Decorative image

Radiotherapy to the brain

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

For small cell lung cancer, doctors sometimes use radiotherapy to the brain to kill any cancer cells that might have spread into the brain but are too small to see.

You usually have 5 to 10 treatments over one week.

Before treatment

Before your radiotherapy you have a planning session and a planning CT scan.

Photo of a CT scanner

The planning session takes between 15 minutes and 2 hours.

You also have a mask (shell) made that keeps your head very still.

Making the mask

Your radiographer or technician makes your mask in the radiotherapy department. They might call the mask a radiotherapy shell.

The mask covers your face, and the top and sides of your head. It attaches to the couch when you are lying down for the planning scan or radiotherapy treatment.

The process of making the mask can vary slightly between hospitals. It usually takes around 30 minutes.

Before making the mask

You need to wear clothes that you can easily take off from your neck and chest. You also need to take off any jewellery from that area.

Facial hair, long hair or dreadlocks can make it difficult to mould the mask. Your radiotherapy team will tell you if you need to shave or tie your hair back.

Making the mask

The technician uses a special kind of plastic that they heat in warm water. This makes it soft and pliable. They put the plastic on to your face so that it moulds exactly. It feels a little like a warm flannel and is a mesh with holes in so you can breathe.

After a few minutes the mesh gets hard. The technician takes the mask off and it cools down. You might need to have one more fitting to make sure it is exactly right.

You wear the mask for your planning CT scan. Your radiotherapy team keep the mask in the department for when you go back for treatment. You wear it for each treatment session.

Photograph of a stereotactic radiotherapy mask for treating brain, head and neck cancers

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. 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. You can signal to them with your hand if you need to move or want the machine to stop.

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 of radiotherapy to the brain

Radiotherapy to the brain can cause side effects. Let your doctor, nurse or radiographer know about any side effects that you have. Then they can find ways to help you.

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.

You might feel sick at times. You can have anti sickness medicines. Let your treatment team know if you still feel sick, as they can give you another type.   

Tell your doctor or nurse if you keep getting headaches. They can give you painkillers to help.

Your skin will always be more sensitive to the sun after treatment. If you have no hair, remember to keep your head covered or wear a hat if you go outside. Or you need to wear a complete sun block.