Radiotherapy to the Brain

Radiotherapy to the Brain

Introduction

This leaflet will explain possible side effects which may develop when receiving radiotherapy treatment to your brain.

The effects are individual and will depend on the dose of radiotherapy you receive and the length of your treatment. Everyone reacts to radiotherapy differently and they will not necessarily experience all of the side effects described. Acute (early) side effects may start within a few fractions of treatment and increase as treatment continues. However these will disappear in the weeks after treatment ends.

Late effects may not occur for a while after the end of treatment. The radiographers will explain the side effects in more detail and answer any questions you may have before you start your treatment.

Driving

You may need to speak to your Consultant if you are driving as it may not be recommended that you drive while having radiotherapy treatment to the brain.

Acute (early) side effects

These early side effects may occur during your treatment and for a short while afterwards.

Tiredness

• Most people will feel tired as a result of having radiotherapy treatment to the brain. Tiredness will often come on gradually as the treatment progresses and may persist for some weeks after the treatment has finished.
• If you feel tired try to rest or sleep. If you are feeling up to it, regular exercise can help, such as taking a short walk.
• Occasionally the tiredness can become worse a few weeks after the treatment and may make you feel irritable and drowsy. This is known as ‘somnolence syndrome’. It may last a few weeks but will get better.

Hair loss

• This is likely to begin about two weeks into your treatment. You will only lose hair from parts of the head that are treated, although you may have some hair loss on the opposite side of the head where the radiotherapy beam passes through. Sometimes the hair loss is permanent, where it does grow back it may be thin and patchy, a different colour or curly instead of straight. It can take from three to six months after treatment before your hair re-growth is completed.
• Some people cut their hair short before treatment to make hair loss easier to cope with.
• Wigs are available on the NHS, please ask a member of staff for details. Some people prefer to wear hats, scarves or turbans.

Skin irritation

• The skin on the scalp and backs of the ears can become pink and itchy during your treatment and for a short while afterwards.
• To minimise this we advise that you wash your hair with tepid water, using a baby shampoo. Try to avoid washing your hair too often, and if you use a hairdryer put it on a cool setting. Avoid exposing the scalp to sun and wind as this can increase any irritation.
• It may be helpful to use a moisturising cream on the skin in the treatment area. There is no evidence to support using a specific cream so speak to the radiographers if you would like some suggestions. Apply the cream thinly and often but not right before your radiotherapy treatment. If the skin starts to peel or blister in the treatment area, stop using the cream and ask your radiographers for further advice.

Headaches

• Sometimes the treatment can cause headaches. If this occurs please discuss with your consultant or a member of the team as you may be advised to adjust your medication.

Nausea

• The treatment may make you feel sick. Please mention this to the treatment radiographers and they can get you seen by a doctor who can prescribe appropriate medications.
• It may help if you drink plenty of fluids; eat small meals and snacks throughout the day. Try to avoid eating or preparing food when you feel sick and avoid fatty foods.

Worsening of symptoms

You may find that the symptoms from the brain tumour get worse during and shortly after the radiotherapy has been completed. This is usually due to the radiotherapy causing the brain tissue to swell slightly resulting in pressure. It may also be because we’ve asked you to reduce your steroids. Let your radiographers, Macmillan Radiotherapy Specialist Radiographer or the consultant know if this happens, as it may be necessary to increase the steroid dose temporarily.

Late side effects

Late effects of radiotherapy can occur months to years after you have completed your treatment. They are determined by many factors such as the radiotherapy dose, the part of the brain treated and the amount of normal brain tissue treated. Your consultant will discuss with you any late effects that may be relevant to your treatment.

They may include:

• Problems thinking clearly, or managing tasks you used to be able to do easily.
• Poor memory – in particular short term, which can be mistaken for confusion.
• Personality changes.
• Symptoms you had from your original tumour, e.g. visual disturbance, limb weakness, speech problems, balance and coordination problems.
• Hypopituitarism – this results in an underactive thyroid which causes weight gain and mood swings. If you have these symptoms mention them to your consultant or member of the team who will arrange for a blood test.
• Permanent hair loss in treatment area

Only a small number of people will experience these side effects, your consultant will discuss with you any late effects that may be relevant to your treatment. Where these side effects do occur it is often possible to manage them with medication.

Very rarely radiotherapy to the brain can cause another brain tumour to develop many years after treatment. If you have any concerns regarding this or any of the side effects of the radiotherapy treatment discuss with your consultant or a member of the team prior to commencing radiotherapy

After treatment

The early side effects from the treatment will continue for several weeks after the treatment course has been completed.

If you develop new symptoms after your treatment is over, or you are concerned that the immediate side effects are not clearing up, you can contact the Macmillan Radiotherapy Specialist Radiographer on  01905 761420

There is often a simple explanation for these symptoms and they do not necessarily mean you will develop the late effects of treatment.

If your symptoms or condition worsens, or if you are concerned about anything, please call your GP, 111, or 999.

Patient Experience

We know that being admitted to hospital can be a difficult and unsettling time for you and your loved ones. If you have any questions or concerns, please do speak with a member of staff on the ward or in the relevant department who will do their best to answer your questions and reassure you. 

Feedback

Feedback is really important and useful to us – it can tell us where we are working well and where improvements can be made. There are lots of ways you can share your experience with us including completing our Friends and Family Test – cards are available and can be posted on all wards, departments and clinics at our hospitals. We value your comments and feedback and thank you for taking the time to share this with us.

Patient Advice and Liaison Service (PALS)

If you have any concerns or questions about your care, we advise you to talk with the nurse in charge or the department manager in the first instance as they are best placed to answer any questions or resolve concerns quickly. If the relevant member of staff is unable to help resolve your concern, you can contact the PALS Team. We offer informal help, advice or support about any aspect of hospital services & experiences.

Our PALS team will liaise with the various departments in our hospitals on your behalf, if you feel unable to do so, to resolve your problems and where appropriate refer to outside help.

If you are still unhappy you can contact the Complaints Department, who can investigate your concerns. You can make a complaint orally, electronically or in writing and we can advise and guide you through the complaints procedure.

How to contact PALS:

Telephone Patient Services: 0300 123 1732 or via email at: [email protected]

Opening times:

The PALS telephone lines are open Monday to Friday from 8.30am to 4.00pm. Please be aware that you may need to leave a voicemail message, but we aim to return your call within one working day.

If you are unable to understand this leaflet, please communicate with a member of staff.  

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