Once a cancer diagnosis has been made, a team of specialists will work together to recommend the best treatment for you. That team will likely consist of a:
- Medical Oncologist
- Radiation Oncologist
- Primary Care Doctor
In some cases, your cancer will need to be treated by using more than one type of treatment. For example, if you have breast cancer, you might have surgery to remove the tumor (by a surgeon), then have radiation therapy to destroy any remaining cancer cells in or near your breast (by a radiation oncologist). You might also receive chemotherapy (by a medical oncologist) to destroy cancer cells that have traveled to other parts of the body.
YOUR RADIATION ONCOLOGIST
Before you begin radiation treatment, you must first visit a radiation oncologist. It is during this visit that you will discuss all of your treatment options and determine if radiation therapy is the best course of treatment for you. Your radiation oncologist will discuss the benefits and risks of radiation therapy, including side effects and alternative treatments that may be an option for you.
We will review your medical history, including any current treatments you are using and any health issues you may have in addition to your cancer. You will also undergo a complete physical exam to assess your physical condition, as well as to determine the extent of your cancer. Your first visit to the Center for Advanced Radiation Oncology and Proton Therapy is a time when you and your family members may sit down with your radiation oncologist to discuss your diagnosis, the role of radiation therapy in your treatment plan and how it will be administered. Our doctors spend 60-90 minutes, or longer, with each new patient. Our goal is to make sure patients and caregivers feel as comfortable as possible with their radiation therapy treatment plan.
Our compassionate staff will guide you to help make your first visit as informative and productive as possible. Please bring the following with you or provide prior to your appointment:
- Detailed records and scans from other doctors regarding your diagnosis
- Past medical and surgical history
- A complete list of the medications (including non-prescription medications) you take and any allergies you may have
When you arrive, you’ll be asked to complete a series of patient forms. You are encouraged to complete this prior to your first visit to help save time.
If you and your radiation oncologist decide that radiation therapy is the best treatment option for you, your radiation oncologist will schedule you for treatment simulation. Treatment simulation is like a practice run for what will happen during actual radiation therapy. Members of your treatment team will place you in the same position you will need to be in during actual treatment. The radiation therapist will mark the areas on your skin where the radiation beams will be directed.
CT scans may also be used to help determine the placement and shape of the radiation beams. To help keep the radiation beams aimed only at your tumor, special devices may be designed for you to protect normal cells from the radiation beams.
Following treatment simulation, your treatment team will review the information collected during the simulation to create a treatment plan for you. This plan should maximize the dose of radiation aimed at your cancer cells and minimize the amount of radiation to which your normal cells are exposed. Your radiation oncologist will then write a prescription for the needed amount of radiation and indicate which parts of your body will receive the treatment.
Once you finish the simulation, your radiation oncologist and other members of the treatment team review the information they obtained during simulation along with your previous medical tests to develop a treatment plan.
A special CT scan is often done to help with the simulation and treatment planning. This CT scan is in addition to your diagnostic CT scan. After reviewing all of this information, your doctor will outline exactly how much radiation you will receive and to what parts of your body.
Each session of external beam radiation therapy is painless, and is similar to what you experience when you have an X-ray. The radiation is aimed at your tumor using a machine located away from your body. Because radiation therapy is a non-invasive procedure, unlike surgery, it is typically given during a series of outpatient sessions, which means you will not need to stay in the hospital. Depending on your specific treatment, it is possible that you may not even need to miss work or have much of a recuperation period from the therapy like you would with other types of cancer treatment.
During your treatment session, your radiation therapist will follow your radiation oncologist’s instructions. Your treatment session will be the same as your treatment simulation. The length of your treatment will depend on the type of radiation you are receiving.
You will most likely receive treatment five days a week, Monday-Friday, and treatments will last for 1-10 weeks, depending on the size, location, and type of your cancer, the intent of the treatment, your general health, and other medical treatments you may be receiving.
It will take 5-15 minutes for the radiation therapist to position you for treatment and for the team to set up the equipment. The therapist will closely monitor you on a television screen while you are receiving the radiation. You will be able to talk with the therapist if you have any questions or concerns during therapy. The therapist can stop the machine if you are feeling sick or uncomfortable during treatment.
Your radiation therapy may be interrupted for a day or more if you develop side effects that require a break in treatment. If you miss treatments, you can make them up at the end of your remaining treatments.
Your radiation oncologist may alter your radiation dose depending on how you respond to the treatment. Your doctor may also order additional tests to see how your body is responding to treatment.
If your tumors shrink significantly in response to the radiation therapy, you may require another simulation so that your radiation oncologist to change the treatment to spare even more normal tissue.
Your treatment team will regularly review your case to ensure your treatment is proceeding as planned.
WEEKLY STATUS CHECKS
During treatment, your radiation oncologist and nurse will see you regularly to follow your progress, evaluate whether you are having any side effects, recommend treatments for those side effects, and address any concerns you may have. As treatment progresses, your doctor may make changes in the schedule or treatment plan depending on your response or reaction to the therapy.
Your radiation therapy team meets on a regular basis with other healthcare professionals to review your case to ensure your treatment is proceeding as planned.
After treatment is completed, follow-up appointments will be scheduled so that your radiation oncologist can make sure your recovery is proceeding normally and can continue to monitor your health status. Your radiation oncologist may also order additional diagnostic tests. Reports on your treatment will 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, your radiation oncologist and nurse are always be available should you need to speak to someone.