Most people with cancer who have radiation therapy have the type called external-beam radiation therapy (EBRT). The information here will describe what to expect during visits for this type of therapy. If you are having a different type, your radiation oncology team will explain the steps involved in your care.
During your first visit to the radiation oncology department, you will meet with the members of your radiation therapy team. Your radiation oncologist will review your history, perform a physical exam, and discuss the recommended course of treatment with you, including expected outcomes and possible side effects.
Simulation is usually the second visit to the radiation oncology department. This is when measurements are taken to find the best way to perform your radiation treatments. Depending on the type of treatment, this may involve taking a computed tomography (CT) scan of the part of the body being treated, or it may involve creating special cushions to help keep your body in the same position every time you have the treatment. Our radiation therapists may draw marks on your skin or even place small, pinpoint tattoos to help make sure you are lined up exactly the same way every day for your treatment. For radiation involving the head, the team creates a positioning mask to help hold your head in the right place.
Treatment planning happens behind the scenes. Your radiation oncologist, dosimetrists, and a medical physicist use the measurements and images from your simulation to create your radiation plan. Their goal is to maximize the effects of the radiation on the part of your body being treated and minimize the effects on other parts of your body. Treatment planning often requires the use of specialized computers with sophisticated radiation treatment planning software. This part of the process may take several days.
After your doctor has approved your radiation treatment plan, you may need to return to the radiation oncology department for a verification simulation. This is essentially a final check or “dry run” to confirm your positioning on the treatment machine and other details of your radiation plan before you begin treatment.
EBRT is usually given in a series of outpatient visits that last 20 to 30 minutes each, five days a week (Monday through Friday). Treatment courses typically last somewhere between two and eight weeks, depending on the tumor type, location, and size. Your doctor will see you for a check-up at least once a week while you are going through radiation treatments.
After you have completed all of your radiation treatments, you will visit your radiation oncologist to create a follow-up plan.