Evaluate your disease and the likely result of radiation therapy
In addition to reviewing your current condition and history, your radiation oncologist may ask for diagnostic procedures to be performed in the radiation therapy department, an imaging center, or at a general hospital. Imaging may include x-rays, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) scans, biopsies and blood tests. Once the nature of the disease has been established, a treatment regime will be planned and prescribed.
Verify the specific size, shape and location of your tumor for use in treatment planning
To accomplish this, you are positioned exactly as you will be for your radiation treatments. This may involve the use of immobilization devices to help you stay still. Marks are made on your skin with colored pens to indicate the treatment area. (Sometimes, very small marks are made with a special dye. In this case, you may feel as though you are being pricked with a pin.)If your treatment involves the use of a head shell, the marks are made on it rather than directly on your skin. All positioning and immobilization details are recorded and sent to your treatment planning team. If your treatment involves radiation to your mouth or throat, you will be required to have a dental assessment, and possibly dental treatment, before you begin your course of radiation.Your radiation therapist uses a CT scanner to obtain high-resolution 3D images of the anatomical region to be treated. In some cases, non-invasive ultrasound technology called Clarity® may also be used to accurately capture images – particularly for soft tissue areas such as the breast or prostate. These images help your treatment team target your cancer as precisely as possible while reducing the impact on organs and critical structures.
Your CT scan takes no more than a few minutes, once you have been positioned.
Determine your specific radiation prescription
Using the simulation information, your radiation oncologist defines the contour and volume of the radiation target, prescribes the appropriate total dose of radiation and over how many days the treatment is to be administered. Every organ in the body has dose tolerance, so the dose to critical structures in the treatment area is equally important as that delivered to the tumor.From this information, your medical physicist works very closely with your radiation oncologist to plan your individualized treatment. Utilizing sophisticated software, your planning team performs a series of computer calculations to arrange the position, dose and frequency of the series of radiation beams. Some techniques modify the beam during treatment, so the radiation is delivered more intensely in some areas and less intensely in others. The specialists on your team collaborate, continuously refining the treatment plan to determine the best possible solution for meeting your therapeutic objectives with minimal damage to surrounding normal tissue and critical organs. Quality assurance calculations are checked and re-checked. This process may take several days.
Receive your radiation treatment
When you come back for your treatment, your radiation therapist takes new images to verify beam accuracy.Once all is ready, your radiation therapist leaves the room to monitor your treatment. You can communicate with each other over the intercom, so speak up if anything frightens you or you start to feel ill. The radiation therapist can stop the procedure at any time.
The linac gantry begins to rotate around you, as you lie very still, breathing normally. You may see this movement and hear some clicking and humming sounds, but the machine will not touch you and the radiation itself is invisible and painless. Short bursts from different angles pass through different parts of your body on the way to the tumor target, to minimize damage to normal tissues. A few minutes later, your treatment is done! Your therapist will help you off the table and out of the room.
Each time you return for treatment, you will repeat the entire process of set-up, imaging and treatment, until your course of treatment is completed.
Throughout your course of treatment, all data, including images and your response to treatment, is stored in your MOSAIQ® electronic medical record. Your team can access it at any time and from anywhere, review and collaborate over it and make any necessary adjustments.
Monitor your progress
After completing your course of treatment, you will have periodic follow-up appointments for up to five years, to monitor your disease and help you manage any post treatment side effects you may experience. Remember, it is important to keep these appointments even though you may be feeling fine. Your radiation oncology nurse or patient navigator can help connect you and your family with additional post-treatment support services.