Having radiotherapy for bladder cancer

Radiotherapy uses high energy x-rays to treat cancer cells. You might have radiotherapy for bladder cancer. 

You have radiotherapy in a hospital radiotherapy department. You usually have it as an outpatient each weekday over 4 to 8 weeks. Some hospitals have rooms near the hospital you can stay in if you have a long way to travel.

You might also have chemotherapy together with the radiotherapy. This is called chemoradiotherapy.

When do you have it?

You might have radiotherapy:

  • as your main treatment instead of surgery to remove your bladder
  • to control your cancer and help with symptoms if your cancer has spread (advanced or metastatic bladder cancer)

This page is about having radiotherapy as your main treatment, instead of surgery. Doctors sometimes call this radical radiotherapy. 

Having radiotherapy instead of surgery means that you don't need to have surgery to remove your bladder. This is sometimes called bladder sparing treatment. You usually have chemotherapy with the radiotherapy (chemoradiotherapy). This helps it work better.

But radiotherapy is not a suitable treatment for everyone. For example, doctors don't usually recommend it if you have:

  • squamous cell bladder cancer
  • carcinoma in situ (CIS) in much of the bladder lining as well as muscle invasive cancer
  • cancer that came back after chemotherapy
  • a blockage in the tubes that take urine from the kidneys into the bladder (ureters)

How you have it

You have radiotherapy treatment in the hospital radiotherapy department. You usually have it Monday to Friday and have a break at the weekends.

Radiotherapy treatment to try to cure bladder cancer can be quite long. It might take between 4 and 7 weeks. Your doctor can tell you how many radiotherapy treatments you need. 

You usually have radiotherapy as an outpatient, so you don't need to stay in hospital. You will have to travel to the hospital each time you have treatment. Some hospitals have rooms nearby where you can stay in if you have a long way to travel.

You go to the radiotherapy department from your ward if you are staying in hospital (inpatient).

Before each radiotherapy session, you’ll need to empty your bladder and bowel. You’ll have a medicine (enema) to insert into your bottom. It’s a good idea to stay close to a toilet once you have had this as you’ll need to use the toilet quite soon after.

With chemotherapy

You might have radiotherapy alone or in combination with chemotherapy. This is called chemoradiotherapy. You can also have chemotherapy before starting chemoradiotherapy.

The radiotherapy room

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 therapy radiographers Open a glossary item 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.

Photo of a linear accelerator

Before each treatment session

The radiographers help you to get onto the treatment couch. You might need to raise your arms over your head.

The radiographers line up the radiotherapy machine using the marks on your body. Once you are in the right position, they leave the room.

During the treatment

You need to lie very still. Your radiographers might take images (x-rays or scans) before your treatment 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.

You won't be radioactive

This type of radiotherapy won't make you radioactive. It's safe to be around other people, including pregnant women and children.

Travelling to radiotherapy appointments

You might have to travel a long way each day for your radiotherapy. This depends on where your nearest cancer centre is. This can make you very tired, especially if you have side effects from the treatment.

You can ask the therapy radiographers Open a glossary item for an appointment time to suit you. They will do their best, but some departments might be very busy. Some radiotherapy departments are open from 7 am till 9 pm.

Car parking can be difficult at hospitals. Ask the radiotherapy staff if you are able to get free parking or discounted parking. They may be able to give you tips on free places to park nearby.

Hospital transport may be available if you have no other way to get to the hospital. But it might not always be at convenient times. It is usually for people who struggle to use public transport or have any other illnesses or disabilities. You might need to arrange hospital transport yourself.

Some people are able to claim back a refund for healthcare travel costs. This is based on the type of appointment and whether you claim certain benefits. Ask the radiotherapy staff for more information about this and hospital transport.

Some hospitals have their own drivers and local charities might offer hospital transport. So do ask if any help is available in your area.

Side effects

Radiotherapy can cause side effects, these include tiredness and red and sore skin in the treatment area.

  • Radiotherapy dose fractionation (3rd Edition)
    The Royal College of Radiographers, 2019

  • Management of carcinoma in situ of the bladder: best practice and recent developments
    D H Tang and S S Chang
    Therapeutic Advances in Urology, 2015. Volume 7, Issue 6, Pages 351 – 364

  • Squamous cell carcinoma of the urinary bladder: Systematic review of clinical characteristics and therapeutic approaches
    J W Martin and Others
    Arab Journal of Urology, 2016. Volume 14, Issue 3, Pages 183 – 191

  • EAU Guideline on Muscle-invasive and Metastatic Bladder Cancer
    J A Witjes and others
    European Association of Urology, 2022

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact patientinformation@cancer.org.uk with details of the particular issue you are interested in if you need additional references for this information.

Last reviewed: 
01 Dec 2022
Next review due: 
01 Dec 2025

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