Radiotherapy treatment is given either externally or internally, depending on the site of the tumour. It is always given at a cancer treatment centre because of the need for specialist equipment. The patient usually attends daily with a break at weekends. Radiotherapy Treatment program may last up to six weeks depending on the technique used. Because of the tiring regime and daily travel, few patients are able to continue working whilst receiving treatment. If your relative lives a long distance from the hospital it may be less exhausting to arrange accommodation nearby.
The treatment plan starts by taking a series of normal x-rays and scans to enable the radiotherapist ( the doctor responsible for prescribing the Radiotherapy treatment ) to obtain an exact picture of the site, size and shape of the tumour. ‘Planning’ takes place in a simulator, an x-ray machine designed to have the same geometric characteristics as the actual radiotherapy treatment machine. Sometimes the planning involves a ‘therapy CT scan’ so that the volume of the tumour can be determined with the patient in exactly the same position as they will be when they receive their treatment.
Depending on the complexity of the planning stage the patient may have to visit the simulator several times until the plan is satisfactory. The skin is usually marked with special indelible pens (tiny tattoos) to help the radiographer adjust the Radiotherapy treatment machine to deliver the exact dose of radiation. Lasers are used by the radiographers to help with the ‘set up’.
For certain areas of the body a plastic shell is made and the marks are placed directly onto this rather than onto the skin. The shell is worn whilst the patient is treated which helps them get into exactly the same position for each Radiotherapy treatment session and to keep very still. Plastic shells are commonly used for treating cancers in the head and neck.
The patient lies on a special treatment couch throughout the Radiotherapy treatment. The radiographer will ‘position’ them correctly and set up the radiotherapy machine. The couch may be moved during the process. For some treatment plans there may be several fields to treat so the setting up process is repeated for each area and each treatment lasts for a few minutes only. Radiotherapy is painless. The radiographer operates the machine from outside the room (for their own protection) but a two-way communication system is in place so the patient shouldn’t feel too cut off as the radiographer, explains exactly what is happening and what to expect. Although the whole process may feel very unfamiliar, the staff will do everything they can to make the visits as stress-free as possible.