Common Questions and Answers
Below are a list of questions, some of which have been answered, and others that are in the process of being answered.
What is curative treatment?
This is also known as “radical” treatment. This means that the aim of your treatment is to cure you of your Cancer. Radiotherapy is often used in conjunction with Chemotherapy, surgery or both to maximise your chance of cure. The radiation dose your doctor will prescribe for you will be fairly high so in most cases you will only be able to have a curative course of radiotherapy once.
What is palliative treatment?
This means that the aim of your radiotherapy is to help control and manage your symptoms to help improve or maintain your Quality of life.
How long is each radiotherapy session?
A typical session first of involves setting the patient up on the treatment couch. The couch will be set up with mattresses, knee rests and any support that was used at the time of the radiotherapy CT scanning. The aim is to reproduce the same set-up each and every day the patient attends. The patient will then lie on the couch and make themselves as comfortable as possible. The mask is then fitted to the patient and fixed to the treatment couch.
The mask is likely to have reference marks drawn on it at the planning stage. The treatment radiographers will dim the room lights so they can see laser lights which shine on the mask. The lasers are calibrated so that the beams coincide at precisely the point at which all of the parts of the treatment machine rotate. This point is called the ’isocentre’. The aim is to use the lasers to position the patient so that the isocentre is in the middle of the tumour volume.
The position of the isocentre is checked against the couch parameters i.e. couch height, couch Lateral and longitudinal measurements. The radiotherapy treatment unit shines a light onto the shell which mimics the radiation beam, so the radiographers use this light field to verify the correct area will be treated.
The treatment unit gantry will move around the patient to the first treatment position. The radiographers will once again carry out checks and measurements, then they are ready to leave the room. Radiation protection laws means that no-one but he patient is allowed in the room when the radiation beam is turned on, so the radiographers move to the console area. From here they can see the patient at all times using CCTV.
The treatment unit then delivers the radiotherapy. This is likely to involve the treatment machine rotating around the patient to different positions. Once the radiation has been delivered the radiographers will re-enter the room and immediately release the patient from their mask.
Setting up the patient takes about ten minutes. After this, delivering the radiation takes only about five minutes. Sometimes x-ray pictures are taken as well, so a patient might be in the room twenty minutes, but it is unlikely to be any more.
Will I be radioactive after my treatment?
You will NOT be radioactive after your treatment because the X-ray radiation is electronically produced. This means once the treatment machine has been switched off the radiation stops.
Do you feel anything when having radiotherapy treatment?
You neither see, nor feel anything whilst having your radiotherapy treatment. The machine does make a “buzzing” sound whilst delivering the radiation.
Will radiotherapy make my hair fall out?
Areas of your head which are in the path of the radiation beam will experience hair loss. Hair loss can occur where the radiation beam exits your brain as well as where it enters. This may mean that only parts of your head experience hair loss. You can ask your radiation therapist where to expect your hair loss to occur. Hair loss does not happen immediately, the hair follicles on your head need to have received a certain dose of radiation before the hair begins to fall out. For some patients hair loss will be permanent, for others the hair will grow back but may be thinner than it was originally. This is dependent upon a variety of factors and your radiation therapist or consultant can talk to you more in depth about this.
Does radiotherapy make you sick?
Radiation treatment to the brain can cause slight inflammation of the brain tissue. This inflammation can cause Nausea, vomiting, double vision and headaches. Most people with brain tumours will already be on steroids (Dexamethasone is commonly used) to help reduce the swelling caused by the tumour. You will stay on your steroids whilst having radiotherapy because this will help counteract the inflammation caused by the treatment. If you develop any problems with headaches, nausea, vomiting or double vision whilst having you radiotherapy or if any existing problems get worse tell you radiation therapist and consultant as soon as possible because your steroid dose may need increasing temporarily. Do not adjust your steroid doses without speaking to a doctor first.
All answers are provided by Russell Fitchett, Superintendent Radiographer, Norfolk and Norwich University Hospital
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