2. What Happens in the days before treatment ?
CT/Simulation
Contouring images
Treatment planning
Radiation Field Design
Quality Assurance
Iso-center check

3. 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.

4. CT/Simulation

5. 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.

6. C O N T U R I g Head/Brain Head and Neck Bladder Lungs Heart Prostate
Femoral Head
Heart
Liver
Prostate
Kidneys
Rectum

7. Treatment Planning
This 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.

8. Collaborative effort of Physician, Physicist, and Dosimetry Staff
Treatment Planning
Collaborative effort of Physician, Physicist, and Dosimetry Staff

9. 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.

10. Radiation Field Design MLC (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.

11. Radiation Field/Beam Manipulation by Designing the MLC Pattern
The design of the MLC pattern is based solely upon the patients unique anatomy in correlation to the physician’s prescription.
As the radiation beam travels through the MLC pattern the intensity of the beam is shaped (modulated) as it enters the target area (cancer). Meaning, the target area (cancer) is receiving the highest prescription radiation dose and the surrounding healthy anatomy is receiving the absolute minimum amount of radiation.

12. Quality Assurance Testing
Upon finishing the Radiation Therapy Treatment plan, our physicist will perform a series of QA testing to ensure that the radiation dose we are delivering to the patient is exactly what the prescription calls for prior to the start of treatment.

13. Isocenter Check
Isocenter Check (Verification CT Simulation)

14. 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)

15. 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.

16. Radiation Therapist work station
Treatment Day
Treatment Machine
Radiation Therapist work station

17. 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.

18. Things to Make note of while undergoing Radiation Therapy

19. 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.

20. 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

21. General Side Effects
Please report all possible side effects or issues to any staff members ASAP.
Thank you