The Treatment Process

Radiation therapy at Advanced ROS is an outpatient procedure where you come and go from your home each day for treatment. Most patients receiving external beam radiation therapy are treated once a day, five days a week, from two to eight weeks. Patients with some types of cancers may receive internal radiation therapy (brachytherapy), where radioactive sources are placed inside the body. For more information about brachytherapy, click here.

Your treatment process will vary depending on the type of treatment your doctor recommends for your unique situation. Most patients receiving external beam therapy will go through the following steps:

Step 1: Consultation with your Radiation Oncologist

During this appointment, Dr. Gerstley or Dr. Torrey will review your current health records, diagnostic tests and any procedures you have had and perform a physical exam. He or she will discuss with you the treatment goals, therapy options and potential side effects you might experience. When you decide to proceed with radiation treatment, we will schedule you for a “Simulation”.

Step 2: Simulation

In the Simulation (or CT Simulation), your doctor and the radiation therapist work together to determine the exact area or “field” where the radiation will be directed. Simulation is done while you are lying on a CT scanning machine table and usually consists of the following steps:

· Making an immobilization device (a device that is custom-molded to your body to help keep you still during treatment
· Placing temporary or permanent reference marks on your skin
· Taking CT images of the area to be treated to give us detailed anatomic information
· Transferring the images to our physics lab so that the doctor and physics staff can develop your treatment plan, a process that typically takes 5 to 7 days.

At the end of the Simulation, you will meet with the Oncology Nurse who will schedule your next appointment and discuss side effects, nursing care and answer any questions you have.

Step 3: Treatment planning

You do not need to be here for this step, but a lot will be going on behind the scenes in the week following your Simulation. The doctor, physicist and dosimetrist work together to interpret the information they have gathered and develop a highly precise and specific plan for your treatment. The most sophisticated computers are used to create a 3D virtual image of the area, identify the exact target(s), and determine the best technique and the best shape for the radiation beams. Computers also allow us to predict how the radiation will interact with tissues; we can run scenarios that help us choose the best treatment strategy for you given the specific goals and the many variables involved.

Step 4: Plan Verify (PV) and/or First Day of Treatment (30 minutes to 1 hour)

Some patients may require a second simulation called a “Plan Verify” (PV) or “Simple Sim” procedure. It’s like a dress rehearsal for a play, when we double-check your treatment plan by doing a run-through. Using the immobilization device and the marks placed during Simulation we will put you in the exact position necessary for treatment. You may or may not receive your first treatment on the same day. We will take special x-rays called “port films” to verify that you are in correct alignment and that the radiation is directed from the proper angle and is the correct shape.

Step 5: Regular Treatments (15 minutes per day)

Your daily treatment takes only a few minutes, the additional time is needed to set up the equipment and place you in the correct position on the treatment table. The radiation therapist leaves the room and turns on the machine, which will then move around you as it delivers radiation from different angles. You just need to lie still and breathe normally. Visual and voice contact with the therapist is always maintained by closed-circuit television and intercom. If you are concerned about anything that happens in the treatment room, you can alert the therapist and the machine can be stopped at any time.

At least once a week your radiation oncologist will meet with you to assess your response to treatment and any side effects. However, you may request to see the doctor at any time by letting your therapist or one of our nurses know. Our therapists and nurses have been trained to recognize various reactions to radiation and they may suggest that the doctor see you before or after treatment if they think that it is necessary.

About once a week the radiation therapist will take additional “port” films to make sure that your treatment fields are still aligned properly, which takes an extra 5 to 10 minutes.

How will I feel during treatment? What about side effects?

There is no pain involved in radiation treatment and you will not become radioactive. Any side effects are specific to the site being treated and vary for each person. Most side effects from radiation are temporary and subside after the treatment has ended. You will receive detailed information about possible side effects from your treatment. Click here for a list of common side effects by treatment site.

Step 6: Follow-up Appointments

When your treatment is completed, your doctor will discuss with you the need for follow-up appointments.