Stereotactic Radiosurgery for benign brain conditions
This leaflet tells you about a type of radiotherapy treatment called stereotactic radiosurgery (SRS).
Please bring a list of your current medication each time you come to Velindre.
Smoking is not allowed within the grounds or inside Velindre Cancer Centre. If you would like help giving up, please ask.
It is important you do not get pregnant during your treatment as radiotherapy can harm a developing baby. If you think you may be pregnant at all, please tell the radiographers straight away.
If you have a pacemaker or implantable cardiac device (ICD) you must tell your doctor or a radiographer before or during your first planning appointment.
What is stereotactic radiosurgery (SRS)?
It is a very precise type of radiotherapy treatment which is given to a small area of the brain. All the radiotherapy is usually given in one treatment (or fraction) or a short course of treatments. We give it this way because it reduces the effect of the radiation on your normal brain tissue. It also helps to reduce the risk of late side effects.
To make sure that you are in the same position for each treatment, you will need to wear a special treatment mask (shell). This shell will feel tight, but this is what we need to ensure your treatment is accurate. If it is unmanageable or painful, please let the radiographers know.
Up to three planning visits are usually needed before you start treatment.
The first planning visit - MRI scan
You may need to have an MRI scan. This will be done before you have your mask made. It will help us plan your treatment.
The second planning visit - making your mask.
The mask used for your treatment is made in the mould room. The mould room is part of the planning department for radiotherapy treatment. It is situated near out-patients, at the front of Velindre hospital.
What is a treatment mask?
The treatment mask is a plastic mask that you will wear each day when you have your radiotherapy treatment.
How is the mask made?
We will use warm plastic (not hot) to take an impression of the back of your head and then the front of your head, from your forehead to your chin. The plastic sheet is full of small holes, so you will be able to breathe normally through your nose and mouth. The plastic is warm as it goes on and it will be allowed to cool. This is not uncomfortable, and most people find it quite soothing.
How long will it take?
It takes about 45 minutes to make the impression, but please allow an hour for your whole appointment.
The third planning visit – CT scan
At this appointment you try on your plastic mask. Then you will need a CT planning scan wearing your mask. This will be at least 4 hours after your mould room session.
On one of your visits to the mould room or planning, we will ask you to sign a treatment consent form. Your consultant will explain this to you. Please ask any questions or discuss any worries that you may have with them.
When will I start treatment?
Treatment normally starts about two to four weeks after these planning visits. If you have any questions before coming to see us, please phone the mould room on 029 2031 6213 and you will be able to speak to a member of the mould room staff.
Treatment
Your treatment will be given on a machine called a linear accelerator or LA. Your radiographers will fit your treatment mask and they will make sure you are as comfortable as possible. They will move the bed, so it is in exactly the right place for your treatment using the room lasers and lights.
They will then place the treatment array over you (as photographed) that has infrared balls attached to it allowing the radiographers to set you up in the right position using specialist software.
This specialist software will also allow the bed to move in several direction and tilt to ensure you are in the exact position required to treat you accurately.
Your radiographers then leave the room to switch the machine on. The treatment is given from several directions. Each direction is called a “beam” and the whole treatment will take between 30 and 45 minutes to give. Your radiographers watch you carefully on CCTV monitors. If you have any problems during the treatment, the machine can be switched off at any time. Just wave your hand.
You will not see or feel anything when you are having your treatment, though you may hear the machine buzzing or beeping.
Side effects
We do not expect you to have many side effects because the area we are treating is small. Here are some of the stereotactic radiotherapy side-effects that you might possibly experience in the short term.
- Tiredness or fatigue - It is very common to feel tired for a few days after stereotactic radiotherapy. Make sure you let yourself rest.
- Pain/headaches - Are common after treatment taking regular pain relief such as paracetamol/ibuprofen can help.
- Unsteadiness/facial twitching/tingling sensation/weakness – depending on your previous symptoms and the area we are treating; your consultant will explain this to you if these side effects are relevant to you.
With receiving radiation there is a rare risk of cancer later in life. Any late term side effects will be discussed with you by your consultant.
There can be restrictions on driving after radiosurgery. Please ask your medical team to advise on whether there are restrictions in your case.
The review radiographer team will contact you to check on any symptoms or side effects. They will be able to advise you about coping with any side effects. The review team will contact you about this maybe or at your first appointment about this.
Follow Up
You will be given details on your follow up appointment at the end of your treatment. Your follow up maybe a few weeks after radiotherapy. The review team may call you at regular intervals after your treatment to run through some questions, but we will inform you of these dates closer to the time.
Contact Phone Numbers
Velindre Hospital 02920 615 888
Mould Room Radiographers 029 2031 6213
Review Radiographer Team 029 2061 5888 ext 6421
Transport from Merthyr
Cancer Aid Merthyr 01685 379633
Transport from Rhondda
Cynon Taff Rowan Tree 01443 479369
Helplines and websites
Tenovus cancer support line 0808 808 1010
Macmillan cancer support 0808 808 0000
Maggie’s Cardiff 029 2240 8024
www.maggies.org/our-centres/maggies-cardiff/
Stop Smoking Wales 0808 250 6061