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Radiotherapy for bone cancer

Radiotherapy uses high energy waves to treat cancer. You may have it to shrink bone cancer before surgery, and to lower the risk of it coming back afterwards. Doctors also use radiotherapy to treat bone cancers that cannot be removed because of their location in the body.

It can slow tumour growth and control the symptoms of advanced cancers (palliative radiotherapy).

Having your radiotherapy

You have this treatment in the radiotherapy department at your cancer centre. You usually have treatment every day from Monday to Friday, with a break at weekends. A course of treatment can last for a few days or a few weeks. Each treatment takes only a few minutes.

Palliative radiotherapy is usually given in 1 to 5 treatment sessions.

What are the side effects?

Radiotherapy usually causes tiredness, reddening of the skin in the treatment area, and loss of hair in the treatment area. Other side effects depend on which part of your body is being treated. Palliative radiotherapy does not usually cause many side effects.


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Radiotherapy for primary bone cancer

Radiotherapy uses high energy X-rays to treat cancer. For primary bone cancer, you may have radiotherapy to

  • Treat a bone cancer that cannot be removed because of its position in your body
  • Shrink Ewing's sarcoma before surgery
  • Lower the risk of the cancer coming back after surgery
  • Shrink bone cancers that are not responding well to chemotherapy

If a bone cancer grows in the central area of the body, it may not be possible to remove it completely. You may have treatment with a combination of surgery and radiotherapy or with radiotherapy alone.

Shrinking a cancer with radiotherapy before surgery can make it easier to remove. You may be able to have a smaller operation. If your doctors think there is a risk that cancer cells may have been left behind after your operation, they may recommend radiotherapy to kill off any remaining cancer cells.

If your cancer has spread or come back after it was first treated, it may not be possible to get rid of it completely. But it may be possible for your doctor to control the growth of the cancer for a while with radiotherapy and chemotherapy.

You may have palliative radiotherapy to

  • Shrink secondary cancers
  • Try to control the growth of advanced cancer
  • Relieve symptoms the bone cancer is causing.

A growing cancer can cause symptoms by pressing on nerves and other body tissues. Secondary bone cancers can be painful. Fortunately, radiotherapy can often shrink them and so relieve the pressure. Radiotherapy can help to strengthen bones weakened by cancer. After the treatment has killed off the cancer cells, the holes in the bone caused by the cancer are repaired by the osteoblasts – the cells in the bones that make the bone framework.


When and where you have treatment

You have radiotherapy treatment in the hospital radiotherapy department at your cancer centre. You cannot have all the radiation you need to kill your cancer in one go. That would cause too many side effects and too much damage to normal body tissue. You have the treatment broken up into a course of smaller dose treatments called fractions. You usually have a fraction every day, from Monday to Friday, with a rest at the weekend.

Most commonly, you have radiotherapy once daily, for a few weeks or days. For Ewing's sarcoma you might have a course of radiotherapy and a course of chemotherapy at the same time. This is sometimes called concurrent chemoradiotherapy. With this type of treatment, you may have radiotherapy treatments twice a day. This is called hyperfractionated radiotherapy. So you might have radiotherapy twice a day for the first two weeks. Then a week with no radiotherapy. And then another 7 days of radiotherapy starting with the next cycle of chemotherapy.

Radiotherapy doses are measured in Grays. It is usually written Gy. For example, a treatment fraction of 2Gy every day for 30 treatments would give a total dose of 60Gy


Planning radiotherapy

Radiotherapy has to be carefully planned. At your first visit you will lie under a special CT scanner or a large machine called a simulator. The doctor uses this to work out where to give your treatment to kill the most cancer cells and miss as much healthy body tissue as possible. A pinprick tattoo is made on your skin and this is used to line up the radiotherapy machine every day when you have your treatment. Sometimes more marks are made with felt pen. Be careful not to wash them off and tell your radiographer if they are becoming fainter – they can draw them in again for you – it is important that you don't do this yourself!


Having your treatment

Image of someone having radiotherapy

Each treatment only takes a few minutes but it may take 10 to 15 minutes to position you and the radiotherapy machine. The radiographer will help position you on the couch and make sure you are comfortable. You will be left alone for the minute or two the machine is switched on. But the staff will be able to hear and see you through an intercom, so call if you need them. The treatment does not hurt. You will not be able to feel it at all. You must lie very still for the few minutes it takes to treat you.

Having external radiotherapy does not make you radioactive. It is perfectly safe to be with other people, including children, throughout your treatment course.

There is more information about having external radiotherapy in the main radiotherapy section.


Possible side effects

Radiotherapy has general side effects. It usually causes

  • Tiredness
  • Reddening of the skin in the treatment area
  • Loss of any body hair in the treatment area

Radiotherapy can cause tiredness for many people. The tiredness wears off over the few weeks following your treatment. Other side effects depend on which part of your body is being treated. For example, you may feel sick and lose your appetite if the area being treated is anywhere near your stomach. We have detailed information about radiotherapy side effects for different areas of the body


General information about radiotherapy

Look at the main radiotherapy section. It tells you more about this type of treatment including

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Updated: 29 May 2013