When radiation is being considered as a part of a treatment plan, a consultation appointment will be scheduled with a Radiation Oncologist. The patient does not receive a radiation treatment at this visit. During this appointment the patient will first meet with a registered nurse who will review the patient's medical history and medication list. If radiation therapy is recommended, the nurse will go over specific instructions related to the radiation. The patient should schedule to be at the physician's office for at least an hour for this initial visit.
The purpose of this appointment is to meet with Conemaugh's radiation oncologist and discuss the role of radiation therapy in treatment. The physician will explain the type of radiation that will be given, the number of treatments that will be necessary, and will answer any questions. If radiation therapy is recommended as part of treatment, and the patient is in agreement to proceed, the patient will be asked to sign an informed consent for radiation therapy. The physician and staff will always be able to answer any additional questions even after this initial consultation. Please note that consent can be withdrawn at any time.
Preparing for the Scan
Patients who are to receive radiation therapy will be scheduled for a CT scan, also known as a “simulation”, in order for treatment planning to begin. The scan times can vary and there may be special instructions to follow for the scan to be optimal for a treatment plan.
The nurse will provide instructions on what to wear when returning for the simulation scan. Special bowel, bladder, stomach, or oral cavity instructions may be given to the patients to ensure the scans are accurate. The nurse will explain all of the protocols to the patient prior to the day of the scan or on consult day.
Day of CT Simulation Scan
During this simulation, the therapists will make molds for the patient, mark the area of treatment, take pictures, and answer any questions the patient may have to ensure the patient and accompanying family members are comfortable with all aspects of this journey.
The therapists will verify the patient's name, date of birth, area of treatment, and that the consent has been signed and reviewed. The patient may be asked to change into a gown for the simulation but instructions may vary.
The therapists will help the patient onto the table and position him / her correctly according to the area of the body being simulated. Therapists do all they can to ensure patient comfort. The patient should remain still and limit movement as much as possible during the scan for accurate results. The scan will begin and be reviewed by the radiation oncology team.
During the simulation, marks are placed on the patient's body for navigation of therapy. The patient is asked to keep the marks on his / her body until returning for the verification simulation which takes place in the treatment room. The therapists will place a clear sticker over the marks to insure they do not come off, but patients are asked to wash gently over these areas as to not scrub off the marks. Depending on the patient's plan of treatment, it may take two to five days until the verification scan. The therapists will give the patient an appointment card with the return date and time.
After the Simulation Scan
Once the scan is complete, the information is sent to Conemaugh's treatment planning system for the dosimetrist to create a plan dedicated to each individual patient. The Radiation Oncologist will write the prescription of how much radiation and the number of treatments. Total treatments can vary depending on the type of cancer, stage, grade, and cell type.
The Radiation Oncologist, physicist, dosimetrist, and therapists are all involved in making sure the plan is accurate and precise for the treatment before the patient arrives in the department for a verification simulation. This plan is a customized treatment for each specific patient and the accuracy is down to millimeters.
Day of Verification Simulation
The therapists will complete the final stage by having the patient come to the office for a verification simulation. Name, date of birth, and area to be treated are all verified prior to entering the room for correct patient confirmation on a daily basis.
The therapists will align the patient to the marks given during the CT scan, to lasers in the room. The therapists appreciate the patient's cooperation during this time, as it is a process that includes rolling and lifting. Once the patient is properly aligned, the therapists will perform specific shifts to the table that come from the treatment plan that the dosimetrist has identified. A mini CT scan and x-rays will be taken to ensure proper alignment has been obtained.
Once the scan has been completed, the images taken will match the treatment plan. The therapists verify the placement of anatomy and the Radiation Oncologist will approve the image. The patient is then moved on the table remotely by the therapists and may feel the table adjust. The therapists are specially trained in moving the table and making precise adjustments. The machine may come close to the patient but will never touch the patient's body.
Once finished, therapists will take pictures of all placement and give any necessary tattoos. These tattoos are permanent and strongly recommended due to the ease of daily set ups and worry free maintenance.
First Day of Treatment
Following the verification simulation, the patient will begin the radiation treatments prescribed by the Radiation Oncologist. The patient can expect to be in the department for treatment no more than 15-20 minutes on average during each treatment but many factors will alter this time frame.
The most important piece of knowledge to remember is everyone is different and may react differently to radiation. Side effects are possible with this form of treatment but severities may fluctuate depending on different dynamics.
The therapists will have patients arrive for treatment at the same time every day. Patients should discuss with the therapists if specific times are needed. Every effort will be made to try to accommodate requests.
In general, follow-up appointments occur between three to four weeks after the completion of radiation therapy. After this initial follow-up, staff will follow the patient's progress on a regular basis. While the patient may be seeing many other providers for care, it is important to participate in this follow-up process so that any radiation-related problems can be identified early and treated.
Thank you for choosing Conemaugh Health System for you care.