There are different types of radiotherapy treatment that can be used depending on your diagnosis and which part of your body is affected. The main categories are external beam and internal treatment (brachytherapy).
External Beam Radiotherapy
The two types of external beam radiotherapy that are offered at Ninewells are x-ray photons or electrons. Photons penetrate deeper into the body, whereas electrons are more superficial. The type of treatment best suited for you is decided by your oncologist. External beam radiotherapy is delivered using a linear accelerator as seen below.
Imaging and accuracy
The aim of radiotherapy is to treat the intended area, whilst minimising the dose to surrounding healthy tissue. It is therefore important that the treatment is accurate and reproducible on a daily basis. We use the same special equipment used during your CT scan to help you to lie down in the same position each day. We take x-ray images before we deliver any treatment and compare these to images from your CT planning scan. We are then able to adjust the position of the treatment couch accordingly.
External Beam Techniques
There are different treatment techniques within external beam radiotherapy. Some of these are summarised below:
Volumetric Modulated Arc Therapy
Volumetric modulated arc therapy or VMAT is a treatment technique where the treatment machine (linear accelerator) rotates around you while the treatment is being delivered. This allows the treatment dose to be focussed on the treatment area while minimising the dose received by surrounding healthy tissue, which can help to reduce the side effects that you might experience. This type of treatment is not suitable for all body sites and your individual circumstances will be taken into account by your doctor when selecting this treatment method for you.
Deep inspiration breath hold for breast cancer
Deep inspiration breath hold or DIBH is a type of treatment that we offer to eligible patients who are having treatment to their left breast. This treatment requires you to be able to repeatedly hold your breath for a period of around 15 to 20 seconds at a time. The oncologists identify who is likely to benefit from this treatment. If this treatment would be of benefit to you, you will be booked in for a coaching appointment, where we have a trial run of the breath hold process. It is important that you prepare for this appointment by practising, as you can feel fatigued from repeatedly holding your breath. The next appointment you will attend is the CT planning scan. The procedure is the same as a standard CT planning scan except you will be required to hold your breath at various points, and will have a small plastic block placed on your abdomen. This appointment can last around an hour.
Stereotactic Ablative Radiotherapy
Stereotactic ablative radiotherapy or SABR is a treatment that we offer to patients who are having their lung treated and who meet certain criteria. Instead of being delivered daily, it is delivered on alternate weekdays, in 3, 5 or 8 treatment appointments. It requires you to have a vacuum bag made Hyperlink to mould room section prior to your CT scan to assist with lining you up in the correct treatment position. Your breathing is monitored during the CT scan by the placement of a plastic block on your chest or abdomen. You should continue to breathe normally throughout the CT scan and treatment appointments. Further information can be found in the Stereotactic Ablative Radiotherapy patient information leaflet. Side-effects
You will see radiographers every time you come in for your radiotherapy treatment. Please mention any side-effects that you are experiencing to them. The radiographers can provide advice and refer you to our Oncology Support Team nurses. You will have scheduled appointments to see our nurses throughout your course of treatment.
Internal radiotherapy
Brachytherapy
Brachytherapy is the term used to describe treatment where the source of radiation is placed close to the area to be treated. For instance, if treatment is to the pelvis the radiation source is inserted through a tube which is placed inside your pelvis. This allows us to deliver a very precise dose directly to the tumour site. For some brachytherapy treatment you will need to attend the ward and theatre to have the tube inserted, this will be discussed with you by your Oncologist at clinic.
