Demystifying radiotherapy: What patients receiving treatment can expect
Process uses high-energy beams to shrink tumours and prevent regrowth of cancer
A patient’s radiotherapy journey can be simplified to: consultation with a radiation oncologist, CT simulation scan, treatment planning, and treatment. File photograph: Mark Kostich/Getty Images
Radiotherapy can often be a step into the unknown for both patients and their families. As a consultant radiation oncologist, I’m going to outline the key points in the treatment course to give a basic understanding of what to expect from this form of treatment.
Radiation oncology, also called radiotherapy, is one of the three primary domains of cancer care (in addition to medical and surgical oncology). Put simply, radiotherapy uses high-energy beams to shrink or eliminate a tumour or prevent cancer from reoccurring. A patient’s radiotherapy journey can be simplified to: consultation with a radiation oncologist, CT simulation scan, treatment planning, and treatment.
During my consultation with a patient, I determine a specific treatment plan and answer any questions that a patient may have. I also take the opportunity to explain what to expect from the treatment and discuss possible side effects that may arise from the treatment course. Side effects vary depending on the individual, the area being treated, and the type of treatment received.
At UPMC Whitfield, we hold monthly information evenings, hosted by our radiation therapists for all patients, family members and children. These evenings focus on information regarding radiotherapy treatment and are a great way to meet our team, get a better understanding of the treatment pathway, see the equipment, and of course, ask any questions.
After the consultation, a patient will undergo a CT simulation scan. At this point in the journey, the radiation therapists will conduct a CT scan of the area of the patient’s body that will be treated with radiotherapy. The radiation therapists will ensure that the patient is in a comfortable position for the scan as the goal will be to position the patient in the same way every day for their radiotherapy treatment.
The information from a patient’s CT scan is then sent to our team of medical physicists, who use the images to accurately plan a personalised treatment to make sure each patient receives the appropriate dose to the right area of the body. This plan is checked at multiple points by the radiation oncologist and the other medical physicists to ensure it is as accurate as possible.
Typically, a patient will start his or her treatment course at an appointed time once a treatment plan has been approved and treatment slots are available. The intensity and type of treatment provided will depend on the affected area, and the amount of time needed to tackle tumours. External beam radiotherapy is the most common form of treatment. The treatment delivery session involves setting up the patient the same way as they were positioned during the CT simulation scan, and an external source of ionising radiation is administered by the radiation therapists. As treatment progresses, X-rays will be taken and reviewed to assess whether any change in the treatment plan is required.
Patients often want to know the impact that radiotherapy treatment will have on their ability to work. In short, it depends. Some patients may experience fatigue and tiredness and others may be able to continue working throughout the duration of their treatment. At all times it’s important that patients get sufficient rest and are sensitive to how their body responds to treatment. Our team of dedicated nursing staff and radiation oncologists closely monitor and manage any side effects our patients may be experiencing during their treatment.
Some patients wonder whether it is safe to be around loved ones after a radiotherapy treatment – be assured that external beam radiotherapy is completely safe and poses no danger to patients or others.
Since opening in 2006, UPMC Whitfield has treated more than 18,000 public and private patients for cancer, and we’re fortunate to have state-of-the-art radiotherapy facilities, where we provide image-guided radiation therapy and intensity-modulated radiation therapy. We also specialise in applying gated and breath-hold techniques to deliver more accurate treatments to the affected areas of the body.
It is important that patients are able to discuss not just the physical aspects of the treatment, but also the psychological and emotional stresses involved. For this reason, all patients receiving radiotherapy here will meet our patient liaison officer. The patient liaison officer will check in with each patient at multiple points over the course of his or her treatment to make sure they are comfortable and happy with the service. Similarly, if a patient is experiencing any problems the patient liaison officer can connect that patient with cancer support services in a patient’s hometown.
In addition to the high-tech equipment, our cancer centre is also equipped with a radiotherapy bell, that patients can ring once they’ve completed their course of treatment as a symbol that that chapter of their cancer care is complete. Radiotherapy is often a difficult process and ringing the bell can be a cathartic experience for our patients, allowing them to leave the centre on a positive note.
It’s also a great source of encouragement to other patients still receiving treatment, and a source of pride to our radiotherapy team when we hear the bell ringing out across the centre.
– Dr Dayle Hacking is consultant radiation oncologist at UPMC Whitfield, Co Waterford