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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
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Radiotherapy| treats cancer cells by using high-energy rays to destroy the cancer cells while doing as little harm as possible to normal cells. It's usually given using beams delivered from outside the body (external radiotherapy).
Radiotherapy is often used after surgery| to treat any cancer cells that may have been left behind. It can also be given to treat secondary brain tumours, or when a primary brain tumour can’t be removed or has come back after surgery. Radiotherapy may sometimes be given along with chemotherapy |tablets to treat high-grade gliomas|.
Radiotherapy is given in the hospital radiotherapy department. It's usually given as a series of short, daily sessions from Monday to Friday, with a rest at the weekend. The length of your treatment will depend on the type and size of brain tumour, but it is usually 2–6 weeks. Some people will have different treatment plans and may have treatment on only three days a week. Your doctor will discuss your treatment plan with you beforehand.
You may need to wear a radiotherapy mask| that covers the whole of your face and front of your head. This mask is usually made from perspex (a type of plastic) or from a type of mesh plastic, which is moulded to fit the shape of your face.
A radiotherapy mask keeps your head as still as possible during treatment. This is to make sure that exactly the right area is treated. Your mask will be made before your treatment is planned. It allows you to see and breathe normally but it may make some people feel claustrophobic. You will only have it on for a few minutes at a time and most people soon get used to it.
For secondary brain tumours and some high-grade tumours, a smaller dose of radiotherapy is given to the whole head, so a mask may not be needed.
A radiotherapy mask being used during treatment
Radiotherapy has to be carefully planned to make sure that it's as effective as possible. This is done using a CT scanner (sometimes called a CT simulator), which takes CT scans of the area to be treated. These CT scans provide lots of images from different angles to build up a three-dimensional picture of the area to be treated.
At the same time, therapy radiographers will take measurements from you which are needed for treatment planning. The radiographer's measurements and the information from the scans are fed into the radiotherapy planning computer to help your doctors plan your treatment more precisely.
Treatment planning is a very important part of radiotherapy and it may take a few visits before the clinical oncologist (the doctor who plans and supervises your treatment) is satisfied with the result.
Before each session of radiotherapy the radiographer, who gives you your treatment, will position you carefully on the couch and make sure you are comfortable.
During your treatment, which will only take a few minutes, you'll be left alone in the room but you can talk to the radiographer, who will watch you carefully from the next room. Radiotherapy is not painful but you do have to be still for a few minutes during treatment.
These types of radiotherapy enable doctors to direct radiation more accurately at brain tumours. The aim is to deliver higher doses of radiotherapy to the tumour while doing as little harm as possible to surrounding brain tissue and to minimise the side effects of treatment. It is sometimes given after standard external radiotherapy or to treat small tumours that cannot be removed with surgery.
This type of radiotherapy gives the treatment from a standard radiotherapy machine which has been adapted. The machine gives concentrated beams of radiation from several different angles which overlap at the brain tumour. This is done either by moving the machine during treatment or by aiming individual beams from a number of different directions.
The radiotherapy dose to the tumour is very high and the dose to surrounding healthy tissues is very low. Several doses are given.
Before treatment, several scans of the brain are taken. These scans are then analysed by computers to ensure that the radiotherapy is precisely targeted to the brain tumour. A special head frame will be made for you before you start treatment. This frame helps to keep your head still while having the radiotherapy.
This treatment is only available in specialist hospitals and is not suitable for everyone with a brain tumour. You could ask your clinical oncologist whether it would be appropriate in your particular situation.
This is a type of stereotactic radiotherapy. It's sometimes called gamma knife treatment, named after onr of the machines that can be used to give this treatment. Unlike stereotactic radiotherapy, sterotactic radiosurgery is given over one session, as a single-dose treatment, taking about 4-5 hours.
It does not use a knife, but uses targeted beams of gamma radiotherapy given from many different angles, which cross at the point of the tumour. You will have several scans and x-rays to find the precise area for the treatment to be given. A special head frame will be made for you before your start treatment. Thos frame helps to keep your head still while having the radiosurgery.
Again, this treatment is only available in specialist hospitals and is not suitable for everyone with a brain tumour. It may be helpful to discuss with your clinical oncologist whether it's a suitable treatment for you.
Side effects can be mild or more troublesome depending on the amount of radiotherapy given and the length of your treatment. Radiotherapy can cause general side effects such as tiredness|, headaches, hair loss| and feeling sick (nausea).|
As radiotherapy often makes you feel tired, try to get as much rest as you can, especially if you have to travel a long way for treatment each day.
Our section on fatigue| has helpful tips on ways of saving energy and dealing with tiredness.
Some people have headaches while they are having their radiotherapy. These can be controlled with painkillers and sometimes steroids which will be prescribed by your doctors.
You will lose hair within the area treated. Most hair loss is temporary but, unfortunately, it may be permanent for some people. This will depend on the dose of treatment you have had. Sometimes hair grows back with a slightly different colour and texture and perhaps not as thickly as before. It usually starts to grow back within 2–3 months of finishing treatment.
Some people develop a skin reaction, similar to sunburn, while having radiotherapy. This normally happens 3–4 weeks after the start of treatment. People with pale skin may find that the skin in the treatment area becomes red and sore or itchy. People with darker skin may find that their skin becomes darker and can have a blue or black tinge. The amount of the reaction depends on the area being treated and the individual person’s skin. Some people have no skin problems at all.
Your radiographers will be looking for these reactions but you should also let them know if you feel any soreness.
Staff at the radiotherapy department will be able to give you advice on skin care. As the skin is sensitive it is best not to over-expose it to the sun or cold winds. Try wearing a soft cotton or silk scarf or hat to cover the area when you go outside.
Four to eight weeks after finishing after radiotherapy, you may find that you generally slow down, have very little energy and feel much less active. You may also feel drowsy and spend more time sleeping. It gradually gets better over a few weeks.
Occasionally some people may feel sick but this can usually be treated effectively by anti-sickness drugs (called anti-emetics), which your doctor can prescribe. You may also find that food tastes different and you may have a metallic taste in your mouth. If you don’t feel like eating, you can replace meals with nutritious, high-calorie drinks. These are available from most chemists and can also be prescribed by your GP.
We have more information and helpful tips on how to cope with different eating problems in our diet and cancer| section.
Some people find the symptoms of the brain tumour temporarily get worse after the treatment has finished. This can make them think their tumour is getting worse. In fact it is either a reaction to the radiotherapy treatment or may be because steroid treatment has been reduced or stopped.
If you find this happening to you it's important to discuss it with your doctor or nurse, who'll be able to provide the right treatment and support.
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.