Once we have all the information we need a plan will be created using our radiotherapy specific planning systems. This plan is unique for you to ensure your treatment is accurate.
Some patients are given instructions to follow before the CT scan and appointments, for example if you will be receiving radiotherapy to your pelvic area. You should have been given an information leaflet by your consultant or from a nurse containing information about bowel and bladder preparations, or this may have been sent with your CT scan appointment letter. This preparation before your CT scan and appointments is extremely important. Please follow the information provided and don't hesitate to ask your radiographer or nurse if you have any questions.
Please wear loose fitting, comfortable clothes that are easily removed, because your radiographer may need to expose some of the skin in the area you are having treatment.
Planning your radiotherapy
The first radiotherapy appointment you have will be a planning appointment. Before your radiotherapy can start we will locate the exact area needing treatment using specialist equipment.
Planning your radiotherapy may involve visits to the mould room and CT scanner. The radiographers will explain each procedure when you attend the department and are always happy to answer any questions you may have.
Planning your radiotherapy may involve visits to the mould room and CT scanner. The radiographers will explain each procedure when you attend the department and are always happy to answer any questions you may have.
Radiotherapy Planning
Radiotherapy treatment planning is carried out by therapeutic radiographers after your consultant has confirmed the area for treatment from your planning CT scan. The process is a way of creating and visualising radiotherapy for cancer patients, using imaging data, dose calculation algorithms and computerised tools. The goal is to produce a treatment that will destroy the tumour while sparing as much healthy tissue as possible. The planning process can take a number of days to complete and then will undergo a series of checks by our radiotherapy physics department.
Radiotherapy CT Scanner
It is likely that you will need a CT scan in order for us to determine where in your body to direct your radiotherapy treatment. This scan is different from the diagnostic scans which you may have had previously. It captures information about your body shape and the location of your internal organs, and is taken with you lying in the same position you will be in for your radiotherapy treatment.
Radiotherapy CT planning scans can take between 30 minutes and 1 hour depending on the type of scan you are having. With the addition of any preparation required before your scan, you could be in the radiotherapy department for 90 minutes or more.
During this scan appointment, the radiographers will ask you to lie down on the CT couch in a suitable position. As this needs to be the same every day that you come in for treatment, please let us know if you are uncomfortable and we will do our best to make things easier for you. We may use special equipment to enable you to maintain this position as comfortably as possible.
Radiotherapy CT planning scans can take between 30 minutes and 1 hour depending on the type of scan you are having. With the addition of any preparation required before your scan, you could be in the radiotherapy department for 90 minutes or more.
During this scan appointment, the radiographers will ask you to lie down on the CT couch in a suitable position. As this needs to be the same every day that you come in for treatment, please let us know if you are uncomfortable and we will do our best to make things easier for you. We may use special equipment to enable you to maintain this position as comfortably as possible.
Some, but not all, CT scans require contrast (an iodine dye that is injected into your body during your CT scan). Just because you had contrast at your diagnostic scan does not mean you will need it at your radiotherapy planning scan. Your radiographer will go through this with you at your appointment.
At the end of this appointment we will ask for your permission to make some permanent marks on your skin. These assist us with lining you up every day for your treatment. They are around the size of a freckle, but are permanent like small tattoos. You can refuse these marks if you would prefer not to have them. The alternative is using pen marks with clear plastic stickers on top, however, it is extremely important that these marks are kept on. If they are lost, the CT planning process would have to begin again, which could mean a delay in your treatment starting. We will provide you with your treatment session appointment list during this appointment.
At the end of this appointment we will ask for your permission to make some permanent marks on your skin. These assist us with lining you up every day for your treatment. They are around the size of a freckle, but are permanent like small tattoos. You can refuse these marks if you would prefer not to have them. The alternative is using pen marks with clear plastic stickers on top, however, it is extremely important that these marks are kept on. If they are lost, the CT planning process would have to begin again, which could mean a delay in your treatment starting. We will provide you with your treatment session appointment list during this appointment.
Radiotherapy tattoo on an index finger for size reference
Radiotherapy ink mark on skin covered by a sticky plastic circle
To identify you for your radiotherapy appointments we use a number called your CHI or hospital number. It is a 10 digit number for example: 0403720065. The first 6 digits are your date of birth e.g. 040372 and the final 4 numbers are unique to you e.g. 0065. When you confirm this number we are able to check we have the correct patient in the treatment room and the correct details displayed on our computer screens. At your CT appointment we will also asked you to sign a form confirming you consent to the radiotherapy process and you are happy with all the information that has been given to you.
Radiotherapy Mould Room
Some patients will require a mould room appointment before their CT planning scan. At this appointment, devices are made to help prevent movement during treatment.
For those getting their head and neck, or brain treated a Beam Direction Shell (BDS) is made. This is created by placing a sheet of flat thermoplastic into a waterbath for 3 minutes. The plastic becomes soft and pliable so it can be moulded around the head, face, neck and shoulders. There are lots of holes in the mask so you can continue to breathe normally and swallow as normal. The mask will then take 10 minutes to harden, resulting in a perfect silhouette of your head, neck and shoulders. The reason we use these masks for radiotherapy treatment is to ensure that you are perfectly still for your CT scan and each treatment appointment. We also draw marks on the mask to allow us to align you in the same position on the treatment couch. An example of one of these masks is in the image below.
For those getting their head and neck, or brain treated a Beam Direction Shell (BDS) is made. This is created by placing a sheet of flat thermoplastic into a waterbath for 3 minutes. The plastic becomes soft and pliable so it can be moulded around the head, face, neck and shoulders. There are lots of holes in the mask so you can continue to breathe normally and swallow as normal. The mask will then take 10 minutes to harden, resulting in a perfect silhouette of your head, neck and shoulders. The reason we use these masks for radiotherapy treatment is to ensure that you are perfectly still for your CT scan and each treatment appointment. We also draw marks on the mask to allow us to align you in the same position on the treatment couch. An example of one of these masks is in the image below.
For those getting their lung or oesophagus treated we will create a Vac-Bag. This is sometimes made prior to your CT appointment, or something during.
A Vac-bag is similar to a beanbag, but once you are lying in the correct position with your arms above your head we remove the air from the bag. This leaves a solid mould of your head and arm position. This allows you to be positioned in exactly the same position each day for your radiotherapy treatment. An example of the Vac-bag is in the image below.
A Vac-bag is similar to a beanbag, but once you are lying in the correct position with your arms above your head we remove the air from the bag. This leaves a solid mould of your head and arm position. This allows you to be positioned in exactly the same position each day for your radiotherapy treatment. An example of the Vac-bag is in the image below.
