effects are most likely for my cancer, and how will you help me through them?
• How will the chemotherapy be given, and will I need a line fitted?
• What signs mean I must contact you urgently during treatment?
• Could this affect my fertility, and should I consider anything before starting?
• How and when will you check whether the cancer has responded, and what are my options if it has not?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my treatment, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this treatment not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for chemoradiotherapy

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: Macmillan Cancer Support — Chemoradiation treatment Macmillan Cancer Support — Chemoradiation for anal cancer Macmillan Cancer Support — Radiotherapy for head and neck cancer Cancer Research UK — Radiotherapy treatment Royal College of Radiologists — Clinical oncology NHS — Radiotherapy

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.