Radiotherapy for kidney cancer

Radiotherapy uses high energy X-rays to kill cancer cells. Radiotherapy is not used often for cancer of the kidney because kidney cancer cells are not as sensitive to radiation as some other types of cancer.

Your doctor may suggest radiotherapy to help control the symptoms of an advanced cancer, such as pain or bleeding into the urine. It can shrink a large cancer and relieve pressure on nearby organs or nerves that may be causing pain. Doctors also use it to treat kidney cancer that has spread to the brain.

You have radiotherapy treatment in the hospital radiotherapy department as an outpatient. You usually have radiotherapy as a series of daily treatments, called fractions.

You often have radiotherapy for symptoms as a small number of treatment fractions, so that you only have to go to the hospital a few times. You may have one treatment a day for a few days. Or you may have a few treatments with a few days break between each. In most centres you have radiotherapy daily, from Monday to Friday, with a break from treatment at weekends.

Radiotherapy is carefully planned. At your first visit you will usually have a CT scan or will be asked to lie under 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. The radiographers use this to line up the radiotherapy machine every day when you have your treatment. Sometimes more marks are made with felt pen. If so, you need to be careful not to wash them off.

The actual treatment only takes a few minutes. 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 you through an intercom, so call if you need them. Below is a picture showing how radiographers can see you on monitors while you have your treatment.

The treatment does not hurt. You won't be able to feel it at all. You must lie very still for the few minutes it takes to treat you. And remember, having external radiotherapy does not make you radioactive. It is perfectly safe to be with other people, including children, throughout your treatment course.

Side effects

The side effects of radiotherapy depend on which part of the body is being treated. The side effects of treatment to the kidney are

• Feeling or being sick
• Diarrhoea
• Reddening of the skin in the treatment area
• Loss of any body hair in the treatment area

You may not have many side effects from your treatment for kidney cancer. If you feel sick, you can have anti sickness medicines to stop it. Radiotherapy can cause tiredness for many people. The tiredness wears off over the few weeks following your treatment. There is information about the side effects of radiotherapy to the abdomen in the radiotherapy section.

This treatment can be very successful at controlling symptoms and slowing down the growth of the cancer. You can have it in a number of different ways. How you have it depends mostly on the size and number of areas of cancer spread in your brain. If only one area is affected, your doctor may recommend stereotactic radiotherapy.

If the cancer affects part of your brain, you will most likely have about 10 separate treatments (fractions). You have this treatment daily, from Monday to Friday, so the complete radiotherapy course takes 2 weeks.

If large areas of your brain are affected by cancer, or your specialist thinks that cancer cells could be there but are too small to show on a scan, you may have whole brain radiotherapy. You usually have this in about 5 treatments (fractions), which takes a week.

This is quite a new technique for treating small areas of the brain with high doses of radiation. It is a very specialised treatment and is mainly available in large treatment centres. The aim of the treatment is to get rid of the cancer in your brain altogether.

Stereotactic treatment has to be given very precisely. Only the area of the cancer receives the high doses of radiation. To make sure of this, you may be fitted with a metal head frame. This is attached to your skull to make sure your head is in exactly the right place for the treatment. It also makes sure that your head cannot move while the treatment is being given. 

You don't have to wear the head frame for long. It is uncomfortable when it is in place, but should not be painful. Some radiotherapy centres don't use the head frame. They use a plate that you bite on instead. You usually have this radiotherapy as a single treatment. You may hear it called radiosurgery, or gamma knife treatment. Gamma knife is the name of one type of machine used to give this treatment.

The main radiotherapy section has detailed information about this type of treatment including

• What radiotherapy is
• How your radiotherapy is planned
• Possible side effects
• Radiotherapy to treat symptoms (palliative radiotherapy)