Planning your radiotherapy treatment
Before you start your treatment you will normally have an appointment at the clinic to see your clinical oncologist. They will discuss the treatment they recommend with you.
Planning your treatment
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Before you start your treatment you will need to have it planned. Radiotherapy may be planned and given in a very simple way for certain conditions, such as with many types of skin cancers and for palliative treatment. Your cancer specialist may simply put marks on your skin with a soft pen where the treatment is needed. For most curative treatments, more detailed and complicated planning is needed.
Planning is a very important part of radiotherapy. It may take a few visits - and can take up to two weeks - to complete before you can start your treatment. Careful planning makes sure that the radiotherapy is as effective as possible. It ensures the rays are aimed precisely at the cancer and cause the least possible damage to the surrounding healthy tissue. The treatment is planned by your clinical oncologist, a physicist and sometimes by a senior radiographer.
On your first visit you may have a CT (computerised tomography) scan taken of the area to be treated. A CT scan takes lots of images from different angles to build up a three-dimensional picture of the area. At the same time, therapy radiographers will take measurements from you, which are needed for treatment planning.
This session will usually take about 45-60 minutes. Sometimes you may also need to have an MRI (magnetic resonance imaging) scan. This uses powerful magnetic fields to give a detailed picture of part of your body, which can give additional useful information.
The radiographer’s measurements and the information from the scans are fed into a planning computer that helps your doctors plan your treatment precisely.
Some special procedures may be needed to make sure the radiographers get a clear picture. For example, to plan treatment to the pelvic area, a liquid that shows up on x-ray may be passed into your back passage or into your bladder, or a tampon may be used to show the exact position of the vagina.
These procedures may be slightly uncomfortable but aren’t painful and only take a few minutes. They are only used for planning the treatment and are not repeated during the treatment sessions. The radiographer will explain these procedures to you. It‘s important for you to feel that you are involved in your treatment, so feel free to ask as many questions as you like.
To help you stay still and in position during the radiotherapy, you may need a device called a mould. This will be made before planning starts, and is used to help keep you still so that the treatment is as effective as possible.
Radiotherapy moulds are sometimes called masks or shells. The mould is made of a plastic mesh or clear perspex.
Moulds are often used for treatments to the head and neck area. Sometimes a mould of your leg, arm or other body part is used to keep the area still during treatment. Any marks can then be made on the mould instead of your skin.
Moulds are commonly used for children having radiotherapy.
Your mould should fit snugly. If the mould is uncomfortable in any way let the radiographer know, as they can usually adjust it. Remember you’ll only have the mould on for the time it takes to give you your treatment.
Our section on making a radiotherapy mask explains the process in more detail.
Once the treatment area has been decided, ink markings are sometimes made on your skin (or on the mould) to pinpoint the exact place where the radiation will be directed. The staff will explain how to look after these markings.
If the marks begin to rub off, tell your radiographer. Don’t try to redraw them yourself. The marks can rub off on to clothing, so some people choose to wear older clothes next to their skin during treatment.
Often two or more small tattoo marks are also made on the skin. These marks are permanent, but they are the size of a pinpoint and will only be done with your permission. It’s a little uncomfortable while the tattoo is being done, but it’s a good way of making sure that treatment is directed accurately.
The tattoo marks are also useful once treatment has finished, as they show the area where the radiotherapy was given and prevent further radiotherapy from being given there in the future. This is useful because radiotherapy can usually only be given to an area of the body once before it starts to cause harm rather than doing good.