What to expect during treatment?

Once the diagnosis has been made, you will most likely talk with your primary care physician along with several cancer specialists to discuss your treatment options. These may include a surgeon, a medical oncologist and a radiation oncologist. These specialists will work together to help recommend the best treatment for you.

In some cases, your cancer will need to be treated by using more than one type of treatment. For example, you might have surgery to remove the tumor (by a surgeon), then have radiation therapy to destroy any remaining cancer cells (by a radiation oncologist). You also might receive chemotherapy (by a medical oncologist) to destroy cancer cells that have spread to other parts of the body.

Meeting With a Radiation Oncologist

If you are considering radiation therapy, you must first meet with a radiation oncologist to see if radiation therapy is right for you. During your first visit, your doctor will evaluate your need for radiation therapy and its likely results. This includes reviewing your current medical problems, past medical history, past surgical history, family history, medications, allergies and lifestyle. The doctor will also perform a physical exam to assess the extent of your disease and judge your general physical condition.

After reviewing your medical tests, including CT scans, MRI scans and PET scans, and completing a thorough examination, your radiation oncologist will discuss with you the potential benefits and risks of radiation therapy and answer your questions. For a list of questions that you may want to ask, please see the section “What Questions Should I Ask My Doctor?

Keeping You Informed

We want you to be involved in your care and have the information you need to make the best choices. Please feel free to ask questions. It is sometimes helpful to keep a notebook handy so you can write down questions as you think of them. Bringing this notebook to your office visits will help you remember all the questions you wanted to ask.

Simulation

To be most effective, radiation therapy must be aimed precisely at the same target or targets each and every time treatment is given. The process of measuring your body and marking your skin to help your team direct the beams of radiation safely and exactly to their intended locations is called simulation.

During simulation, your radiation oncologist and radiation therapist place you on the simulation machine in the exact position you will be in during the actual treatment. Your radiation therapist, under your doctor’s supervision, then marks the area to be treated directly on your skin or on immobilization devices. Immobilization devices are molds, casts, headrests or other devices that help you remain in the same position during the entire treatment. The radiation therapist marks your skin and/or the immobilization devices, either with a bright, temporary paint or a set of small, permanent tattoos.

Your radiation oncologist may request that special blocks or shields be made for you. These blocks or shields are put in the external beam therapy machine before each of your treatments and are used to shape the radiation to your tumor and keep the rays from hitting normal tissue.

Treatment Planning

Once you have finished with the simulation, your radiation oncologist and other members of the treatment team review the information they obtained during simulation along with your previous medical tests to develop a treatment plan. Often, a special treatment planning CT scan is done to help with the simulation and treatment planning. This CT scan is in addition to your diagnostic CT scan. Frequently, sophisticated treatment-planning computer software is used to help design the best possible treatment plan. After reviewing all of this information, your doctor will write a prescription that outlines exactly how much radiation you will receive and to what parts of your body.

During Treatment

After meeting with the members of your care team, a plan for treatment will be in place. Most patients who undergo radiation therapy receive external beam radiation therapy. These treatments are usually scheduled five days a week, Monday through Friday, and continue for one to 10 weeks. The number of radiation treatments you will need depends on the size, location and type of cancer you have; and the intent of the treatment; your general health and other medical treatments you may be receiving.

External beam radiation therapy is one of the radiation therapy treatment options. Depending on the type and location of the cancer, there are a variety of other treatment options. For more information click on the information listed to the left.

Our patients are important to us. Please ask your care provider if you have any questions about your treatment.

Weekly Status Checks

During radiation therapy, your radiation oncologist and nurse will see you regularly to follow your progress, evaluate whether you are having any side effects, recommend treatment options for those side effects (such as medication) and address any concerns you may be having. As treatment progresses, your doctor may make changes in the schedule or treatment plan, depending on your response or reaction to the therapy.

Your radiation therapy team may gather on a regular basis with other healthcare professionals to review your case to ensure your treatment is proceeding as planned. During these sessions, all the members of the team discuss your progress, as well as any concerns.

Weekly Beam Films

During your course of treatment, correct positions of the treatment beams will be regularly verified with images made using the treatment beam itself. These images (called port films, beam films or portal verification) represent an important quality assurance check but do not evaluate the tumor itself.

After Treatment

Follow-Up

After treatment is completed, follow-up appointments will be scheduled so that your radiation oncologist can make sure your recovery is proceeding normally and can continue to monitor your health status. Your radiation oncologist may also order additional diagnostic tests. Reports on your treatment may also be sent to the other doctors helping treat your cancer.

As time goes by, the number of times you need to visit your radiation oncologist will decrease. However, you should know that your radiation oncology team will always be available should you need to speak to someone about your treatment.