Your treatment begins with the planning stage. Before planning your treatment, the radiation oncologist may ask for some diagnostic procedures and imaging to be done. During the planning session with the radiation oncologist and radiation therapist, you will be asked to lie very still while X-rays or scans are taken to define the treatment area. The doctor will use these to make a treatment plan for you.
The treatment plan is created using special software that calculates the beam angles and radiation dose needed for the most effective treatment. Each treatment plan is unique based upon the type, size and location of your cancer.
The total dose of radiation needed to treat the cancer is carefully calculated. The total dose is then divided into many ‘fractions’ which are delivered as your radiation therapy plan – usually short sessions of radiotherapy treatment on most days each week, for several weeks.
Treatment sessions continue until you have had the total dose of radiation. By having a small fraction of the total dose on many sessions, it is more likely to work better than having the whole dose at one session and it also reduces the severity of side effects.
Like planning, you will only need to go through preparation one time. In order to ensure that the radiation hits the selected target with absolute precision you need to be positioned in a secure and comfortable way on the treatment table. There are different types of frames and devices that can be used to help you get into the correct position and hold completely still during the treatment.
The radiation therapist may put tattoos or dots of colored ink on your skin to mark the treatment area, then use them each day to make sure you are in the correct position.
When you begin your treatment program, you will take your place in the fixation device that has been selected and customized for you. Data from the planning and imaging sessions is used to make sure you are in the correct position, and imaging may take place to confirm placement and target information.
When all is ready, the treatment will begin as the linac begins to rotate around you. The movement may be continuous or step by step. The radiation itself is invisible and painless, and you will be fully awake.
One or more members of your treatment team will monitor everything from outside the treatment room. You can easily communicate with them via intercom, and you have the ability to release your fixation at any time if necessary.
Each session of treatment usually only lasts a few minutes (although it may take several minutes to position you and the machine correctly each time). By emitting the treatment in short bursts from different angles, each burst will pass through different parts of your body on the way to the target. This helps to reduce damage to normal tissues.
Most patients attend follow-up clinics following their course of radiation therapy treatments, typically for up to five years. These are held to help manage any post-treatment side effects and to monitor the disease regression or progression.
Always consult your doctor or a member of your medical team if you have any questions.