Radiotherapy to the brain

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This page is designed to give you basic information about radiotherapy treatment to the brain. It describes the planning and treatment process and explains the common side effects you may experience. You may not experience any side effects but it is also possible that you may experience a side effect that is not mentioned here. 

Planning your radiotherapy   

For some patients the planning process consists of a single visit to make a simple mask and to plan the radiotherapy. The treatment is planned on an X-ray unit called the simulator. 

Other patients require a more complex planning procedure and the pattern of visits is described below: 

First visit

In order for you to be positioned precisely for your treatment a shell or mask will be made. At this appointment an impression will be taken of your face using Plaster of Paris bandage in order to manufacture the perspex mask. See - "Iridium Radiotherapy Treatments (moulds)"

At this visit you will be given a list of all your treatment appointment dates and times. 

Second visit

At this appointment x-rays are taken of you wearing your mask. This will either involve a CT scan or a set of x-rays taken in the simulator. 

Before the next visit the doctor will use these x-rays or the scan to plan the area needing treatment.

Third visit

The purpose of this visit is to check that your treatment plan is correct. This process is called ‘verification’ and is carried out in the simulator, with you lying in the treatment position.

Treatment

At each treatment appointment the radiographers will help to position you in your mask on the treatment couch. During the treatment the radiographers will leave the room but are watching you closely via a TV monitor. The actual treatment only takes a few minutes, but you are usually in the treatment room for about 10 – 15 minutes.

During the first week of treatment more x-ray pictures are taken of you in the treatment position as additional checks to your treatment plan. 

Each week throughout the course of your treatment you will have an opportunity to see either the doctor or a specialist radiographer to discuss any problems or queries that arise.

The radiotherapy will not make you ill and you will be well enough to travel. You may or may not be allowed to drive yourself. This should be discussed with you doctor prior to treatment. 

Medication

If you are currently taking steroids, the dose is often kept at the same level between leaving hospital after your operation and starting radiotherapy. This dose may be adjusted during your radiotherapy following discussion with the doctor.

Side effects

Any side effects vary from person to person. The type and site of your tumour may also determine the side effects you experience. The most common side effects you may experience are listed below: 

Hair loss: Unfortunately you will lose your hair in the area being treated. This normally happens two to three weeks after the commencement of the radiotherapy. We try to arrange treatment so that your hair will re-grow, but your treatment will never be compromised for the sake of keeping your hair. Hair can take a long time to re-grow following radiotherapy. A wig can be organised for you if required.

During radiotherapy you can continue to wash your hair normally but using a mild baby shampoo. The hair should be gently towel dried and a hairdryer should not be used. 

Skin: The skin in the treatment area may gradually redden from the second week of treatment onwards. It may become dry, itchy and sore especially around the ears if they are in the treatment area. To minimise dryness and irritation aqueous lotion may be used in the treatment area. During the summer months the area should be protected from the sun to prevent sun damage. Any reaction will soon clear up after treatment has finished. 

Tiredness: This side effect varies greatly from person to person. Generally it increases throughout the radiotherapy and may last for a few weeks after completion of your treatment (see information on coping with fatigue).  

Pituitary function: In some patients the pituitary gland may receive a dose of radiotherapy, this may affect the gland and its hormone production. If it occurs, this happens a year or more after radiotherapy, and is easily managed. If this side effect applies to you, the team will explain it fully.

What happens after treatment has finished ?

The doctor will arrange to see you in clinic one month after completion of treatment. This will be to check that you are well after your radiotherapy and to assess your steroid doses.

After this visit the doctor will see you every three months for the first year. Visits after this will be at regular, but longer intervals.

Not everyone will need follow-up CT scans, but you may have one organised after three months.

Additional general information The cancerbacup booklet "Understanding radiotherapy" can usually be obtained from the racks around the centre or alternatively by phoning cancerbacup directly on 0800 181199. A copy of the information film Chemotherapy & Radiotherapy can be ordered directly by email only hep@clara.co.uk



Further general information Your doctors and specialist nurses are in an ideal position to give you relevant information on your disease and treatment as they know your individual circumstances. Cancerbackup has a help line (0808 800 1234) and a prize winning video available in English, Italian, Urdu, Bengali, Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk has over 500 pages describing cancer, its management, practical tips and tool which patients, their carers and their doctors have found helpful during the cancer journey.


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