Planning For Your Treatment
The first appointment needed after the consultation is called a “simulation.” This is a “mapping out” session where a radiation therapist positions you in the necessary treatment position and takes a series of X-rays or special CT scans to outline the treatment area that has been prescribed by your physician. If you have any special needs when lying on the table please tell your therapist before lying down. The simulation takes approximately one to two hours. Please note that these CT scans provide a guide for treatment planning purposes only. They are not scans to evaluate the status of disease nor are they tests to measure how your tumor is responding to the treatment. The data from the scan is collected, and a computerized treatment plan specific to your body is generated by the department’s physicist and medical dosimetrist.
In order for you to remain still during the treatments, a customized positioning tool called an immobilization device may be created for you. Immobilization devices can consist of face masks or arm, leg, body, or pelvic molds. In addition to keeping you still on the treatment table, these devices are utilized to help the radiation therapist place you in the same position on a daily basis.
Throughout the simulation procedure, it is important that you remain still. You may breathe normally. Once you are positioned correctly, the simulation therapist leaves the room to view your anatomy under fluoroscopy or to take X-rays. The therapist monitors you via a closed-circuit television, and you can communicate with the therapist through an intercom at all times.
Tattoos will also be given to outline the treatment set-up points and ensure accurate delivery of the daily treatments. Tattoos are freckle-like marks that consist of a drop of ink placed under the skin with the tip of a needle. A tattoo is permanent. In addition, marks may also be drawn on your skin in the treatment area using a washable crayon-like pencil. You need to leave these marks on. The therapist will touch them up during the course of therapy. You will be instructed when you can remove the marks.
During the simulation, an identification face photo and set-up photos will be taken for documentation. All of the photos taken during the course of treatment are kept in your confidential medical record.
During the course of your treatments, your physician may want to modify your treatment area. This may require additional simulation procedures. We will notify you in advance so you can prepare your schedule accordingly.
The data from the treatment plan helps the physician determine the amount of radiation needed over the course of your treatment. In addition, the information from the plan is used to confirm the daily dose of radiation and the total number of treatments you will receive. Based on the area being treated, custom-made lead shields may be necessary to spare healthy organs and tissue from being exposed to the radiation. Your actual treatment will begin after the physician approves the plan, a process which takes several days. You will not be physically present during the planning period.