Having radiotherapy for bladder cancer

Radiotherapy uses high energy x-rays to kill bladder cancer cells. You might have it as part of your treatment for invasive bladder cancer. 

When do you have it?

You might have radiotherapy:

  • as your main treatment instead of surgery
  • if your bladder cancer has spread (advanced bladder cancer)

You have radiotherapy on its own or combined with chemotherapy (chemoradiotherapy).

Having radiotherapy instead of surgery means that you don't need to have surgery to remove your bladder.

But radiotherapy is not usually recommended if you have:

  • squamous cell bladder cancer
  • carcinoma in situ (CIS) in much of the bladder lining as well as 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.

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

During the treatment

You need to lie very still on your back, in the same position as you were when you had your planning scan.

The room will be dark while the radiographer gets you into position. You will hear them saying measurements to each other to get you in the right position.

They make sure that you're in the same position each day by lining you up with the lasers in the treatment room.

When finished your radiographer leaves to operate the machine in the next room. They can see and hear you on a CCTV screen. You can talk to each other over an intercom. Tell them or put your hand up if you need to stop or if you're uncomfortable. Keep as still as possible.

They first take some x-ray pictures to make sure you're in the correct position. Once checked they start your treatment. 

The machine makes a whirring and buzzing sound. You won’t see or feel anything during the treatment.

Each radiotherapy treatment takes between 15 to 30 minutes.

After treatment

When finished the radiographers will come back into the room. You can get off the treatment couch and you can go home or back to the ward.

They will tell you of any special care that you should take, or of any side effects that you can expect.

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

Radiotherapy can cause side effects, these include tiredness and red and sore skin in the treatment area.

Last reviewed: 
21 Jun 2019
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    The Royal College of Radiographers, 2016.

  • London Cancer. Clinical Radiotherapy Guidelines for Carcinoma of the Bladder
    London Cancer North and East, 2014

  • Management of carcinoma in situ of the bladder: best practice and recent developments
    D H Tang and S S Chang
    Therapeutic Advances in Urology, 2015. Volume 7, Issue 6, Pages 351 – 364

  • UpToDate
    Accessed October 2018

  • Squamous cell carcinoma of the urinary bladder: Systematic review of clinical characteristics and therapeutic approaches
    J W Martin and Others
    Arab Journal of Urology, 2016. Volume 14, Issue 3, Pages 183 – 191

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact patientinformation@cancer.org.uk with details of the particular issue you are interested in if you need additional references for this information.

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