Having radiotherapy for bladder cancer

What is radiotherapy?

Radiotherapy uses high energy x-rays to treat cancer cells.

You have radiotherapy in a hospital radiotherapy department. You usually have it as an outpatient each weekday over 4 to 7 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.

Find out more about 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. 

Read about having radiotherapy for cancer that has spread (metastatic bladder cancer)

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.

See how you have chemoradiotherapy for bladder cancer

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 radiographers 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.

Before each treatment session

You may need to wear a hospital gown and remove certain clothing. The radiographers will talk you through this. Then the radiographers help you to get onto the treatment couch. They will get you into the same position as you were for your planning scan. 

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. This is 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. 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

Side effects

Radiotherapy can cause side effects. These include:

• tiredness

• red, sore skin in the pelvis area

• feeling or being sick

• changes to your bowel movements, such as loose stools or needing to go urgently

• bladder irritation which can cause wanting to pass urine all the time, but when you go you pass very little and feeling a burning pain

Most of these side effects can be managed easily. Let your radiotherapy team know if you feel different and they can give you support. 

Find out more about the possible side effects of radiotherapy