Having radiotherapy for secondary breast cancer

Radiotherapy uses high energy x-rays to treat cancer cells. It can shrink the cancer, relieve symptoms, and help you feel more comfortable. 

Why you might have radiotherapy

You can have radiotherapy to different areas of the body at the same time.

Radiotherapy is helpful for treating breast cancer that has spread to:

  • one or more areas of bone
  • the skin
  • parts of the brain

You have your treatment in the hospital radiotherapy department, usually as an outpatient. You might have one treatment a day for a few days or over a couple of weeks. Each treatment is called a fraction and takes a few minutes.

Some hospitals have rooms nearby that 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.

External beam radiotherapy to the bones

You might have external beam radiotherapy Open a glossary item to areas of the bone where the breast cancer has spread. It can help strengthen the bone and relieve pain. You may not notice the benefit of the treatment straight away, as it can take some days for the treatment to work.

You may have some side effects. These side effects depend on which bones are treated, but they usually improve over time. 

Radiotherapy as an injection for cancer spread to the bones

Sometimes your breast cancer can spread into several places in the bones. If this happens, you may have strontium 89. This is to help to control the pain.

Strontium 89 (also called by its brand name Metastron) is a type of radiotherapy.

You have it as an injection into a vein. It circulates through your body and is taken up by the cancer cells in the bone.

The radiation from the injection is small. It isn’t dangerous to anyone else. But it can kill some of the cancer cells.  

Radiotherapy to treat spinal cord compression

You usually have radiotherapy if you have something called spinal cord compression. This happens when breast cancer spreads to the bones in the spine causing pressure on the spinal cord. 

Pain is often the first symptom, it could be anywhere in your back, spine, or neck. Radiotherapy reduces pressure on the spinal cord by targeting and destroying the cancer cells. 

Other symptoms include:

  • weakness in your legs or arms
  • difficulty walking
  • difficulty controlling your bladder or bowel
This can be serious and needs urgent medical attention. It is important to speak to your doctor or phone your advice helpline straight away if you have symptoms.

Radiotherapy to the brain

Breast cancer can sometimes spread to the brain. You may have radiotherapy to the brain to help relieve any symptoms you have. Your doctor will explain more about your treatment and what this will involve. 

It is usual to have some side effects after treatment, these can include feeling weak and sick. 

Radiotherapy to the skin

Sometimes breast cancer cells can start growing in the skin. They may start to grow on, or near the scar after an operation to remove the primary cancer. Or they can grow in other parts of the body. This is called secondary or metastatic cancer.  

The skin may become itchy, red, and painful. 

Radiotherapy can help to reduce the pain and improve your symptoms. 

Planning radiotherapy

Before you start radiotherapy treatment you have an appointment to plan your treatment.

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 session

The radiographers help you to get onto the treatment couch. You might need to raise your arms over your head. If you're having radiotherapy to the brain, you'll wear a mask or head frame to keep your head still.

The room is darkened and the radiographers line you up in the radiotherapy machine using laser lights. You will hear them saying measurements to each other to get you in the right position. 

Then they leave you alone in the room for a few minutes.

During the treatment

You need to lie very still. 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.

Breathing technique

You might need to hold your breath at times during the treatment if you have radiotherapy to your left breast. This is to protect your heart from the radiotherapy.

The radiographer talks to you over a speaker. They tell you when to hold your breath. It could last between 2 to 17 seconds. This technique is called deep inspiration breath hold (DIBH).

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. This depends 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. Ask the radiotherapy staff if you are able to get free parking or 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 for secondary breast cancer can make you tired. It can also make your skin in the treatment area red and sore. You can also have other side effects depending on the area of your body having treatment. 

Last reviewed: 
15 Mar 2021
Next review due: 
15 Mar 2024
  • Advanced breast cancer: diagnosis and treatment
    National Institute for Health and Care Excellence (NICE), 2009 (updated 2017)

  • 4th ESO–ESMO International Consensus Guidelines for Advanced Breast Cancer

    F Cardoso and others

    Annals of Oncology, 2018. Volume 29, Pages 1634–1657

  • SEOM clinical guidelines in advanced and recurrent breast cancer 

    J Chacón López-Muñiz and Others

    Clinical & Translational Oncology 2019. Volume 21, Issue 1, Pages 31–45

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