What is SRS?

Stereotactic radiosurgery (SRS) is a procedure for treating a small area within the brain using focused beams of radiation with high precision, to help shrink or control the growth of a tumour. 

In SRS the treatment beam is shaped to match the exact size and shape of the tumour from all angles.  As we can direct the radiotherapy very accurately, we can minimise the amount of X-rays that pass through your healthy tissue. 

Stereotactic radiosurgery is suitable for small, clearly defined tumours which may be difficult to remove surgically, or where surgery is likely to be associated with a high risk of side effects. 

Before you come for your SRS, you will attend an appointment for planning. A member of the SRS team will contact you to arrange this appointment as soon as they receive a referral from your specialist doctor.  If you require hospital transport, please inform us at this point.  

A mask will be made to keep your head still during treatment. This appointment will be at Clatterbridge Cancer Centre Liverpool: 65 Pembroke Place, Liverpool, L7 8YA.  

You will have a CT scan wearing the mask. You will also require a magnetic resonance imaging scan (MRI) you will normally have an injection of contrast/dye for your MRI. This helps us to see the tumour in more detail. You do not need to wear your mask for the MRI scan.

Please allow plenty of time for your planning appointment. It is a good idea to bring some food and a drink and wear comfortable clothing. Refreshments are available to purchase in the hospital. 

You will be asked to complete a quality of life questionnaire. Please return this to the therapeutic radiographers. 

The mask is made from a soft plastic. It has perforations like a mesh so you can breathe through it during treatment.
A mask for treatment

Side view of the thermoplastic mask, with perforated holes so you can breathe during treatment

The therapeutic radiographers will discuss the details of your treatment appointment with you; it is usually within 2 weeks from your planning appointment. This gives us time to design and check your individual treatment plan. 

You will wear your mask for treatment. You will not feel anything during the treatment and it will take approximately 20 minutes. The treatment bed will move and the Therapeutic Radiographers will take a CT scan (x-ray pictures) to ensure the accurate positioning of the treatment beams.

The Therapeutic Radiographers will leave the room for treatment. They can see you at all times on the CCTV cameras and are able to speak to you on the intercom. The machine moves around you and makes a dull buzzing noise as it delivers the treatment. Music can be played in the treatment room.

You will be asked to stay in the hospital for 15 minutes after your treatment.

The stereotactic radiosurgery treatment machine is a large machine with a table for patients to lie on. A large arm rotates around the bed to deliver the treatment
Stereotactic radiosurgery treatment machine

 

After your SRS treatment, a neuro-oncology nurse from Clatterbridge will contact you. This will be the next working day.  If you have any queries or concerns, you can call 0151 556 5583 where you will be asked to leave a message. A member of staff will call you back ASAP. You can also contact the Triage 24 hour helpline on 0800 169 5555.

There will be a further specialist nurse telephone follow up 2 weeks after treatment to check on your symptoms and guide you on your medication.

You will normally be discharged back to your referring team at this point. You will have regular scans as required under their care.  

You will be sent a further quality of life questionnaire 6 weeks after your treatment. 

A telephone follow up with the neuro-oncology nurses will take place at 6 months post treatment to check for any long-term effects due to SRS treatment. 

When you have SRS, there is a risk of swelling in the treatment area. To reduce this risk we will normally recommend that you take steroid medication, which we will prescribe for you. If you are already taking this, we may advise that the dose you are taking is temporarily increased. The doctor, nurse or therapeutic radiographer will explain how and when to take your medication. 

Your specialist doctor will explain the full SRS procedure and the side effects that are specific to you.  Side effects may build up gradually and can take a number of weeks to wear off. The most common short-term side effects are: 

  • Tiredness - this can continue for a few weeks after treatment.
  • Skin reaction - Skin can become dry, red and sensitive. Please take care in the sun and use gentle baby shampoo. 
  • Hair loss - This varies very much from person to person and is normally just a thinning in the treatment area.
  • Nausea - anti-sickness medication can be prescribed if you experience nausea or dizziness. 

There are some possible longer-term side effects that can occur many months to years after radiotherapy. Your doctor will inform you of any applicable to you.

Once you have been given all the information about your treatment and possible side effects, you will be asked to sign a consent form. You will receive a copy of this. 

You must inform the DVLA when diagnosed with a brain tumour. Forms can be found on the Gov.uk website. You should ask your doctor for advice, who might tell you to surrender your licence. You must not drive during treatment. You can be fined up to £1,000 if you do not inform the DVLA about a medical condition that affects your driving. You may be prosecuted if you are involved in an accident as a result. 

Maggie's Wirral

Maggie's is a charity providing free cancer support and information to anybody who been affected by cancer.  Our cancer nurse specialists, psychologists and benefits advisors are here to support you during treatment or after your treatment has finished.    

The Maggie's Centres allow you to share experiences with others in a similar situation around our kitchen table. We provide courses on survivorship, bereavement, stress management, mindfulness, tai chi, yoga, relaxation or cancer support groups.  

You do not need an appointment or a referral to access any support from Maggie's Wirral - you can just drop in.  Our telephone number is 0151 334 4301. 

Cancer Information and Support Centres

The Clatterbridge Cancer Centre's Cancer Information and Support Centres:
Tel: 0151 318 8805

Clatterbridge Cancer Centre - Liverpool  
65 Pembroke Place, Liverpool, L7 8YA 
Tel: 0151 556 5000  
www.clatterbridgecc.nhs.uk