5 things to expect and ways to prepare for your radiation therapy

As we’ve previously discussed, there are many myths and misconceptions about radiation therapy, also known as radiotherapy, often leaving patients and their family members unsure about what to anticipate during their treatment course. Let’s demystify some of that today.

ONE: first day of school, down in the dungeons?

• Much like first-day-of-school jitters, your first session (or fraction) of radiation therapy is often the most anxiety-provoking. This is only natural as it’s something new and unfamiliar.
• Radiation therapy often takes place below ground for reasons of shielding, and so it is likely that you will receive your therapy on the lowest floor of the building.
• Prior to therapy starting, a session called ‘planning’ or ‘simulation’ is performed to mimic the exact position and setup for treatment. If the brain, head or neck region is being targeted, a special customised mask may need to be created. You may wish to bring a support person with you to navigate through these sorts of new experiences.
• At treatment you will be welcomed and orientated by a team of radiation therapists (RTs) who specialise in radiation therapy delivery as per the plan prescribed by your oncologist.
• This team of RTs will remain fairly constant during your therapy period and before long, as their faces become familiar, you would have formed your own school clique!

TWO: timing and punctuality

• The length of someone’s radiation therapy will vary according to many factors including the target location, the amount being treated, and the dose per day.
• Your schedule for the coming week is provided usually towards the end of the preceding week and we endeavour to make this time suitable to your needs.
• We ask that you arrive about 5-10 minutes prior to your allocated time to allow you to get into your gown and to check any other preparation instructions specific to you (e.g. checking for a full bladder).
• In general, the “beam-on” time, meaning the time the delivery of radiation is taking place, is between 5 to 20 minutes. Prior to this, the setup time to get you into the correct position can take up to 15 minutes to ensure ultimate accuracy.
• All in all, you’ll be in the department for about 30-60 minutes per day but it will fly by and you’ll get into a daily rhythm. Some patients even miss coming in every day after the course is complete – but you can come visit if you want.

THREE: getting from point A to point B

• With any type of radiation therapy, energy levels can be reduced. Usually this is not to a degree that would impact your ability to drive, so feel free to drive yourself if you feel able.
• There are often parking allocations or allowances for cancer therapy patients on treatment, so ask your treating department about this. The last thing you’d want is a parking fine!
• If you feel too tired, or experience any other side effects from treatment impacting your ability to drive, it’s best then to ask a relative or friend to drive you.
• Otherwise, your radiation therapy department may be able to provide transport services with a bus or van service to pick you up from home and drop you off, depending on the suburb you live. A V.I.P service so that you have one less thing to worry about.

FOUR: who’s keeping an eye on me?

• During your treatment course, there are scheduled reviews with the radiation therapy nurses and your treating oncology team.
• At least once a week, a radiation oncology doctor will see you to answer any questions, review and manage any side effects and to guide you in regards to follow-up appointments.
• If you have an issue or question that isn’t urgent, then write them down in a notebook or your phone to ask at your next scheduled review. If it can’t wait untill then, you can see the nurses at any time during department hours, and they can contact the doctors if needed. You’re never alone through treatment.

FIVE: special considerations

• There are a few special mentions to flag in regards to radiation therapy that may or may not apply to you.
• If you are a woman, it’s important that you don’t become pregnant during your treatment as radiation therapy could harm a developing baby. If you are a man, your doctors may advise you not to conceive a child during treatment and for a few months after. You can ask your doctors about whether this applies to you.
• If you have a pacemaker or ICD, you must tell your treating team before or during your first planning appointment. These devices can be affected during radiation therapy and may need additional monitoring during treatment, as well as consideration in developing your treatment plan.

About the Author: Dr Eun-Ji Hwang is a Radiation Oncologist in training in Sydney, trying to stop the confusion around radiation therapy. One blog at a time.