At the University of Maryland Radiation Oncology Center at Union Hospital, we want you to know what you can expect from your course of radiation therapy. The delivery of radiation is a careful process. It involves several careful steps to make sure that an effective dose of radiation reaches tumor cells while affecting as little healthy tissue as possible.
Treatment with radiation therapy begins with an initial consultation. This involves an appointment with one of our radiation oncologists. You may be asked to bring along medical information – such as images, surgical notes and pathology reports – that relate to your diagnosis. At your appointment, you will be interviewed and receive a physical exam. The radiation oncologist will arrive at a treatment plan with you, and go over the potential benefits and side effects of that treatment. You will have opportunities to ask questions, just as you are welcome to ask questions at any point – before, during or after your treatment.
After the consultation, the radiation oncologist may wish to talk with your referring physician to make sure the recommended treatment is right for you. If they determine radiation therapy is appropriate and you agree to proceed with the treatment, the next step is simulation.
The simulation process will help make sure that you are placed correctly during each treatment session. A custom form will be made to fit your body so that you can lie on the treatment table in the same position every time you receive radiation therapy. Also, the area that will receive the treatment will be identified. The radiation therapist will make tiny marks on your skin so that the treatment can be aimed at the same location each time. While you will not receive radiation during your simulation, the radiation therapy machine will take a series of CT images. These images will help later in making sure you are positioned correctly.
Computerized Treatment Planning
Information gathered during the simulation is sent directly to a computer. This will help the radiation oncologist and dosimetrist – the professional who determines what angle and how strong the radiation beams should be – plan your treatment. The system shows your body shape and how the radiation will enter and exit your body. It also shows how the radiation dose is distributed throughout the area being treated. The goal is to maximize the dose of radiation reaching the cancer cells while minimizing radiation delivered to healthy tissues.
You will come back for an appointment that is similar to a “dress rehearsal” for your treatment. During treatment verification, the information gathered during the steps of simulation and treatment planning is put together. You will be placed in the same position you were during simulation. The treatment machine will take X-ray images to make sure the radiation will be delivered according to your treatment plan. These images will be compared to the CT images taken during your simulation. During your course of treatment, these images may be taken again to verify the position of your tumor. If there are any changes to your tumor size or shape, your treatment plan will be adjusted accordingly.
Usually a day or two after the treatment verification, your treatment will begin. You or a family member will be asked to sign a consent form that allows us to treat you. Depending on your treatment plan, you may receive radiation therapy once or twice a day, Monday through Friday, for one to eight weeks. Please arrive on time for each of your treatment sessions. If you cannot keep your appointment, please call to let the radiation therapist know, and we will do our best to reschedule you in a timely manner.
You will be scheduled to see your radiation oncologist at least once a week to check up on your progress and address any concerns you have. Our staff can also assist you with your concerns at any time.
How radiation affects normal tissues during and after treatment varies greatly. Your radiation oncologist will talk with you about the possible side effects of your treatment and how to manage them. The skin in your treatment area may become dry, red and irritated. Treat this area gently. Use only lotions or creams prescribed by your radiation oncologist on this area.
You may feel very tired, especially during the last weeks of therapy. While you may continue most activities during therapy, do not overdo it. Depending on your job, you may continue to work full time or part time, or you may need to take some time off. Ask for help with household duties if you need it. Your body is working hard to fight cancer, so give it what it needs – REST!
Last Day of Treatment
On your last day of treatment, a nurse or your radiation oncologist will meet with you to give you discharge instructions. You will schedule a follow up appointment, usually for two to four weeks later. These follow up appointments will continue for up to a year, and sometimes even beyond. Your radiation oncologist will determine how often he or she needs to see you. Even after treatment is complete, you should feel free to contact us if you have questions or concerns at any time.