Radiotherapy
Radiotherapy means using radiation, usually x-rays to treat cancer cells. It is a common treatment for brain and spinal cord tumours.
You can have radiotherapy to:
the tumour and the surrounding area of healthy tissue
the whole brain
the whole spinal cord
Radiotherapy might be your main treatment if you can’t have surgery to remove the tumour for any reason. For example, if you are too unwell to have an operation. Or if the tumour is in an area of the brain that is difficult for doctors to operate on, such as the brainstem.
You may also have radiotherapy after surgery to:
treat any tumour that your surgeon couldn't remove
lower the risk of the brain tumour coming back in the future
Some people might have radiotherapy and chemotherapy together (chemoradiotherapy).
Radiotherapy can only start once the wounds from the operation have fully healed, which takes a few weeks. You might feel anxious about waiting to start your treatment. Your doctor is the best person to talk to if you have any concerns about the timing of your radiotherapy treatment.
Find out more about surgery and chemotherapy for brain and spinal cord tumours
The full dose of radiotherapy is usually divided into a number of smaller doses called fractions. This allows the healthy cells to recover between treatments. For some types of tumour, you might be able to have the full dose of radiotherapy over a single fraction (radiosurgery).
You usually have one treatment (fraction) a day, from Monday to Friday, for between 3 to 6 weeks. This means that you have between 15 and 30 treatments of radiotherapy in total.
You might have radiotherapy to help with symptoms or slow down the growth of your tumour. This is called palliative radiotherapy and is usually a shorter course of treatment. This might be for around 2 weeks.
You usually have external radiotherapy to treat a brain or spinal cord tumour. External radiotherapy destroys cancer cells by using radiation aimed at a cancer from a machine. The most common type of machine used is called a linear accelerator machine (LINAC). This uses electricity to create the radiotherapy beams.
You can have different types of external radiotherapy:
conformal radiotherapy
stereotactic radiotherapy (SRT)
proton beam therapy (PBT)
Conformal radiotherapy shapes the radiation beams to closely fit the tumours. This means that the tumour receives a high dose of radiation and healthy tissues around receive a lower dose.
You have conformal radiotherapy on a LINAC machine. This is the most common type of radiotherapy for brain and spinal cord tumours.
Find out more about conformal radiotherapy
Stereotactic radiotherapy gives high doses of radiation from different angles around the body. This means that your treatment team can direct a very high dose of radiation to the tumour and a much lower dose to the tissues around it.
Stereotactic radiotherapy isn’t suitable for everyone. You might have it for a tumour that measures less than 3 cm across.
Some people have radiosurgery. This is a very high dose of stereotactic radiotherapy over a single treatment.
Find out about stereotactic radiotherapy and radiosurgery for brain tumours
This treatment uses high energy proton beams to destroy cancer cells. It is only suitable for certain types of cancer. For adults, this includes cancers that started in the base of the skull or near the spine.
Your head needs to be kept as still as possible during radiotherapy. This is so the treatment is as accurate as possible. Keeping the head still is called immobilisation. So, before you start radiotherapy you have a radiotherapy mask made or a head frame fitted. The type of immobilisation you have depends on the type of radiotherapy you have.
Before treatment you also have a planning CT scan. This helps your doctors map where the radiation needs to go.
Read about having a planning CT scan and a radiotherapy mask or frame fitted
Radiotherapy machines are very big and could make you feel nervous when you see them for the first time. The machine rotates around you to give the treatment. But it 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 your music player. So you can listen to your own music.
To have treatment you lie on the treatment table. Because your position is so important, the radiographers may take a little while to get you ready. The radiographers attach your mask or head frame into the treatment table. They then leave the room before your treatment starts. This is so they are not exposed to the radiation
Your radiographers watch and listen to you on a CCTV screen in the next room. Tell them if you need to move or want the machine to stop.
You need to lie very still. The machine makes whirring and beeping sounds. You can't feel the radiotherapy when you have the treatment.
This type of radiotherapy won't make you radioactive. It's safe to be around other people, including pregnant women and children.
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.
Radiotherapy for a brain tumour can make you feel tired. There are other possible side effects.
Last reviewed: 05 Apr 2023
Next review due: 05 Apr 2026
Your radiotherapy treatment plan is individual to you. Your radiotherapy team carefully work out how much radiation you need and exactly where you need it.
Stereotactic radiotherapy is a type of external radiotherapy. Some people may have a very high dose of stereotactic radiotherapy over one treatment. This is called radiosurgery.
Radiotherapy to the brain and spinal cord can cause side effects. These include tiredness and hair loss.
Practical and emotional support is available to help you cope with a brain or spinal cord tumour.
Primary brain tumours are cancers that start in the brain.
About Cancer generously supported by Dangoor Education since 2010. Learn more about Dangoor Education
What to ask your doctor about clinical trials.
Meet and chat to other cancer people affected by cancer.
Questions about cancer? Call freephone 0808 800 40 40 from 9 to 5 - Monday to Friday. Alternatively, you can email us.
