Radiation Treatment Process for Breast Cancer
Step 1: Consult
On your first day, you will come in for a consult with your doctor. A radiation oncology nurse will take you into an exam room and check your vital signs (Blood Pressure, Temperature, Pulse) and weight. The radiation oncologist will do a quick examination. Once you have had a consultation with your respective doctor and he/she has given you the necessary information about your specific cancer, the basic plan of action on how your treatment will be approached, and discussed possible side-effects of your radiation treatment, you will have a time set up to get a CT scan.
Step 2: CT scan
The CT scan will give the treatment team a 3D rendering of the patient’s internal anatomy. This scan will be used by our planning department and doctors to create your specialized treatment plan. On the day of your appointment, a therapist will come and get you and show you to the CT room. You will be assisted on the CT table by the therapist and straightened to ensure that your body is aligned on the table. You will be placed in the same position that you are to be treated in on a daily basis.
This will include sitting in a reclined position with the arm on the effected side raised above your head. The arm needs to be in the same position everyday for your treatments. Achieving this includes making a device called a VacLok. The VacLok originally starts out with the consistency and flexibility of a beanbag chair. The VacLok will be formed around your elbow, and then, all of the air will be vacuumed out of it to form a hard mold of your arm. The mold will be used everyday to ensure that you are in the same position. After the VacLok is made, you will be scanned once to ensure that your internal anatomy is indeed aligned. When the therapist determines that you are aligned properly you will be ready for the actual CT scan.
Lasers will be used for the therapist to mark crosshairs on your skin, and “BB’s” will be placed over these marks so that their location can be seen on the CT scan. Next, the scan will be performed. The CT table will move through the scanner. At this point you will not feel anything and nothing will actually touch you. The room is mounted with cameras and audio equipment so that the therapist can see and hear you at all times should you need anything. All you need to do at this point is to remain as still and relaxed as much as possible. After the scan is complete, it will be sent to Varian Eclipse Planning System for our dosimetrists and physicians to create your individualized treatment plan. You will be assisted off the CT table and given an appointment time for your first treatment, if one has already been determined, if one has not, the clinic will call you with more information and an appointment time when your plan has been completed.
Step 3: Treatment Planning
The scanned information is sent to the dosimetry planning department as soon as it is completed so that your site specific radiation therapy treatment plan can be made. The planning process can take up to a week. When the team has completed your plan, you will be assigned to a treatment room and given an initial “start” appointment.
Step 4: Your Treatment
Your first appointment will take a little longer than the rest of your treatments. You will be taken to a treatment room. Once in the room, you will get in the same position that you were in during your CT scan. The table will be raised, and you will then be aligned to the crosshairs that were marked on your skin. While trying to get you aligned, the therapists will be moving you around. You should relax, “lay heavy”, and let the therapist do all the moving. At this point, shifts will be made from these marks based on what the dosimetry team has planned for you. Once shifts have been made, radiographic images will be taken to ensure that you are aligned according to your plan and will be checked by your oncology physician before any actual radiation treatment is administered. It should be noted that films taken in the treatment room are used for set up and localizing specific anatomy and do not show a progression or digression of your disease. Once these images are approved by the physician, your skin will be remarked and you will then receive your first treatment. The machine will rotate to different angles based on your treatment plan. During your treatment, you will not feel the radiation, however, you will hear the machine buzzing.
Step 5: Tattooing
After completing your first treatment, permanent marks, or tattoos, will be made on your skin. This involves placing a drop of ink on the skin and using a tiny lancet to make the marks. These tiny permanent marks allow the Radiation Therapists to ensure consistency in your daily set-up. They also allow you, the patient, the freedom to shower or bathe without the worry of maintaining ink marks and tape on your skin.
Step 6: Photograph
After the permanent marks have been made, a photograph of your treatment set up will be taken for the clinic’s records. This is to ensure that your treatment set up will be consistent should a different therapist need to treat you at a later date.
Step 7: Scheduling
Since this will be the room where you receive your daily treatments, you will discuss a daily treatment time with your radiation therapist. Available time slots will vary depending on your treatment room’s schedule. The decided treatment time will be consistent throughout your treatment regimen. Treatments are given Monday through Friday- you will not have to come for treatment on Saturday or Sunday.
Step 8: Weekly Follow-up
After your first week of treatment, every Monday you will visit with a physician. This is a time when you can talk to the doctor about any concerns or side-effects you may be experiencing.