Radiation Therapy

What is radiation therapy?

Radiation therapy is a treatment for your brain tumor using a special energy beam aimed at your tumor. There are several types of radiation beams which are made by special machines or from radioactive substances. Your doctor will explain these to you when you are told about your treatment plan.

Why do I need radiation therapy?

Radiation therapy is used to treat brain tumors for several reasons. If your tumor was inoperable or if your neurosurgeon was unable to remove all of your tumor, radiation therapy may be prescribed. Even when a brain tumor is "completely" removed, some cells, which your physician could not see, may remain. Radiation therapy is a way to destroy or slow the growth of these cells.

What will happen during radiation therapy?

The first part of your radiation therapy is called "simulation." During this session a radiation oncologist, a physician who specializes in radiation therapy, will pinpoint your treatment area and define your treatment ports. Treatment ports are the areas where the radiation beams pass through to get to your tumor. You will be asked to lie quietly on the treatment table during this procedure, although you will not be receiving radiation at this time. In order to locate your ports accurately for each treatment, a special mask for your face may be made. This mask will fit your face exactly and will be used each time you have a treatment. You may also have marks placed on your face or scalp with semi-permanent ink. Do not wash off this ink as these marks serve the same purpose as your mask.

During your actual radiation therapy, you will be asked to lie on a treatment table without moving. A radiation technologist will give you the treatment that the radiation oncologist has prescribed. The treatment will only last a few minutes, and you will not feel anything.

How long does the treatment last?

Radiation treatment for brain tumors is usually given 5 days a week for 5 to 7 weeks. The length of treatment will depend upon your tumor type and your situation. Your physician will explain this to you when he tells you about your treatment plan.

Will my activities be restricted during radiation therapy?

You may continue your all normal activities, including working, driving, and sexual activity, as tolerated during your radiation treatment. If you have had surgery, your physician may tell you to decrease some of your activities. Check with your nurse or neurosurgeon about restrictions to your activity. You may feel some fatigue during treatment which may limit the amount of activities that you can perform. See the section on side effects below for suggestions on how you can handle fatigue.

What are the side effects of radiation therapy?

Most people have relatively few immediate side effects from radiation therapy to the brain. The first side effect you may notice is hair loss. This will begin about two weeks after the start of your therapy. The amount of hair loss is individual. Some people lose all of their hair while others only lose patches. Your hair will usually grow back after your therapy is completed. See "Self care do's and don'ts during radiation therapy" and "Hints for selecting a wig" handouts, which are attached to these instructions.

The second immediate side effect is a skin reaction to the radiation. Your skin may become reddened, flaky and itchy. Notify your radiation oncologist if this occurs. Do not try to treat this yourself. See "Self care do's and don'ts during radiation therapy."

Another side effect of radiation therapy which is bothersome to many patients is fatigue. Many people notice a decrease in their energy level during treatment. The best way to combat fatigue is to prioritize your activities, take frequent rest breaks, eat a healthy diet, and let others help you during this therapy period. Your fatigue will usually begin to resolve about six weeks after you finish your radiation therapy.

Because the radiation is killing tumor cells, you may have some edema, or swelling in your brain around the tumor area. For this reason you will be given a prescription for steroids, which will help decrease the edema. Make sure to take these medication exactly as your doctor prescribes. Also ask your nurse for a medication handout about the type of steroid you will be taking.

Edema (swelling in your brain) can sometimes cause changes in your neurological status. Call your neurosurgeon immediately if you notice:

	Change in your speech, muscle strength, or sensations
	If you have a seizure or if your seizures change in type or frequency.

Also notify your neurosurgeon if you become confused, or if you are so tired that your family members have difficulty waking you up.

Radiation to the brain may also have some long term side effects. Your neurosurgeon and radiation oncologist will discuss these with you as they determine your treatment plan. They will also help you weigh the risks and benefits of radiation treatment for your brain tumor. Please always feel free to ask any of your health care providers questions about your therapy. If they do not know the answer they can help you find someone who does.

Where can I obtain more information about radiation therapy?

Your nurse may be able to provide you with more detailed handouts from the following resources. If she/he does not have any available handouts you may contact the following resources who will send you the information quickly and usually without a charge.

Skin Care

	DO wash your hair with mild soap or shampoo (baby shampoo or a PH balanced shampoo) two to three times per week.
	DO pat skin dry with a soft towel.
	DO apply cornstarch to help reduce itching.
	DO wear a hat, cap or scarf when outdoors.
	DO NOT wash off the marks on your face and scalp.
	DO NOT use soaps, perfumes, powders, oils, Vaseline or other skin care products on your scalp unless given to you by your physician or nurse.
	DO NOT use: conditioners, hot rollers, or curling irons.
	DO NOT scratch or rub scalp if itching develops.
	DO NOT apply cornstarch if your scalp begins to drain.
	DO NOT sit in direct sunlight or under a sunlamp.
	DO NOT use hot water bottles, heating pads, or icepacks on your scalp.
	DO NOT use adhesive tape, dressings, or band-aids on your scalp unless instructed to do so by your physician or nurse.

Hints For Selecting A Cranial Prosthesis (i.e. Wig/Hairpiece)

	Try to select and purchase your wig prior to your hair loss.
	Questions to ask when buying a wig: What is the cost? What is included in the cost? (fitting, altering, sizing, etc) Will the store assist you if you have any problems with your wig? How do you clean the wig? Is the wig vented? What is involved in the care of the wig? Will the color of the wig fade?
	You may purchase a wig from your own stylist or ask your nurse for suggestions, or your local cancer society. Many cancer societies have wigs at no charge.
	Wigs and hairpieces my be tax-deductible or may be covered by your insurance. Get a prescription for a cranial prosthesis (wig) from your physician and keep the receipt from its purchase.
	Other head coverings that you may use are hats, nightcaps, scarfs, turbans or baseball caps. Your nurse or local cancer societies may have further information.

Hints to Reduce Hair Loss

	DO cut hair to a shorter length to reduce weight on your hair shaft.
	DO use satin pillowcases to decrease tangles at night and reduce excessive friction.
	DO eat a diet with adequate proteins.
	DO use a infant comb and brush set when new hair begins to grow back. This promotes circulation and new hair growth without scalp trauma.
	DO NOT over shampoo.
	DO NOT use: hot rollers, curling irons, tease your hair, conditioners, hair sprays, hair dyes or permanent solutions.