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Oxford University Hospitals NHS Foundation Trust
Cancer Services

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Pre-treatment

You will have been seen by your consultant clinical oncologist in the Outpatient Department. They will have discussed with you the benefits and risks of radiotherapy and what the treatment involves in your particular case.

 

There is a general patient information leaflet explaining what having the treatment involves, common side effects and some general information about the department. Specific information leaflets will provide more detail, specific to the type of treatment planned for you and how you can help yourself during and following treatment.

These are intended as a guide because the timing and effects of treatment may vary from one person to another. These leaflets will highlight the key points of the discussions you will have had with your doctor and treatment team. Your doctor will give you copies of these before you leave so that you can read them later or show them to your family and carer.

Consent

You will be asked to sign a consent form, which is a written record that you have agreed to the radiotherapy and that you give your permission to proceed with planning and treatment. It is important that you understand the information you have been given, and that you ask questions if you don't understand or if you want more information. You may withdraw your consent at any time.

Research

World class research is carried out in and across the Thames Valley. During your visit, you may be approached about clinical trials and research studies. If you would like further information, please ask your health care professional when you attend the appointment. Participation in research is voluntary. If you would like more information about radiotherapy research being conducted at our hospital, please ask your clinical oncologist.

Planning

When you have Radiotherapy, your treatment needs to be planned carefully and specifically for you. This:

  • identifies the exact part of your body to be treated
  • helps the doctors and radiographers work out the best position for you to lie in for your treatment
  • is important to plan your radiotherapy specifically for you.

This may involve a few visits to the Radiotherapy Department before treatment starts. You may have treatment on the same day as planning, but usually it is necessary to come back another day to start your treatment, to allow the doctors, radiographers and physicists time to finalise your treatment plan.

Appointment list

The planning team will give you an appointment list, with your radiotherapy appointments. When you start treatment you will receive a replacement list of appointments, which may include review appointments, with your doctor or nurse. These will be on the same day of your treatment. Make sure you book in for each treatment and each review appointment separately.

Important information

Pregnancy

Female patients (aged 12 to 55 years old) must be aware of the importance of not being or becoming pregnant at any time throughout a course of radiotherapy. Normally a pregnancy test is done at your pre-treatment appointment for confirmation.

Radiotherapy can cause a miscarriage or cause a child to be born with abnormalities. If you think you may be pregnant at any time during your treatment it is extremely important that you tell a member of staff immediately.

Pacemaker

If you have a pacemaker you should let the clinical oncologist and/or radiographers know. This does not stop you from having treatment, but you may need simple additional monitoring.

Smoking

Stopping smoking during and after radiotherapy is very worthwhile. Research has shown that smoking may make the radiotherapy less effective as well as increasing the side effects.

Stopping smoking or cutting down at such a stressful time can be very difficult. If you want help or advice you can talk to your specialist nurse, who will be able to suggest ways of stopping smoking. Organisations such as QUIT also offer advice and valuable support.

CT scanner

Radiotherapy Planning usually takes place in a CT scanner (or simulator), which uses X-rays to gain information about the area to be treated.

A CT scanner

The staff will ask you to lie on a fairly hard couch (which some people find uncomfortable). You have to lie very still in the correct position required for your Radiotherapy so that the measurements are accurate and the Radiographer can record the correct position for your treatment.

During your CT scan the couch moves in and out of the 'polo hole' shaped part of the machine for a few minutes. Nothing will touch or hurt you, and you will not feel anything. This CT scanning process normally takes about 15 to 45 minutes. If any special preparation (eating/drinking) is needed for your scan, the Doctor or Scheduler, who books your appointment, will give you instructions.

Skin markings/ tattoos

The therapy radiographers will draw on your skin with felt pen. As the pen marks drawn on your skin will wash away, you will be given small tattoos. These tattoos are the size of small dots and they are permanent. They are used to place you in the correct position for treatment every day.

 

Moulds/shells/mask

If you are to have radiotherapy to your head, neck or a limb you may have an extra step in your planning process - the making of a shell (or cast). It is important to keep the part of the body being treated as still as possible during treatment.

This shell or cast is made of a perforated sheet of thermoplastic so you can breathe easily if it covers your face. This special kind of plastic is heated in warm water so that it becomes soft and pliable. A radiographer drapes the plastic over the appropriate part of your body, when soft and warm, so that it moulds to your body exactly. It feels a little like having a warm flannel put onto your skin.

A CT mask in place on a patient's head

Once the plastic has moulded and become hard (which takes a few minutes) the radiographer takes it off. The shell is then ready to be used. Any marks to guide the radiographers can be drawn on the shell, not on your skin.

It will feel snug, but it can help to remember that you will only have the shell on for a short period of time.