A diagnosis of cancer can bring on a flood of emotions and concerns. At Turville Bay Radiation Oncology Center, we strive to care for patients and their loved ones while treating the disease. Radiation alone, or in combination with other cancer treatments, can successfully treat many different types of cancer. Our team of professionals is dedicated to tailoring a treatment plan to meet your medical needs in a non-institutional setting. Staff is always available to answer questions, help ease anxieties, and offer comfort.
When your primary care physician or other specialist refers you to our clinic, our patient scheduler will contact you to set up the initial consultation appointment. A packet of informational material and health-related forms will be sent to you prior to the appointment day. It is important that the forms be filled out completely and brought to the consultation. Interpreters are available but must be scheduled in advance. Referring physicians send pertinent medical records to our clinic, but you should bring any medical records in your possession, a list of medications, insurance information, and referral forms with you on the day of your consultation.
Consultation with a Radiation Oncologist
No matter what type of radiation therapy you receive, your treatment begins with consultation. Most patients are referred to radiation oncology by other specialists who have done tests to determine if cancer is present and at what stage. The consultation appointment takes about 1-2 hours and gives you the opportunity to meet with one of the radiation oncologists (a physician specializing in the treatment of cancer with radiation) and learn about your treatment options.
Before meeting with the doctor, you will meet with a nurse who will take your pulse, blood pressure, weight, and health history. You’ll learn what you can expect from radiation treatment, including possible side effects. Then the consultation with the Radiation Oncologist will begin. He or she will take the information you bring with you, review your medical history with you, and perform a physical examination. The radiation oncologist may communicate a great deal of information in a short period of time. Family members or significant others are encouraged to accompany you on this visit. It may be useful for you to bring a prepared list of questions. It may also be helpful to have another person to take notes and ask questions.
To comply with current health care standards, Turville Bay does not allow the use of recording devices or cameras on its property. Protected health information (including pictures) should never reside on a personal portable device. Your privacy is important to us.
After the examination, the doctor will discuss your treatment options (including benefits and risks) and give his/her recommendations. If you decide that radiation treatment is right for you, a treatment planning CT scan and/or simulation will be scheduled.
The simulation/treatment planning appointment, which takes about one hour, is required to properly plan your radiation therapy. To be most effective, radiation therapy must be aimed precisely at the same target each time treatment is given. The process of measuring your body and marking your skin to help safely direct the beams of radiation occurs during the CT simulation.
Images are taken to determine the precise area to be treated. We do this with the help of a CT Scanner. The CT scanner does not deliver the radiation treatment. During the CT simulation, your radiation oncologist and radiation therapist(s) position you on the CT scanner in the exact position you will be in during actual treatment. Because positioning is so important for your treatment you may have a custom mold, mask, or headrest made. These immobilization devices help you remain in the same position during the entire treatment. Depending on the area treated, your physician may request that you receive IV contrast or barium to drink. Contrast is used to highlight organs so that they can be seen on X-ray or CT images. When imaging is complete, the therapist will either place a temporary mark on your skin and cover it with protective tape or give you small permanent tattoos (very small black dots). These marks are sometimes placed on your customized immobilization device. The marks will be used to position you each day for your radiation treatments. When this appointment is complete, you will be given an appointment to begin your course of treatment, usually one to three weeks after the CT appointment.
During the days following your 2nd appointment, images obtained from the CT scanner are transferred to a sophisticated treatment planning computer system where a virtual three-dimensional image is created and the treatment plan is developed. This step takes place even though you are not in the radiation oncology department. The planning team (radiation oncologist, dosimetrists, and medical physicists) custom designs the best treatment plan for you. This process can take a couple of days or up to three weeks depending on the complexity of the plan. After reviewing all of your information and your treatment plan, your doctor will write a prescription that outlines exactly how much radiation you will receive and what parts of your body will receive the radiation. The final step in the simulation and planning process is the verification simulation. This is done on the treatment machine. If temporary marks were used, they will be replaced with tattoos. Each patient is different and each treatment plan is unique – verification of all treatment parameters ensures that you are ready to start your treatment.
It is not unusual to feel anxious on the first day of treatment. We hope you will share your concerns with us. We are here to answer your questions. during treatment, you will lay down on the treatment table in the same position as your initial set-up. The radiation therapists will use the tattoos that were placed on your skin (or immobilization device) during the CT simulation to position you correctly. The therapists will then leave the room and go into an adjoining control room. Images are taken regularly and then reviewed by your doctor to ensure proper positioning. They do not show disease. Therapists constantly monitor you with audiovisual technology while administering the radiation. You can communicate with the therapist if you have any concerns. Radiation therapy is usually given on a structured schedule over the course of several weeks or months. Most patients receive 4 or 5 treatments each week for several weeks. Although treatments are scheduled for 15 or 30 minutes, you will receive radiation for only a fraction of that time. Much of that time is spent on positioning. Patients do not feel anything during the radiation treatment is painless.
Radiation works best when it is given in small doses over several sessions. In this way, it can destroy the tumor cells and yet allow sufficient time for the normal healthy cells around the tumor to repair any damage from the radiation.
Radiation therapists are always available to answer questions. You will meet once each week with your nurse and radiation oncologist for assessment of your progress and for you to express any concerns. Please inform the radiation oncologist of any new symptoms if they arise. The side effects of the radiation depend on the exact type of tumor treated and the location of the radiation treatment.
Managing Side Effects
Many people encounter varying issues due to radiation therapy. Skin changes, fatigue, diarrhea, or trouble eating are perhaps the most common. Side effects vary from person to person and depend on the type of radiation dose and the area of the body being treated. Early side effects (those occurring early in treatment) may include skin changes, fatigues and hair loss. Most side effects go away with time once treatment is complete. Tell your radiation therapist and radiation oncologist about your issues, as there may be ways to reduce discomfort.
Review potential side effects by clicking the link below and talk with your healthcare providers about what is happening to you.
After Treatments are Complete
After your treatments are complete, a follow up appointment will be scheduled so that your radiation oncologist can make sure your recovery is proceeding normally. Follow-up care is aimed at assessing the disease status and managing side effects. Your radiation oncologist may also order additional lab work, X-Rays, and other diagnostic tests. Reports on your treatment may also be sent to the other doctors helping treat your cancer. As time goes by, the number of times you need to visit your radiation oncologist will decrease. However, you should know that your radiation oncology team will always be available if you ever need to speak to someone about your treatment.