Radiotherapy for invasive and advanced bladder cancer

Radiotherapy uses high-energy rays to destroy cancer cells. You may be given it to try to cure bladder cancer (radical radiotherapy) or to relieve symptoms (palliative radiotherapy).

If the cancer hasn’t spread outside the pelvis, you may have radiotherapy to try to cure the cancer. You will usually have radiotherapy with another treatment. You may have it with chemotherapy, which makes the cells more sensitive to radiotherapy. This is called chemoradiation. Some people have treatment with a gas called carbogen and tablets called nicotinamide.

Radiotherapy is carefully planned. You will have small, permanent marks made on your skin to show where the rays will be directed. You will usually have radiotherapy as an outpatient. Treatments are usually 10 to 15 minutes and are given Monday to Friday. Your doctor or nurse will explain which type of radiotherapy you will have and the possible side effects.

If the cancer has spread to other parts of the body, your doctors may suggest you have radiotherapy to help control symptoms. Usually, you will have only one to five treatments. Side effects are usually mild.

Radiotherapy

Radiotherapy treats cancer by using high-energy rays to destroy the cancer cells while doing as little harm as possible to normal cells. It is given using equipment similar to a large x-ray machine.

You can be given radiotherapy to try to cure bladder cancer (radical radiotherapy) or to relieve symptoms (palliative radiotherapy).

We have lots of information about radiotherapy. We also have a video that explains the treatment and the radiotherapy machine.

Radiotherapy explained

Consultant Clinical Oncologist Vincent Khoo describes external beam radiotherapy, how it works, and what it involves.

Information about our videos

Radiotherapy explained

Consultant Clinical Oncologist Vincent Khoo describes external beam radiotherapy, how it works, and what it involves.

Information about our videos


Radiotherapy to cure the cancer (radical radiotherapy)

If the cancer has not spread outside of the pelvis, you may be offered radiotherapy to try to cure the cancer. Having radiotherapy instead of surgery means you’ll still have your bladder.

Having other treatment with radiotherapy

Usually, you have other treatment with radiotherapy to help make it work better. This may be chemotherapy with the drugs mitomycin and 5FU. Chemotherapy makes the cancer cells more sensitive to the effects of radiotherapy. You usually have chemotherapy every day (Monday to Friday) in the first and fourth week of your radiotherapy. When chemotherapy is given with radiotherapy, it is called chemoradiation.

Instead of chemotherapy, some people have treatment with a gas called carbogen and tablets called nicotinamide. You breathe in carbogen for a few minutes before and during your radiotherapy. Nicotinamide tablets increase the supply of oxygen to the cancer cells. You take them before radiotherapy.

You may also have chemotherapy before your radiotherapy. This is to shrink the cancer and reduce the risk of it coming back after treatment.


How radiotherapy is given

Radiotherapy is given in the hospital radiotherapy department as a series of short daily treatments. You can usually have it as an outpatient. Each treatment takes 10 to 15 minutes.

The treatments are usually given Monday to Friday, with a rest at the weekend. A course of radiotherapy for bladder cancer may last for 4 to 7 weeks. Your doctor or nurse will tell you what to expect and explain the possible side effects. There are different ways of giving radiotherapy to treat bladder cancer:

  • Image guided radiotherapy (IGRT) uses a radiotherapy machine that takes x-ray images of the bladder. This means that the radiotherapy treatment can be adjusted to the precise size and position of the bladder. It makes the treatment very accurate.
  • Intensity modulated radiotherapy (IMRT) shapes the radiotherapy beams, allowing different doses of radiotherapy to be given to different parts of the bladder. It may be helpful for people who have large bladder tumours or if the cancer has spread to the lymph nodes in the pelvis.

Your radiotherapy team can tell you more about IGRT and IMRT. There is also more information about these treatments in our section about radiotherapy.


Planning your radiotherapy

Radiotherapy has to be carefully planned to make sure it’s as effective as possible. It’s planned by a cancer specialist (clinical oncologist) and it may take a few visits.

On your first visit to the radiotherapy department, you’ll be asked to have a CT scan or lie under a machine called a simulator, which takes x-rays of the area to be treated.

You may need some small marks made on your skin to help the radiographer (who gives you your treatment) position you accurately and to show where the rays will be directed. These marks must stay visible throughout your treatment, and permanent marks (like tiny tattoos) are usually used. These are extremely small, and will only be done with your permission. It may be a little uncomfortable while they are done.


Treatment sessions

At the beginning of each session of radiotherapy, the radiographer will position you carefully on the couch and make sure you are comfortable. During your treatment you’ll be alone in the room, but you can talk to the radiographer who will watch you from the next room. Radiotherapy is not painful, but you will have to lie still for a few minutes during the treatment.


Radiotherapy for symptom control (palliative radiotherapy)

You may be given radiotherapy to control symptoms if the cancer has spread to other parts of your body. Usually, one to five radiotherapy treatments are given over a week. Side effects are uncommon and often mild if they do happen.

Treating bladder symptoms

Radiotherapy may be used to relieve bladder symptoms, such as pain or bleeding. It may be given as three treatments over a week, usually on alternate days. For example, you may have the radiotherapy to relieve bladder symptoms on Monday, Wednesday and Friday.

Each treatment takes around 10–15 minutes. Sometimes you will only have one treatment.

Treating bone symptoms

Radiotherapy can also treat symptoms caused by cancer that has spread to the bones. Often, just one radiotherapy treatment is needed, but sometimes up to five treatments are given over five days.

It can take up to four to six weeks for the full benefits of the radiotherapy to be felt, but you may notice improvements in your pain much sooner than this.

We have more information about secondary cancer in the bone and coping with advanced cancer.

Back to Radiotherapy explained

Who might I meet?

You will meet many different specialists before, during and after radiotherapy treatment.