Having radiotherapy to the brain (prophylactic cranial irradiation)

You usually have a planning CT scan in the radiotherapy department.

The scan shows the cancer and the area around it. You might have other types of scans or x-rays to help your treatment team plan your radiotherapy. The plan they create is just for you.

Your radiographers tell you what is going to happen. They help you into position on the scan couch. You might have a type of firm cushion called a vacbag to help you keep still.

The CT scanner couch is the same type of bed that you lie on for your treatment sessions. You need to lie very still. Tell your radiographers if you aren't comfortable.

Injection of dye

You might need an injection of contrast into a vein in your hand. This is a dye that helps body tissues show up more clearly on the scan.

Before you have the contrast, your radiographer asks you about any medical conditions or allergies. Some people are allergic to the contrast.

Having the scan

Once you are in position your radiographers put some markers on your skin. They move the couch up and through the scanner. They then leave the room and the scan starts.

The scan takes about 5 minutes. You won't feel anything. Your radiographers can see and hear you from the CT control area where they operate the scanner.

You might need to have a radiotherapy mask or mould made before you start treatment. They can also be called shells.

They keep the treatment area of your body still each time you have your radiotherapy. This is so your treatment is as accurate as possible.

You can see through most types of masks or moulds, as they usually have lots of small holes. Your radiographers might make marks on them. They use the marks to accurately line up the radiotherapy machine for each treatment. It is important that you are in exactly the same position each time.

It takes between 10 to 45 minutes to make a mask or mould.

Before making the mask

The mask is normally made directly against your skin. It's helpful to wear clothing that you can easily take off. You also need to take off any jewellery from that area.

Having a lot of facial hair can make it difficult to make a head and neck mask. The radiotherapy staff will advise you about any hair issues at your planning session.

Making the mask

A mould technician or radiographer makes the mask in the mould room of the radiotherapy department or during your CT planning scan.

The process of making a mask can vary slightly between hospitals. Most often they use a special kind of plastic heated in warm water or an oven so that it becomes soft and pliable. Your technician puts the plastic mesh on to your face so that it moulds to fit your face exactly. It feels a little like having a warm flannel put onto your face. You can still breathe easily, as the plastic has lots of holes in it.

After a few minutes the plastic mesh becomes hard. Your technician takes the mask off. It is then ready for use.

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.

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 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.

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 your radiographers 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 7 am till 9 pm.

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.

Hospital transport may be available if you have no other way to get to the hospital. But it might not always be at convenient times. It is usually for people who struggle to use public transport. Or who have any other illnesses or disabilities. You might need to arrange hospital transport yourself.

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 and hospital transport.

Some hospitals have their own drivers and local charities might offer hospital transport. So do ask if any help is available in your area.