Brain tumour radiotherapy
A planned course of radiation that aims to treat tumours in the brain or spinal cord, given as daily beams or as a smaller number of very focused treatments.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Radiotherapy aims to treat brain or spinal cord tumours using planned radiation; it is a treatment, not surgery.
- The aim differs by tumour type, from long-term control to easing symptoms, so it cannot be assumed to be curative.
- Tiredness is very common and can last weeks to months, and treatment can briefly worsen symptoms by causing swelling early on.
- Some late effects, including memory and thinking changes or hormone effects, can appear over time, so follow-up matters.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Can treat brain or spinal cord tumours, with the aim of cure or long-term control for some types
Some tumours are better treated primarily with surgery or with other approaches, depending on type and position.
Tiredness builds up and scalp skin may become sore, with possible hair loss in the treated area. Your usual symptoms may briefly worsen due to swelling...
A named contact route and rapid access for worsening headaches, seizures or new neurological symptoms.
Tiredness builds up and scalp skin may become sore, with possible hair loss in the treated area. Your usual...
Tiredness often continues and can be marked; in a few people it becomes severe (somnolence syndrome) before...
Energy gradually returns, though it can take months. The effect on the tumour is assessed with scans over this...
Late effects such as memory or thinking changes, hormone changes or, rarely, radiation necrosis can appear and are...
What is brain tumour radiotherapy?
Brain tumour radiotherapy uses controlled doses of high-energy radiation to damage tumour cells in the brain or spinal cord so they cannot keep growing. It is a treatment, not an operation, so there is no surgical wound, although the scalp skin in the treated area can react and hair can be affected.
It can be the main treatment, or it may be given after surgery to treat tumour that could not be fully removed and to lower the chance of it coming back. It is often combined with chemotherapy for certain tumours. For some tumours the aim is to cure or give long-term control; for others, including cancer that has spread to the brain from elsewhere, the aim may be to control growth or ease symptoms. Understanding which aim applies to you matters.
Treatment is delivered in different ways. Standard external beam radiotherapy gives a daily dose over a number of weeks. Stereotactic radiotherapy and radiosurgery focus the dose very precisely on small targets, sometimes in a single session or a few sessions, to spare healthy brain. Your team chooses the approach based on the type, size, number and position of tumours and your general health.
Radiotherapy cannot promise to remove every tumour cell or that a tumour will never return, and it does not treat areas outside the planned target. Care is led by a multidisciplinary team that includes a clinical oncologist who plans and oversees treatment.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
External beam radiotherapy (fractionated)
Daily treatment, usually Monday to Friday over 2 to 6 weeks, using techniques such as IMRT or VMAT. The number of sessions depends on the tumour type, size and aim of...
Stereotactic radiosurgery (SRS)
A single high, very focused dose to a small target, delivered by systems such as Gamma Knife, CyberKnife or a linear accelerator. Used for small, well-defined tumours and...
Stereotactic radiotherapy (SRT)
Focused treatment given in a few sessions (often 3 to 5) rather than one, used when a single dose is not suitable but precise targeting is still wanted.
Whole brain radiotherapy
Treats the whole brain rather than a single spot, sometimes used when there are several secondary tumours. It can ease symptoms but carries a higher chance of tiredness and...
Preparing for your treatment
- See a clinical oncologist who explains the aim of treatment, the type of radiotherapy and the likely side effects.
- Have a planning session with a CT scan, usually with an MRI, in the treatment position.
- Have a fitted mask (or, for some radiosurgery, a frame) made to keep your head perfectly still during treatment.
- Tell your team about steroids, anti-seizure medicines, and any other medicines or conditions you have.
- Ask how treatment might affect driving, work and daily activities during the course.
- Discuss whether chemotherapy will be given as well, and what that involves.
- Plan for daily travel and for tiredness that can build up, and arrange support at home.
- Ask what to do if your usual symptoms, such as headaches or seizures, worsen during treatment.
What happens
You first have a planning session. A close-fitting plastic mask is made by moulding warmed netting over your face and head; it holds your head in exactly the same position each time. You then have a CT planning scan, usually with an MRI, in the mask. The team designs your individual plan over the following days. For some radiosurgery a rigid frame is used instead of a mask.
Each treatment session is usually not painful and quick. You lie still in the mask while the machine delivers shaped beams from different angles; the radiographers leave the room but watch and talk to you. You do not become radioactive. Standard treatment is usually once a day, Monday to Friday, over a number of weeks, while stereotactic treatment may be a single session or a few sessions.
Throughout, the team monitors your symptoms. Because radiotherapy can briefly cause swelling in the brain, your usual symptoms may worsen for a time, and steroids are sometimes used to help. Tell the team about new or worsening headaches, sickness or seizures so they can support you.
Is this treatment right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Some tumours are better treated primarily with surgery or with other approaches, depending on type and position.
- Previous radiotherapy to the same area may make safe re-treatment difficult.
- Very widespread disease may be treated with a different aim, so curative radiotherapy may not be appropriate.
- Whole brain radiotherapy may not be the right choice where the likely benefit is small relative to its effects.
Delay or rearrange if…
- You have an active infection or unstable medical problem that needs treating first.
- Important scans or pathology results are still awaited.
- Your symptoms or swelling need stabilising, for example with steroids, before treatment.
- Medication issues need reviewing before starting.
Alternatives to discuss
- Surgery to remove or debulk the tumour where possible.
- Chemotherapy or other drug treatments as part of a wider plan.
- Active monitoring with scans for some slow-growing tumours.
- Best supportive (palliative) care focused on symptoms where treatment would not help overall.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- Can treat brain or spinal cord tumours, with the aim of cure or long-term control for some types
- Can be used after surgery to treat tumour that could not be fully removed
- Stereotactic techniques target small tumours precisely while sparing healthy brain
- Can ease symptoms such as headaches or neurological problems when control rather than cure is the aim
- Can be combined with chemotherapy for certain tumours to improve control
Risks & complications
- Tiredness that builds up during treatment and can last weeks to months
- Hair loss or thinning in the treated area, which can be permanent after higher doses
- Sore or red scalp skin in the treated area
- Feeling sick, usually helped by anti-sickness medicines
- A temporary worsening of symptoms early on due to brain swelling (often helped by steroids)
- Headaches and reduced appetite
- Severe tiredness a few weeks after treatment (somnolence syndrome)
- Eye dryness or, over time, cataracts when the eyes are near the treated area
- Long-term effects on memory, concentration and clear thinking, more likely with whole brain treatment
- A small area of damaged brain tissue (radiation necrosis), often 1 to 3 years later
- Hormone changes if the pituitary gland is in the treated area
- Hearing changes, and very rarely a second tumour many years later
The biggest uncertainties are how well the tumour is controlled and which late effects might develop, particularly on memory and thinking, hormones or, rarely, healthy brain tissue. Early on, treatment can briefly worsen symptoms by causing swelling. The balance of benefit and risk depends heavily on the tumour type, its position and the aim of treatment. Ask your clinical oncologist what the aim is for you, what to do if symptoms worsen during the course, and which late effects will be monitored.
Published figures to discuss
Outcomes and side-effect rates vary widely with the tumour type, grade, size, number and position, whether it is a primary or a secondary tumour, the technique and dose used, and your general health. Reputable UK patient sources describe most side effects qualitatively rather than as single fixed percentages, and outcomes are assessed individually with scans over time. We therefore describe risks in words rather than inventing exact figures.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Fatigue during and after brain radiotherapy | Common | Fatigue can build over treatment and may last weeks to months. | Guide sourcesClinical context |
| Hair loss in the treated area | Common when scalp is in the beam path | Regrowth depends on dose; high-dose areas may have permanent thinning. | Guide sourcesClinical context |
| Brain swelling, headache or seizure worsening | Uncommon to common depending on tumour, dose and swelling before treatment | Steroids or anti-seizure medicines may be needed; worsening neurological symptoms should be reported urgently. | Guide sourcesClinical context |
| Late cognitive, endocrine or radionecrosis effects | Uncommon but important, risk rises with larger treated volume, higher dose and longer survival | Long-term follow-up should include memory, fatigue, pituitary function when relevant and MRI interpretation. | NHS — Malignant brain tumour treatmentnhs.ukSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
Radiotherapy does not have a surgical recovery, but tiredness often builds up over the course and can persist for weeks to months. Some effects appear later, which is why scans and follow-up are part of the plan.
- Tiredness that can last for weeks or months after treatment finishes
- Hair loss or thinning in the treated area, which may or may not grow back
- A short period where usual symptoms feel worse before they settle, due to swelling
- Scalp skin that becomes sore during treatment and then heals
Aftercare
- Rest and pace yourself, as tiredness can be significant and last some time.
- Take steroids, anti-seizure or other medicines exactly as prescribed and ask before stopping them.
- Care for the treated scalp skin gently and protect it from sun.
- Report new or worsening headaches, sickness, drowsiness, weakness or seizures promptly.
- Keep follow-up appointments and scans so the tumour and any late effects can be monitored.
- Ask about support for memory, concentration, mood, work and driving as you recover.
- Check the current rules on driving with your team, as a brain tumour and its treatment can affect your licence.
- Daily travel to the centre arranged for the whole course
- Steroid and anti-seizure medicines understood, with a plan for changes
- Support at home for tiredness in the weeks after treatment
- Questions about the aim of treatment written down for your clinical oncologist
- Driving and work situation discussed with your team
- Clinic contact number saved for worsening symptoms
- Follow-up scan and review plan understood
⚠ Get urgent help if…
- A sudden or severe headache, especially with vomiting or drowsiness
- A new or worsening seizure
- New weakness, numbness, confusion or difficulty speaking
- Sudden changes in vision
- A high temperature or feeling very unwell (possible infection)
- Becoming very drowsy or hard to wake
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A good result depends on the aim of treatment: for some tumours it means long-term control or cure, and for others it means slowing growth or easing symptoms. The effect is judged over weeks to months using scans, because the brain continues to settle after treatment and changes can be hard to interpret at first.
Radiotherapy cannot promise to remove every tumour cell or that a tumour will never come back, and it does not treat areas outside the planned target. Your team will explain how your scans will be followed and what the findings mean for you, including what would happen if the tumour grew or returned.
How long the benefit lasts depends greatly on the tumour type, its grade and position, whether it was a primary brain tumour or a secondary from elsewhere, and your general health. Some tumours are controlled for many years, while others are harder to control, so honest, individual discussion matters more than any single figure. Because late effects can appear over time, long-term follow-up with scans is part of the plan.
Related tests, treatments or support
For certain tumours, such as some gliomas, radiotherapy is combined with chemotherapy to improve control, and it is often used after surgery. The right combination depends on the tumour type and is decided by the multidisciplinary team. Steroids are sometimes used alongside treatment to manage swelling and symptoms.
Follow-up & long-term care
After treatment you have regular reviews and scans, often for years, to check the tumour's response and to watch for late effects. Hormone levels are monitored if the pituitary gland was in the treated area. Support for memory, concentration, fatigue, mood and return to work or driving is part of good follow-up, and you should report new or worsening neurological symptoms between appointments.
- Regular follow-up scans on the schedule your team advises
- Hormone blood tests if the pituitary gland was treated
- Support and rehabilitation for memory, concentration and fatigue if needed
- Ongoing review of anti-seizure or steroid medicines
- Up-to-date advice on driving as your situation changes
Repeat, follow-on and what comes next
- The tumour's response is judged over weeks to months with scans, which can be hard to interpret early; growth or recurrence prompts further discussion.
- Re-treating the same area with radiotherapy is often not possible, so options after relapse may differ.
- Some late effects, such as radiation necrosis or hormone changes, may need their own treatment and monitoring.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A named contact route and rapid access for worsening headaches, seizures or new neurological symptoms.
- A clear schedule of follow-up scans and a plan for what growth or recurrence would trigger.
- Monitoring for late effects, including hormones, and support for memory, fatigue, mood and return to work.
- Clear, up-to-date advice on driving, and coordination between private and NHS teams.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The technique used (standard external beam, stereotactic radiosurgery or radiotherapy, or whole brain) and number of sessions
- Planning scans (CT and usually MRI), the fitted mask or frame and the physics planning
- Whether chemotherapy is included for certain tumours
- The clinical oncologist's fees and the radiotherapy facility fees
- Any admission needed for symptom support during the course
- Follow-up scans, appointments and monitoring for late effects
- The clinical oncologist's fees and the radiotherapy facility fees
- Planning scans, the mask or frame and the physics planning
- Whether chemotherapy and its costs are included, if relevant
- Follow-up scans and appointments and how long they continue
- Monitoring for late effects such as hormone changes
- What happens, and who pays, if you develop a complication or need further treatment
- How private care will be coordinated with your NHS team
On the NHS? Brain tumour radiotherapy, including stereotactic techniques, is a standard NHS treatment in specialist centres when clinically indicated; private care may be used for speed or a second opinion and is coordinated with NHS teams.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not being clear whether the aim is cure, long-term control, or easing symptoms.
- Underplaying late effects on memory, thinking, hormones or healthy brain tissue.
- Not explaining that symptoms can briefly worsen early on due to swelling.
- No discussion of alternatives such as surgery, chemotherapy or active monitoring.
- Not covering the practical and legal effects on driving and work.
Marketing red flags
- Promoting a branded system (for example a named 'knife') as a guaranteed cure or as without risks.
- Implying stereotactic treatment is always better without reference to your specific tumour.
- Downplaying tiredness and late effects, or the possibility that the tumour may not be controlled.
- Pushing treatment without an MDT discussion or without offering alternatives.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- Is the aim of my radiotherapy to cure, to give long-term control, or to ease symptoms?
- Which technique do you recommend (standard, stereotactic or whole brain), and how many sessions?
- Will I have chemotherapy as well, and what does that involve?
- What could happen to my usual symptoms during treatment, and what should I do?
- Which late effects, including memory, hormones and thinking, will you monitor for?
- How will my scans be followed, and what would happen if the tumour grew or came back?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my treatment, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this treatment not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Is brain tumour radiotherapy available on the NHS?
Does radiotherapy cure a brain tumour?
Will I lose my hair, and will it grow back?
Why might my symptoms feel worse at first?
Will it affect my memory and thinking?
Can I drive during and after treatment?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: Cancer Research UK — Radiotherapy side effects for brain and spinal cord tumours Cancer Research UK — Stereotactic radiotherapy for brain and spinal cord tumours Macmillan — Radiotherapy for a brain tumour The Brain Tumour Charity — Radiotherapy side effects (adults) The Brain Tumour Charity — Stereotactic radiotherapy side effects (adults) NHS — Malignant brain tumour treatment
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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