What Happens in the What Happens in the days before treatment ?days before treatment ?

CT/Simulation

Contouring images

Treatment planning

Radiation Field Design

Quality Assurance

Iso-center check

CT/Simulation

A series of detailed pictures taken of areas within the

body to precisely locate and mark the target (cancer) area that is going to be receiving the radiation

therapy.

CT/SimulationCT/Simulation

Contouring Images

The Images from your CT/Simulation are downloaded

into a treatment planning program. Then, the important anatomy in and/or around the

radiation therapy field are outlined.

CCOONNT T O O UURRIINNgg

Head/Brain Head and Neck

Bladder

Rectum

Prostate

Femoral Head

Lungs

Heart

Liver

Kidneys

Treatment PlanningThis is a process in which

the Physician, Physicist, and Dosimetry staff work together to optimize

delivering the highest prescription dose to the

target area while minimizing radiation to the normal

anatomy.

Treatment

Planning

Collaborative effort of Physician, Physicist, and Dosimetry Staff

Radiation Field/Beam Design

The radiation fields will be designed according to the Physician’s

prescription with the aid of the treatment planning system. This 3-D shaping (modulation) helps prevent/minimize radiation dose

to the surrounding healthy anatomy.

Radiation Field DesignMLC (Multi Leaf

Collimation)• The Radiation Beam is Shaped (modulated)

internally; inside the Treatment Machine.

• There are hundreds of interlocking lead ‘leaves’ working together to create one unique dynamic shape altering the 3-D effect of the radiation beam.

Radiation Field/Beam Manipulation

by Designing the MLC PatternDesigning the MLC Pattern

• The design of the MLC pattern is based The design of the MLC pattern is based solely upon the patients unique anatomy in solely upon the patients unique anatomy in correlation to the physician’s prescription.correlation to the physician’s prescription.

• As the radiation beam travels through the As the radiation beam travels through the MLC pattern the intensity of the beam is MLC pattern the intensity of the beam is shaped (modulated) as it enters the target shaped (modulated) as it enters the target area (cancer). Meaning, the target area area (cancer). Meaning, the target area (cancer) is receiving the highest prescription (cancer) is receiving the highest prescription radiation dose and the surrounding healthy radiation dose and the surrounding healthy anatomy is receiving the absolute minimum anatomy is receiving the absolute minimum amount of radiation. amount of radiation.

Quality Assurance Quality Assurance TestingTesting

Upon finishing the Radiation Therapy Upon finishing the Radiation Therapy Treatment plan, our physicist will Treatment plan, our physicist will perform a series of QA testing to perform a series of QA testing to ensure that the radiation dose we ensure that the radiation dose we

are delivering to the patient is are delivering to the patient is exactly what the prescription calls exactly what the prescription calls for prior to the start of treatment.for prior to the start of treatment.

Isocenter Check

Isocenter Check (Verification CT Simulation)

Isocenter Check

This is a process in which we verify the center of the radiation field that correlates with the center of the

target (cancer) area receiving radiation. In addition this confirms

that the patient’s position is accurate. This procedure produces the final markings of the radiation

field. (3 points)Note: Patient will get permanent tattoo

marks the size of a small freckle. (Usually 3)

Scheduling the Treatment Course

• Treatment days are Monday-Friday, no weekends.• A standing appointment time will be set up prior to

the first day. It is important to have the same appointment time everyday but arrangements can be made from time to time.

• Our clinic tries very hard to accommodate the patient’s home and work schedules; however, appointments may be limited to overall volume.

• In the event we are closed for a holiday or for an unexpected circumstance, we will take the days missed and add them to the end of your treatment.

• Try not to schedule travel plans within close proximity (5-7 days) to the end of the treatment date because that date could change.

Treatment Day

Radiation Therapist work station

Treatment Machine

What to Expect during Treatment• Most people are nervous the first couple of days of

treatment; however, the actual treatment received on a daily basis is the easiest part of the entire process.

• There is no sensation at all from start to finish from the radiation. Ex, getting an X-ray.

• The Patient is monitored by sight and sound 100% of the time while in the treatment room.

• It is extremely important to lay completely still during treatment.

• Please empty pants pockets of unnecessary items prior to entering room. Ex: coins, wallets, knives, combs..

***

Note: The Treatment table can be elevated 5 feet off the ground so never attempt to dismount the table without the help and direction from a therapist.

Things to Make Things to Make note of while note of while undergoing undergoing Radiation Radiation TherapyTherapy

Nutrition While Undergoing Radiation

• Please eat balanced meals, and stay well hydrated.

• Do not try to diet or lose weight during the treatments.

• It is extremely important that patients try and maintain the same weight throughout the entire course.

• Weight gain or loss over 10 lbs may result in re-planning.

• Weekly Weights will be kept on record.

General Side Effects

• Fatigue may occur as you near the end of treatment

• Hair loss or thinning of hair in the treated area may occur and is likely to re-grow

• Irritation/Redness to the treatment area may occur depending on the site of treatment

General Side Effects

•Please report all possible side effects or issues to

any staff members ASAP.

Thank you