The days before The days before TreatmentTreatment

- CT/Simulation

- Image Contouring

- 3D Treatment Planning

- Radiation Field Design (MLC, BLOCKS)

- Isocenter Check (Verification Simulation)

CT/SimulationCT/Simulation

A series of detailed pictures A series of detailed pictures taken of areas within the taken of areas within the

body to precisely locate and body to precisely locate and mark the target (cancer) mark the target (cancer) area that is going to be area that is going to be receiving the radiation receiving the radiation

therapy.therapy.

CT/SimulationCT/Simulation

Contouring Contouring ImagesImages

The Images from your The Images from your CT/Simulation are downloaded CT/Simulation are downloaded

into a treatment planning into a treatment planning program. Then, the important program. Then, the important anatomy in and/or around the anatomy in and/or around the

radiation therapy field are radiation therapy field are outlined.outlined.

CCOONNT T O O UURRIINNgg

Head/Brain Head and Neck

Bladder

Rectum

Prostate

Femoral Head

Lungs

Heart

Liver

Kidneys

Treatment PlanningTreatment PlanningThis is a process in which This is a process in which

the Physician, Physicist, and the Physician, Physicist, and Dosimetry staff work Dosimetry staff work together to optimize together to optimize

delivering the highest delivering the highest prescription dose to the prescription dose to the

target area while minimizing target area while minimizing radiation to the normal radiation to the normal

tissue.tissue.

Treatment Treatment

PlanningPlanning

Collaborative effort of Physician, Physicist, and Dosimetry Staff

Radiation Field/Beam Design

The radiation field will be designed The radiation field will be designed according to the Physician’s prescription according to the Physician’s prescription with the aid of the treatment planning with the aid of the treatment planning

system. This 3-D shaping helps system. This 3-D shaping helps prevent/minimize radiation dose to the prevent/minimize radiation dose to the

surrounding healthy anatomy.surrounding healthy anatomy.

•MLC (Multi Leaf Collimation) and/or

•Cerrobend Blocking

Radiation Field DesignMLC (Multi Leaf

Collimation)• The Radiation Beam is Shaped The Radiation Beam is Shaped internallyinternally; inside ; inside

the Treatment Machine.the Treatment Machine.

• There are hundreds of interlocking lead ‘leaves’ There are hundreds of interlocking lead ‘leaves’ working together to create one unique dynamic working together to create one unique dynamic shape altering the 3-D effect of the radiation shape altering the 3-D effect of the radiation beam.beam.

Radiation Field Design

• Radiation Beam is Shaped Radiation Beam is Shaped externallyexternally; outside the ; outside the

Treatment Machine if necessary.Treatment Machine if necessary.

Cerrobend Blocks

Isocenter CheckIsocenter Check

Isocenter Check (Verification CT Simulation)

Isocenter CheckIsocenter Check

This is a process in which we This is a process in which we verify the verify the center of the radiation fieldcenter of the radiation field that correlates with the that correlates with the center of the center of the

target (cancer) area receiving target (cancer) area receiving radiationradiation. In addition this confirms . In addition this confirms

that the patient position is accurate. that the patient position is accurate. This procedure produces the final This procedure produces the final markings of the radiation field. (3 markings of the radiation field. (3

points)points)Note: Patient will get permanent tattoo Note: Patient will get permanent tattoo

marks the size of a small freckle. (Usually 3)marks the size of a small freckle. (Usually 3)

Scheduling the Scheduling the Treatment CourseTreatment Course

• Treatment days are Monday-Friday, no weekends.Treatment days are Monday-Friday, no weekends.• A standing appointment time will be set up prior to A standing appointment time will be set up prior to

the first day. It is important to have the same the first day. It is important to have the same appointment time everyday but arrangements can be appointment time everyday but arrangements can be made from time to time.made from time to time.

• Our clinic tries very hard to accommodate the Our clinic tries very hard to accommodate the patient’s home and work schedules; however, patient’s home and work schedules; however, appointments may be limited to overall volume.appointments may be limited to overall volume.

• In the event we are closed for a holiday or for an In the event we are closed for a holiday or for an unexpected circumstance, we will take the days unexpected circumstance, we will take the days missed and add them to the end of your treatment. missed and add them to the end of your treatment.

• Try not to schedule travel plans within close Try not to schedule travel plans within close proximity (5-7 days) to the end of treatment date proximity (5-7 days) to the end of treatment date because that date could change.because that date could change.

Treatment Treatment DayDay

Treatment Machine

Radiation Therapist work station

What to Expect during What to Expect during TreatmentTreatment• Most people are nervous the first couple of days of Most people are nervous the first couple of days of

treatment; however, the actual treatment received treatment; however, the actual treatment received on a daily basis is the easiest part of the entire on a daily basis is the easiest part of the entire process. process.

• There is no sensation at all from start to finish from There is no sensation at all from start to finish from the radiation. Ex, getting an X-ray.the radiation. Ex, getting an X-ray.

• The Patient is monitored by sight and sound 100% of The Patient is monitored by sight and sound 100% of the time while in the treatment room.the time while in the treatment room.

• It is extremely important to lay completely still It is extremely important to lay completely still during treatment.during treatment.

• Please empty pants pockets of unnecessary items Please empty pants pockets of unnecessary items prior to entering room. Ex: coins, wallets, knives, prior to entering room. Ex: coins, wallets, knives, combscombs

Note: Note: The Treatment table can be The Treatment table can be elevated 5 feet off the elevated 5 feet off the groundground so never attempt to dismount the table without the so never attempt to dismount the table without the help and direction from a therapist.help and direction from a therapist.

Things to Make Things to Make note of while note of while undergoing undergoing Radiation Radiation TherapyTherapy

Nutrition While Undergoing Nutrition While Undergoing RadiationRadiation

• Please eat balanced meals, and stay well Please eat balanced meals, and stay well hydrated.hydrated.

• Do not Do not trytry to diet or lose weight during the to diet or lose weight during the treatments. treatments.

• It is extremely important that patients try and It is extremely important that patients try and maintain the same weight throughout the maintain the same weight throughout the entire course.entire course.

• Weight gain or loss over 10 lbs may result in Weight gain or loss over 10 lbs may result in re-planning.re-planning.

• Weekly Weights will be kept on record.Weekly Weights will be kept on record.

Note: A reference packet of basic diet guidelines will be Note: A reference packet of basic diet guidelines will be given to you.given to you.

General Side General Side EffectsEffects

• Fatigue may occur when nearing the end Fatigue may occur when nearing the end of treatment of treatment

• Hair loss or thinning of hair in the treated Hair loss or thinning of hair in the treated area may occur but is likely to re-growarea may occur but is likely to re-grow

• Irritation/Redness to the treatment area Irritation/Redness to the treatment area may occur depending on the site of may occur depending on the site of treatmenttreatment

General Side General Side EffectsEffects

•Please report all possible Please report all possible side effects or issues to side effects or issues to

any staff members ASAP.any staff members ASAP.

Thank youThank you