The total dose of radiation and the number of treatments you need will depend on a set of highly individual factors. Such considerations include the type, size and location of your cancer, your general health, and any other treatments you may be receiving, or have received.
Your individualized course of radiation treatments will be evaluated, planned, and implemented in phases. These phases include consultation, simulation and daily treatments.
We encourage you to attend our "Preparing for Radiation Therapy" program, a one hour, free education session designed to educate our patients and their caregivers about their radiation therapy experience. Our program is facilitated by members of our radiation therapy team.
Most often your first visit to the radiation therapy department will not involve any treatments. This appointment allows the radiation oncologist, the physician who specializes in radiation treatments, the opportunity to review your imaging studies and records, evaluate your general condition and discuss with you the details of radiation treatments. The radiation oncologist may also call upon your referring physician and other cancer specialists to help determine the best method of treatment for you. This is also a chance for you to ask any unanswered questions. We recommend you bring a family member or close friend along for this visit.
This phase is very technical and usually involves a team effort made up of the radiation oncologist, physicist, and radiation therapist. AtlantiCare Regional Medical Center's (ARMC) Radiation Oncology program utilizes a CT scanner that contains software that will precisely localize the area the physician wishes to treat with radiation. This software allows physicians to "fuse" previous imaging, studies such as MRIs and PET scans, to the simulation CT scan, this method is used when relevant scans are available. The radiation team uses the data gained from this scan to mark the area of treatment. This process usually involves taking several CT images.
Once the area to be treated is localized by the team, you will be given small, but permanent tattoos. These tattoos are not very noticeable and allow you to maintain proper daily hygiene during your course of treatment. The tattoos are absolutely necessary for the accuracy of the treatment. Photographs of the treatment area will also be taken at this time and possibly again just prior to your first treatment.
Once the treatment area is defined, the physician, physicist and dosimetrists will review all of the information gained from and the scans themselves and formulate a tailored individualized treatment plan. The team will enter technical data into a treatment-planning computer to develop an approach to deliver radiation from possibly several different directions and establishing the length of time for each treatment segment. This plan is reviewed and approved by the radiation oncologist prior to implementation.
For your daily radiation treatments you will lie on a table in the same position you were in for the simulation procedure. The treatment unit (Linear Accelerator) will be directed according to the computerized treatment plan and the marks on your skin. ARMC also utilizes IGRT (Image Guided Radiation Therapy) to ensure the accuracy of daily treatments. IGRT allows the radiation therapists and physicians to administer ultra-precise doses of radiation to previously unreachable tumors.
Tumors are not stationary, unchanging targets; they move between and during treatments. IGRT uses daily CT scanning to create three dimensional images that pinpoint the exact size, location and coordinates of the tumor. In the past, radiation oncologists have had to compensate for tumor movements by making the radiation beam larger, exposing a significant volume of healthy tissue to radiation. With IGRT, two robotically controlled "arms" capture CT, fluoroscopic and x-ray images on a daily basis, pinpointing the position of the cancer just prior to treatment. This increased precision allows for higher doses of radiation - ultimately leading to higher cure rates.
After the therapists have prepared you to receive your treatment, he or she will leave the treatment room. It is important that you remain still and breathe normally during this time. You will be monitored by closed-circuit TV and intercom for the entirety of your treatment. The treatment times can vary greatly depending on your treatment plan, generally though ranging from 5 to 15 minutes. Every effort will be made to schedule your daily treatment at a time that is convenient for you.
While under treatment, you will have a weekly scheduled visit with the physician and nurse to discuss your progress, concerns, and possible side effects. However, should any problems arise before your weekly visit, please inform any staff member that you wish to speak with the physician and/or nurse before your treatment.
During your course of radiation therapy, the radiation oncologist will communicate with the physics staff, therapists, and nurses to continually assess your progress.