Once a diagnosis is made, you will likely be referred to a team of cancer specialists. This usually may include a surgeon, a medical oncologist and a radiation oncologist. A radiation oncologist is a cancer specialist who is the most knowledgeable about the use of radiation therapy in the treatment of cancer and some benign conditions. Our doctors work closely with other specialists on your team to determine the most effective treatment for you. This site deals primarily with your Radiation Oncology treatment.
Your Initial Consultation
It is helpful for you to arrive 15 minutes before your appointment time bringing with you a bit of required information. This will allow us more time to answer questions and discuss any concerns you have. Remember to bring with you on the day of your consultation a copy of your health insurance card, a picture ID, the name(s) of all the physicians currently involved in your care and a list of medications you are currently taking.
During your first visit with the doctor, a detailed medical history and physical examination will be performed. The doctor will review the results of various tests that have already been done. Sometimes, additional tests such as a CT scan or a PET/CT scan might be ordered before your radiation oncologist will decide on your need for radiation therapy.
Before Your Treatment Begins
Once your radiation oncologist recommends a course of radiation therapy, you will be given a Simulation appointment. On this day your appointment is scheduled with radiation therapists who are supervised by your radiation oncologist to map out your treatment area using a special x-ray unit called a simulator, and/or by using a special CT scanner. Unless previously arranged, you will see your Radiation Oncologist only briefly on this day as he/she checks on the simulation process. Usually, your treatment planning will involve taking detailed images of your body and making precise marks in the areas that will receive the radiation beams. This process may take 45 – 90 minutes to complete. With these images our treatment planning team will map out an individualized plan that’s right for you.
During the simulation process, your treatment position will be determined. Often specialized treatment aids, or immobilization devices, are made to ensure that you are in the same position everyday during your treatments. This is an important process in your care as it will ensure accurate delivery of the radiation beam and improve your comfort throughout the course of your treatments. You will have plenty of opportunity to ask questions about your radiation treatment during this visit, but not while you are on the simulation table as this would add to the length of time you’re on the table, thereby contributing to inaccuracy and discomfort.
Your radiation oncologist and radiation therapists will determine how you will be positioned on the table to optimize your treatment. Measurements may be taken as reference points for the development of the radiation dosimetry plan. It is important to find a comfortable position that you can hold for 15 – 30 minutes. An immobilizing device may be used to hold you in place and provide extra support. This device is molded to your body so that your comfort is maximized by cradling you in place. In some cases particularly with head/neck cancers, this device may be a mask. The mask is created out of firm plastic and is molded to your face, which is a quick and painless procedure. It too is designed fit comfortably so that breathing is easy.
A radiation therapist will mark your body to indicate the precise reference spot for your treatment. The type of markings used will depend on your tumor site and the type of treatment that you will receive. Some marks can be made by a marking pen and are not permanent. Others marks are permanent tattoos, the size of a freckle, that cannot be rubbed off or washed away during the course of your treatment. Please discuss any concerns about receiving these tattoos with your radiation therapy team.
In most cases, you will not be receiving a radiation treatment the day of your simulation procedure. Simulation results in a computer-generated plan for treatment that is reviewed and approved by your Radiation Oncologist. The normal time frame to begin treatments is approximately 5-12 working days after your simulation. You will be given an appointment card with the time and date of your first appointment for treatment.
Your appointment time will typically be the same time throughout your course of treatment (examples: Daily at 2:15 p.m. or daily at 10:45 a.m.). Routine treatment times are scheduled daily, Monday through Friday, between 8:00 am and 4:30 pm, except for holidays.
The Treatment Process
A very large machine called a linear accelerator is used to deliver radiation. It will rotate around you to deliver the radiation dose to your tumor from multiple angles. As the treatment begins, you will lie on a table. The radiation therapist will align your body to ensure proper administration of the therapy. Then, the table will raise you up under the linear accelerator.
Your therapist will step outside the room to monitor your treatment via closed circuit television. You can communicate by using the intercom system.
The linear accelerator will make a buzzing sound while the radiation is being delivered, but you will not feel or see it. It is very important that you do not move during your treatment.
During the course of treatment, you will be seen once a week by the radiation oncologist to monitor how you are responding to the treatments. Our nursing staff is also available to answer questions that you have. Follow instructions carefully, and report any unusual symptoms to your radiation therapy team.
Once Your Treatment Begins
The treatment area may be washed, but only with a mild soap. Gently pat the area dry with a soft towel. Dry, itching skin with some redness are common skin reactions to radiation therapy. Talk with your radiation therapist about recommended skin care. Remember, the treatment area should be protected from the sun during the course of treatment.
Use of sunscreen is acceptable but cosmetics, creams, lotions and powders should not be applied to the treatment area unless you are instructed to do so. Hats, visors and high collars are encouraged it if will help protect the treated area from the sun. Additionally, the treatment area should receive no form of heat from hot water bottles, heating pads or jacuzzis.
Your weight will be checked weekly to help monitor your progress and tolerance to the treatments. If anything related to your treatment is worrying you please notify your therapist or nurse.
Follow-up appointments are an important means of measuring your cancer and body’s response to treatments. This may include blood work and x-rays or other imaging exams including MRI or PET/CT studies. It is extremely important to schedule and keep regular appointments after your therapy.
Important things to remember
- Wear comfortable clothes for treatment because you may have change into a gown.
- If you must see your radiation oncologist on a day other than your regularly scheduled day, please let your nurse or therapist know. They will help you arrange a different time for the physician meeting.
- It is essential that you do not skip any treatments or other clinic appointments. If you must reschedule your appointment, please call us as soon as possible.
- Your therapist will advise you of any schedule changes due to major holidays.
- Maintaining a healthy lifestyle is also a part of your treatment.
We recommend that you leave valuable items such as jewelry and watches at home on the day of your appointment as we cannot be responsible for them.