Radiotherapy can help relieve symptoms caused by cancer that has spread to the brain.
How radiotherapy can help
When cancer has spread to the brain from cancer elsewhere in the body, it is called a secondary brain tumour or a brain metastasis.
A cancer growing inside the brain increases pressure inside the skull. This can cause symptoms such as:
- a bad headache
- increasing drowsiness
Radiotherapy is the most common treatment for secondary brain tumours. It can shrink the cancer, relieve the pressure inside your skull, and so relieve your symptoms.
Your doctor might suggest that you have radiotherapy to the whole of your brain, as well as the obvious areas of cancer. This is because there are likely to be cancer cells in other parts of the brain that are too small to show up on a scan. Radiotherapy to the whole head may kill these small areas of cancer and stop them causing problems in the future.
How you have treatment
You have radiotherapy to the brain as a course of daily treatment sessions called fractions. How long the course lasts varies. But it is likely to be 1 to 2 weeks of daily treatments.
You have a specialised CT planning scan so the treatment team can plan exactly where to give the radiotherapy.
To have the treatment you lie on a radiotherapy couch. The radiographers help you to get into the right position. It is very important that you keep perfectly still. You might have a mask or shell to wear to help with this. While you are lying down, the mask fixes over your face and head and onto the radiotherapy couch. It makes sure that you don’t move in the middle of your treatment.
Daniel (radiographer): Before your treatment starts your doctor will need to work out exactly where the treatment needs to go and also which parts need to be avoided by the treatment.
To have radiotherapy you lie in the same position as you did for your planning scans.
To stop you moving and to make sure your treatment is directed at the cancer you wear a custom mask over your face which is attached to the couch.
We line up the machine using marks on your mask and then leave the room. We control the machine form a separate room this is so we aren’t exposed to radiation.
Treatment takes a few minutes and you’ll be able to talk to us using an intercom. We can see you and hear you while you’re having treatment and we will check that you’re OK.
When your treatment starts you won’t feel anything. You may hear the machine as it moves around you giving the treatment from different angles.
Because we’re aiming to give the same treatment to the same part of the body every day the treatment process is exactly the same everyday so you shouldn’t really notice any difference.
You’ll see someone from the team caring for you once a week while you’re having treatment. They’ll ask how you are and ask about any side effects.
The staff then leave the room. This is so they are not exposed to the radiation. You will be alone for a few minutes. The radiographers watch you carefully on a closed circuit television screen.
You can't feel the radiotherapy. It doesn’t hurt but you might find it uncomfortable to lie in position during the treatment. The radiotherapy couch can be quite hard. You can ask your doctor or specialist nurse if you can take a painkiller half an hour beforehand if you think it might help.
Some people with secondary brain cancers have stereotactic radiotherapy, which aims the radiotherapy beams at the areas of cancer. This is most likely if you have only one or two secondary tumours to treat in the brain.
Radiotherapy treatment to control symptoms of brain cancer may take a few days or weeks to work. The radiotherapy might cause a little swelling around the tumour at first, which may make your symptoms seem as though they are getting worse. You should then notice that your symptoms start to improve within a couple of weeks.
The radiotherapy might also help to stop new areas of cancer developing in the brain. So although you won't notice it, the treatment may be stopping the situation from getting worse.
Side effects of brain radiotherapy
Some or all of your hair might fall out if you have treatment to your brain.
You only get hair loss within the area treated with radiotherapy. It usually starts to grow back a few months after the treatment is over. This growth is sometimes patchy, particularly at first.
Your nurse can give you information about coping with hair loss and getting a wig before the treatment starts. There are also other ways of covering your head.
Radiotherapy to the head often makes people feel sick. You need anti sickness medicines to take every day before your treatment.
The treatment makes you increasingly drowsy as you go through the course. You might find it very hard to stay awake after a week or so. This drowsiness gradually goes within a few weeks of your treatment finishing.