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What to Expect

After a cancer diagnosis, you’ll consult with your primary care physician and specialists, such as a radiation oncologist, to explore treatment options. Often, a combination of treatments is necessary. For instance, breast cancer treatment may involve surgery to remove the tumor, followed by radiation therapy to eliminate remaining cancer cells, and possibly chemotherapy to address cells that have spread. Your radiation oncologist will review your medical history, imaging, and conduct a physical examination to discuss the benefits and risks of radiation therapy, addressing any questions you have.

Before Treatment

Consultation with a Radiation Oncologist

If radiation therapy is being considered, schedule a consultation with a radiation oncologist. During this visit, the oncologist will assess your condition to determine if radiation therapy is appropriate. This evaluation includes reviewing your medical history, current symptoms, and performing a physical exam to assess disease extent and overall health. Your medical records, including imaging and lab results, will be examined. Treatment options are often discussed among a multidisciplinary team, including medical oncologists, surgeons, radiologists, and pathologists, to tailor recommendations. The oncologist will explain the benefits, risks, side effects, and alternatives of radiation therapy. Your care team may also include an oncology nurse navigator to guide you through treatment and recovery, and a nutrition counselor to assist with dietary needs during treatment. If you opt for radiation therapy, you’ll proceed to treatment planning at the appropriate time.

Simulation

After simulation, the radiation oncologist and treatment team develop a plan based on the simulation data and previous medical tests. The goal is to maximize radiation to cancer cells while minimizing exposure to healthy tissues. This involves selecting the radiation technique, dose, and beam angles. A team comprising the radiation oncologist, medical physicist, and dosimetrist collaborates to create the optimal treatment plan using advanced planning software. The radiation oncologist then prescribes the specific radiation dose and target areas.

Treatment Planning

Once you have finished simulation, your radiation oncologist and other members of the treatment team review information obtained during simulation along with your previous medical tests to develop a treatment plan. The goal of radiation therapy is to develop a plan that maximizes the dose to the cancer cells and minimizes the dose to healthy tissues. Radiation treatment technique and radiation dose, as well as beam angles and shapes will be selected during the planning process. A team of experts including your radiation oncologist, medical physicist and dosimetrist will work together to develop the radiation treatment plan. A sophisticated treatment-planning computer and associated software will be used to help design the best possible treatment plan. After reviewing all of this information, your radiation oncologist will write a prescription that outlines exactly how much radiation you will receive and to what parts of your body.

Quality Assurance Before Treatment

Once the treatment plan is approved, the treatment team ensures it functions correctly on the linear accelerator before starting your sessions.

During Treatment

External Beam Radiation Therapy Sessions

External beam radiation therapy sessions are painless, similar to receiving an X-ray. Radiation is delivered from a machine outside your body, typically a linear accelerator. This noninvasive treatment is usually administered on an outpatient basis, allowing you to maintain daily activities without the recovery period associated with more invasive procedures.

The radiation therapist administers treatment according to the radiation oncologist’s plan. If an immobilization device was created during simulation, it will be used during each session to ensure consistent positioning. The therapist positions you and sets up the equipment, with session duration varying based on plan complexity.

Once positioned, the therapist leaves the room and monitors you from a control room during treatment. You can communicate with the therapist via an intercom if needed. The machine may move to direct the radiation beam precisely at the tumor, producing sounds like clicking or whirring, but the therapist controls it at all times.

The radiation oncologist monitors your treatment and may adjust the radiation dose based on your response. Additional tests, such as blood work or imaging, may be conducted to assess your body’s reaction. If significant changes occur, another simulation may be necessary to modify the treatment plan accordingly.

Treatments are typically scheduled five days a week, Monday through Friday, for 1 to 7 weeks, depending on factors like tumor type, location, cancer type, treatment goals, overall health, and concurrent treatments. The radiation oncologist considers all these factors when determining your treatment course.

Part of your radiation therapy may target the tumor and surrounding tissues at risk for harboring microscopic cancer cells, followed by a focused treatment on the tumor area itself, requiring a higher dose to eliminate cancer cells. This is known as a boost.

Weekly Checkups

During radiation therapy, you’ll have regular appointments with your radiation oncologist and nurse to monitor progress, manage side effects, and address concerns. The doctor may adjust your treatment plan based on your response. The treatment team meets regularly to review your case and ensure the treatment proceeds as planned.

Quality Assurance During Treatment

Throughout your treatment, the accuracy of the radiation beams is regularly verified using imaging techniques like X-rays, CT scans, or ultrasounds, depending on your specific treatment. These images ensure the treatment setup aligns with the intended target.

After Treatment

Follow-Up

After completing treatment, follow-up appointments are scheduled to monitor your recovery. The radiation oncologist, along with other team members, may order additional tests to assess your progress. Reports on your treatment may be shared with other physicians involved in your care.

Our centers offer the STAR Program, a cancer rehabilitation initiative providing coordinated care from certified medical professionals. Continued follow-up in radiation oncology is recommended to evaluate for long-term side effects and ensure the cancer does not return. Over time, the frequency of visits will decrease, but your radiation oncology team remains available for any concerns related to your treatment.