Radiotherapy to the brain

Radiotherapy uses radiation, usually x-rays, to destroy cancer cells.

You might have radiotherapy to treat leukaemia cells that have spread to the brain or spinal cord. It is not common for leukaemia to spread in this way and chemotherapy is a more commonly used treatment.

Before treatment

Before your radiotherapy you have a planning session and a planning CT scan. You often also have a mask made that keeps your head very still.

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 able to 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

Your radiographers help you to get into position on the radiotherapy table. If you need to wear a mask for your radiotherapy, they will position the mask over your face and attach it to the table. The mask keeps your head completely still while you have treatment.

The room is darkened and your radiographers line you up in the radiotherapy machine using laser lights and the marks on the mask or your skin. You will hear them saying measurements to each other to get you in the right position. They then leave you alone in the room for a few minutes.

During the treatment

You need to lie very still on your back. 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, depending 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 7am till 9pm.

Car parking can be difficult at hospitals. You can ask the radiotherapy staff if they can give you a hospital parking permit for free parking or advice on discounted parking. They may be able to give you tips on free places to park nearby.

The radiotherapy staff may be able to arrange transport if you have no other way to get to the hospital. Your radiotherapy doctor would have to agree. This is because it is only for people that would struggle using public transport and have no access to a car. 

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.

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

You will have some side effects during treatment and for a few weeks afterwards. These include:

You might feel sick at times. Your treatment team will give you anti sickness medicines. Let them know if you still feel sick, as they can give you other medicines. 

Radiotherapy to the brain can make you feel very tired. The tiredness usually comes on gradually as you go through your treatment. By the end of the course of treatment you may feel very tired.

The tiredness usually carries on for about 6 to 8 weeks and then starts to get better.

In a few people, the tiredness can become very severe a few weeks after the end of treatment. You might also feel drowsy and irritable. This is a rare side effect and is called somnolence syndrome. It doesn't need treatment and gets better on its own over a few weeks.

It is important to rest or sleep when you need to. But it is likely to help if you can get some regular exercise. A daily walk is good if you are able to do that.

The radiotherapy can make your hair fall out in the treatment area. You might have already lost your hair due to chemotherapy. Your radiographers will advise you to moisturise the skin each day and will let you know which creams to use. 

You will need to keep your head covered if you are out in the sun because the skin will be more sensitive.

Your hair usually grows back after the treatment ends but it might be patchy.

Possible long term side effects

Some people have long term side effects. These can include:

The lens inside your eye can cloud over so that you can’t see very well. This is called a cataract. If you do get cataracts, they can be treated with simple surgery. Doctors take out the clouded lens and put a false one in its place.

The skin on your head will always be more sensitive to the sun so always wear a hat in sunny weather. 

Last reviewed: 
11 May 2020
Next review due: 
11 May 2023
  • Perez and Brady's Principles and Practice of Radiation Oncology
    EC Halperin, CA Perez and LW Brady
    Lippincott Williams & Wilkins, 2008

  • Cancer: Principles and Practice of Oncology (10th edition)
    De Vita VT, Lawrence TS and Rosenberg SA.
    Lippincott, Williams and Wilkins, 2015

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