Radiotherapy for kidney cancer

Radiotherapy uses high energy X-rays to kill cancer cells. Radiotherapy is not used often for cancer of the kidney because kidney cancer cells are not as sensitive to radiation as some other types of cancer.

Your doctor may suggest radiotherapy to help control the symptoms of an advanced cancer. It can shrink a large cancer and relieve pressure on nearby organs or nerves that may be causing pain. Doctors also use it to treat kidney cancer that has spread to the brain.

You have radiotherapy treatment in the hospital radiotherapy department as an out patient. You usually have radiotherapy as a series of daily treatments, called fractions.

Radiotherapy for symptoms is often given over a small number of treatment fractions, so that you only have to come to the hospital a few times. You may have one treatment a day for a few days, or a few treatments with a few days break between each. In most centres you have radiotherapy daily, from Monday to Friday, with a break from treatment at weekends.

Radiotherapy is carefully planned. At your first visit you will usually be asked to lie under a large machine called a simulator.

The doctor uses this to work out where to give your treatment to kill the most cancer cells and miss as much healthy body tissue as possible. A pinprick tattoo is made on your skin and this is used to line up the radiotherapy machine every day when you have your treatment. Sometimes more marks are made with felt pen. If so, you must be careful not to wash them off.

Sometimes treatment may be planned without a simulator. For example, if you have a painful area in a bone, you will be able to show the doctor exactly where it is, so the simulator will not be needed.

The actual treatment only takes a few minutes. The radiographer will help position you on the couch and make sure you are comfortable. You will be left alone for the minute or two the machine is switched on. But the staff will be able to hear you through an intercom, so call if you need them. Below is a picture showing how radiographers can see you on monitors while you have your treatment.

The treatment does not hurt. You will not be able to feel it at all. You must lie very still for the few minutes it takes to treat you. And remember, having external radiotherapy does not make you radioactive. It is perfectly safe to be with other people, including children, throughout your treatment course.

Side effects

The side effects of radiotherapy depend on which part of the body is being treated. The side effects of treatment to the kidney are

• Feeling or being sick
• Diarrhoea
• Reddening of the skin in the treatment area
• Loss of any body hair in the treatment area

You may not have many side effects from your treatment for kidney cancer. If you feel sick, you can be given an anti-sickness drug such as metoclopramide (Maxalon) or ondansetron (Zofran) to stop this. Your doctor will be giving you the radiotherapy to make you feel better. So it is important that the treatment itself does not make you feel worse. Radiotherapy can cause tiredness for many people. The tiredness wears off over the few weeks following your treatment. There is more about the side effects of radiotherapy to the abdomen in the radiotherapy section of CancerHelp UK.

This treatment can be very successful at controlling symptoms and slowing down the growth of the cancer. It can be given in a number of different ways. How it is given depends mostly on the size and number of areas of cancer spread in your brain. If there is only one area affected, it may be treated with stereotactic radiotherapy.

If the cancer affects part of your brain, you will most likely be given about 10 separate treatments (fractions). This treatment will be given daily, Monday to Friday, so the complete radiotherapy course will take 2 weeks.

If there are widespread areas of your brain affected by cancer, or if your radiotherapy specialist thinks there could be cancer cells spread throughout that are too small to detect on a scan, you can be treated with whole brain radiotherapy. This is usually given in about 5 treatments (fractions), which takes a week.

This is quite a new technique for treating small areas of the brain with high doses of radiation. It is a very specialised treatment and can only be given in large treatment centres. The aim of the treatment is to get rid of the cancer in your brain altogether.

Stereotactic treatment has to be given very precisely. Only the area of the cancer should receive the high doses of radiation. To make sure of this, you may be fitted with a metal head frame. This is screwed to your skull to make sure your head is in exactly the right place for the treatment. And to make sure your head cannot move while the treatment is being given. This sounds worse than it is. You do not have to wear the head frame for long. It is uncomfortable when it is in place, but should not be painful. Some radiotherapy centres do not use the head frame. They use a plate that you bite on instead. The radiotherapy is usually given in a single treatment. You may hear it called 'radiosurgery', or 'gamma knife' treatment. 'Gamma knife' is the name of one type of machine used to give this treatment.

There is a main radiotherapy section in CancerHelp UK. It will tell you more about this type of treatment including

• What radiotherapy is
• How your radiotherapy treatment is planned
• Possible side effects
• Radiotherapy to treat symptoms (palliative radiotherapy)