Preparing for Radiation Therapy
The process of radiation therapy will be customized for patients, depending on which form of radiation therapy patients and their physicians choose as their options. Overall, there are four basic steps of radiation therapy that we can share to give patients an idea of what to expect. These steps include consultation, simulation, treatment planning and treatment delivery.
Consultation is the first step of the radiation therapy process. This involves an appointment with a radiation oncologist, who reviews a patient’s medical records, pathology reports and radiology images and performs a physical examination. If, based on this review, treatment by radiation therapy is chosen, the patient will be offered an appointment for simulation.
During simulation, a special CT scan positions and marks the patient for radiation therapy. Images from the scan are used to determine the exact treatment plan. To make sure the radiation therapy treats exactly the same place in the body each time, a device such as a mold or mask may be designed to help the patient assume and remain in the same position each day. Such devices are not necessary for all patients. At the end of simulation, several small marks may be placed on the skin to identify the area to be treated. These marks should not be removed or washed away. Staff will discuss with patients how to protect the marks so they remain in place.
This step of the radiation process involves the radiation oncologist, the physicist and dosimetrist. Using the CT scan images, they work together to design the field of radiation therapy treatment. The focus of treatment planning is to deliver a high dose of radiation to the tumor while limiting the dose received by surrounding tissue that is normal. This helps preserve normal tissue and reduces side effects of treatment. Treatment plans are customized for each patient and become the blueprint for treatment delivery.
On the first day of treatment, the patient is placed in the position for treatment using immobilization devices that might be necessary for them. Radiation therapists are responsible for positioning the patient and for delivering the radiation dose prescribed by the radiation oncologist. Images are taken on the first day of treatment and at regular intervals, if necessary. These images confirm that the area of the body being treated has not changed position. Radiation therapists view the patient from monitors adjacent to the treatment room and can talk with the patient via intercom. Individual treatment sessions typically do not last long; often, the patient will be in the treatment room for no more than 20 minutes, and much of this time is used for accurate positioning.
Weekly Status Checks
During radiation therapy, physicians and other members of our team will see patients at least once weekly to follow their progress, evaluate side effects, recommend treatment for side effects and answer any questions. As treatment progresses, physicians may order blood tests, imaging and other tests to measure how patients are responding to treatment. If the size of a tumor changes significantly, another simulation may be required.
Post Treatment Follow-up
After treatment is completed, a follow-up appointment will be scheduled to monitor the recovery and overall health of our patients. Additional diagnostic tests may be ordered. Reports on the status of our patients are sent to all physicians involved in patient care. As time goes by, the frequency of visits to The Cancer Center will decrease, but physicians and other providers are always available to talk with patients and address any questions and concerns they may have.