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What to Expect During Treatment
The IMRT/IGRT treatment process generally consists of several steps, including consultation, positioning, imaging, treatment planning, plan verification and treatment delivery. At our center you will find a dedicated team of medical professionals that will work with you every step of the way.
Consultation
The first step is that you will meet with Dr. Noah Taylor, your Radiation Oncologist, who will review your medical history, pathology reports and pertinent medical information to determine the most successful course of treatment.
Once a course of treatment has been determined, the majority of patients will be scheduled for a CT scan planning appointment prior to the start of treatment.
Prior to the actual CT scan, a special molded device that will assist the patient to maintain the same position each treatment is molded during this treatment preparation session. For most cancer sites, this consists of a formed cast that is used only while the patient is actually receiving treatment. Colored, semi-permanent ink may be used to mark the patient’s skin to assist in positioning the patient for treatment by aligning the radiation equipment with the targeted area. A special non-contrast CT scan in the treatment position is taken to properly map the target area and to use as a reference image for each treatment. This session usually takes between 30 to 60 minutes. There is no preparation for this appointment.
Following the CT scan, the radiotherapy treatment planning process usually requires several days and does not require your presence. Therefore, your appointment for the first treatment will be approximately one week after the CT scan.
Treatment Planning
Using the information gathered during positioning and imaging, the Radiation Oncologist Dr. Taylor, Radiation Physicist and Radiation Dosimetrist (a person specially trained to calculate and plan radiation doses) work together to deign the most effective IMRT treatment plan for your situation. As part of the treatment planning, your medical team conducts extensive quality assurance testing with the treatment equipment to ensure the planned treatment can be accurately and easily carried out.
Treatment Delivery
The first IMRT/IGRT treatment session is usually longer than subsequent treatments so that additional X-ray films and checks can be performed. A typical treatment session lasts about 15 minutes.
In the treatment room, the patient is positioned on the treatment table utilizing the specially molded device. The radiation therapist uses the marks on the patient’s skin or mask to assist in accurately locating the treatment area.
The radiation therapist leaves the treatment room and remotely controls a digital On-Board Imager device to fine tune the patient’s position and move the treatment couch into final position. The On-Board Imager rotates around the patient to take digital images of the targeted area. Usually two or more images are taken from different angles. A complete rotation of the machine may be used to generate a three-dimensional image. These images are then used to guide the final adjustments of the treatment couch.
Although the patient is alone in the treatment room, he or she can be seen on a television screen stationed at the control panel. The therapist can communicate with the patient through an intercom. Patients do not see or hear the radiation nor experience any type of discomfort or feeling.
Radiation therapy usually is given five days a week for approximately 6 to 8 weeks depending on the treatment plan. When radiation is utilized for palliative care, the course of treatment lasts for two to three weeks. For each radiation therapy sessions, the patient is in the treatment room for about 15 minutes. These types of schedules, which use small amounts of daily radiation rather than a few large doses, assist in protecting normal body tissues in the treatment area. Weekend rest breaks allow normal cells to recover. The total dose of radiation and the number of treatments a patient requires depends on the size and location of the cancer, the type of tumor, the patient’s general health and other pertinent factors.
Follow-Up Care
When your course of treatment is completed, you will have a series of follow-up visits in which your doctor will monitor your condition and the effects of the treatment. Your doctor may require blood tests, X-rays, and/or scans at these appointments. Discuss with your doctor how to stay healthy after treatment. Inquire about nutrition, exercise, and other environmental changes that could help you maintain a healthy lifestyle. Equally as important, find out about support groups for cancer patients and survivors, so that you can connect with others who have had similar experiences.