Radiotherapy is a common treatment for brain tumours. Find out what happens during and after your radiotherapy.
Radiotherapy means the use of radiation, usually x-rays, to treat cancer cells.
When you have it
Radiotherapy might be your main treatment if you have a brain tumour that your surgeon cannot remove.
Or you may have radiotherapy after surgery to:
- treat any tumour that your surgeon couldn't remove
- try to lower the risk of the brain tumour coming back in the future
How often you have radiotherapy
You are most likely to have radiotherapy for a brain tumour as a series of treatments for 3 to 7 weeks.
You usually have one treatment a day, from Monday to Friday. Or you might have treatment twice a day for some types of tumour.
You might have radiotherapy to help with symptoms or slow down the growth of your tumour. This is called palliative radiotherapy and is usually a shorter course of treatment. For example, over about 2 weeks.
Types of radiotherapy
You usually have external beam radiotherapy to treat brain tumours. External radiotherapy destroys cancer cells using radiation aimed at a cancer from a machine. The most common type of radiotherapy machine is called a linear accelerator machine (LINAC). This uses electricity to create the radiotherapy beams.
You might have a type of external beam radiotherapy called stereotactic radiotherapy. It uses the LINAC machine. This treatment gives high doses of radiotherapy to the area of the tumour and can treat some small tumours in certain areas of the brain.
Treatment is usually divided into daily doses called fractions. The number of fractions can vary from 3 to 30 fractions, depending on a person's situation.
Or some people have radiosurgery. This is very high dose stereotactic radiotherapy over a shorter period of time. For example, you might have a single treatment, or up to 5 treatments.
Before your radiotherapy treatment
Your head needs to be kept as still as possible during radiotherapy. This is called immobilisation. So before your treatment you have a plastic mask made. Or you might have a head frame fitted. The type of immobilisation you have depends on the type of radiotherapy you have.
The mask is made to mould the shape of your face. It covers the whole of your face and the front of your head. The mask in turn attaches to the scanner or radiotherapy machine bed while you are wearing it. This means that you can't move, but there is nothing actually attached to you directly.
The head frame is attached to your skull using 4 pins. Before they attach the frame, you have 4 injections of local anaesthetic at the points where the frame is attached to your head. Your head frame is then fixed into the radiotherapy machine while you are lying on the treatment couch.
Before treatment you also have a planning CT scan.
The radiotherapy room
Radiotherapy machines are very big. They usually rotate around you to give your treatment. The machine does not touch you at any point.
Before you start your course of treatment your radiographers explain what you'll see and hear. In some departments the treatment rooms have docks for you to plug in your music player. So you can listen to your own music.
During your treatment
To have treatment you lie on the treatment table. The radiographer attaches your mask or head into the scanner or radiotherapy machine. They leave the room before your treatment starts.
You need to lie very still. The machine makes whirring and beeping sounds. You can't feel the radiotherapy when you have the treatment.
Your radiographers watch and listen to you on a CCTV screen in the next room. Tell them if you need to move or want the machine to stop.
There may be a small delay while the radiographers take pictures of the tumour and compare them to your planning CT scan. The couch might move as they adjust your position.
Daniel (radiographer): Before your treatment starts your doctor will need to work out exactly where the treatment needs to go and also which parts need to be avoided by the treatment.
To have radiotherapy you lie in the same position as you did for your planning scans.
To stop you moving and to make sure your treatment is directed at the cancer you wear a custom mask over your face which is attached to the couch.
We line up the machine using marks on your mask and then leave the room. We control the machine form a separate room this is so we aren’t exposed to radiation.
Treatment takes a few minutes and you’ll be able to talk to us using an intercom. We can see you and hear you while you’re having treatment and we will check that you’re OK.
When your treatment starts you won’t feel anything. You may hear the machine as it moves around you giving the treatment from different angles.
Because we’re aiming to give the same treatment to the same part of the body every day the treatment process is exactly the same everyday so you shouldn’t really notice any difference.
You’ll see someone from the team caring for you once a week while you’re having treatment. They’ll ask how you are and ask about any side effects.
You won't be radioactive
External radiotherapy does not make you radioactive. It's safe to be with other people throughout your course of treatment, including pregnant women and children.
Travelling to radiotherapy appointments
Tell the radiotherapy department staff if you prefer treatment at a particular time of day. They can try to arrange this.
Car parking can be difficult at hospitals. It’s worth asking the radiotherapy unit staff:
- if they can give you a hospital parking permit
- about discounted parking rates
- where you can get help with travel fares
- for tips on free places to park nearby
If you have no other way to get to the hospital, the radiotherapy staff might be able to arrange transport for you. But it might not always be at convenient times. Some hospitals have their own drivers or can arrange ambulances. Some charities offer hospital transport.
Radiotherapy for a brain tumour can make you feel tired. There are other possible side effects.