Before, During and After Radiation Treatment

University of Wisconsin Carbone Cancer Center radiation oncologists have put together this guide to radiation treatment.
Before Treatment
  • Meeting with a Radiation Oncologist for a Consult: Before deciding if you would like to receive radiation therapy treatments, you must first meet with a radiation oncologist to help decide if radiation therapy is right for you.

    During your consult, you will first meet with a nurse. The nurse will take you into an exam room to record your weight, vital signs, medications, and allergies. Next you will meet with the doctors- typically a radiation oncology resident and radiation oncologist will meet with you. They will examine you and ask you questions. You may be asked about your current medical problems, past medical history, past surgical history, medications, and lifestyle.

    Treatment options, as well as the benefits and risks of these options, will be discussed with you. If radiation therapy treatments are indicated, the doctors will talk to you about treatment plans. If you decide that radiation therapy is right for you, you will be scheduled for a planning CT scans and/or simulation.

    Other staff members you may meet during your consult visit are: medical students, radiation therapy students, nurse practitioners, physician assistants, and research associates.
  • Treatment Planning CT Scans and Simulations: In order for the radiation beams to be effective, they must be aimed at the same target for each treatment. The process of measuring your body and marking your skin to help your team direct the beams is called a simulation or treatment planning CT scan.

    During a simulation or treatment planning CT scan, you will be positioned on the table the same way you will be for treatment. Because positioning is so important for your treatment, you may have a special mask or mold made. The radiation therapists will mark the area on your body that the doctor wants to be treated with radiation therapy and take X-ray images of the area. Depending on the area treated, your physician may request that you receive IV contrast or barium to drink. Contrast is used to highlight organs so that they can be seen on X-ray or CT images. After your X-rays or CT scans are completed the radiation therapist will mark your skin with a set a small, permanent tattoos. The tattoos will be used to position you each day for your radiation treatments.
  • Treatment Planning: Once you have finished with your treatment planning CT or simulation, your radiation oncologist and other members of the treatment team review the information. This step takes place even though you are not in the radiation oncology department. Tumors are not regular - they come in different shapes and sizes. To design the radiation therapy to the size, shape and location of your tumor, your treatment team (radiation oncologists, residents, medical physicists and dosimetrists) uses computers and your treatment planning images to plan your treatment. Depending on the complexity of your treatment, this step can take anywhere from two days to two weeks. After reviewing all of your information and your treatment plan, your doctor will write a prescription that outlines exactly how much radiation you will receive and what parts of your body will receive the radiation.
During Treatment
The radiation therapist will give your treatment following your radiation oncologist’s instructions. The first day of treatment will take approximately 45 minutes. After the first day, your treatments will take approximately 15-30 minutes. The radiation therapists will help you lie down on the table in the same position you were in for the treatment planning CT or simulation. They will be using the tattoos that were placed on your skin during your treatment planning appointment to help position you and may make shifts according to your treatment plan.

Once you are positioned, the radiation therapist will take X-rays (also called port films). Port films are taken on the first day of treatment and once a week. The port films are used to check your positioning and do not show if any disease is present. After your doctor reviews the port films, you will receive the first treatment. During the port films and your treatments, the therapists will step out of the room. They are closely monitoring you on a television screen while giving your radiation. There is a microphone in the treatment room so you can always talk with the therapist if you have any concerns. The machine can be stopped at any time if you are feeling sick or uncomfortable. During your treatment, the therapist may move the treatment machine or treatment table. The machine might make noises during treatment that sound like clicking, knocking or whirring but the radiation therapist is in complete control of the machine at all times.
Weekly Status Checks
During radiation therapy, your radiation oncologist and nurse will see you regularly to follow your progress, evaluate any side effects, and address any concerns you may have. You may want to bring a family member or friend with you to these appointments.
After Treatment: Follow-Up
After treatment is completed, follow-up appointments will be scheduled so that your radiation oncologist can make sure your recovery is proceeding normally and can continue to monitor your health. Your doctor may order labs, X-rays and other diagnostic tests.

As time goes by, the number of times you need to visit your radiation oncologist will decrease. However, please know that your radiation oncology team will always be available if you need to speak to someone about your treatment.