What to Expect Before During & After Treatment

Meeting with a Radiation Oncologist

If radiation therapy is a proposed as a treatment for cancer, an initial consultation with the Radiation Oncologist is necessary. During this first visit, the Radiation Oncologist evaluates the need for radiation therapy and its likely results. This consultation includes a review of your current medical problems, past medical history, past surgical history, family history, medications, allergies and lifestyle. The Radiation Oncologist also performs a physical exam to assess the extent of disease and to evaluate general physical condition. You may also be seen by an RN who has special education and training in the care of patients who are treated with radiation.

After a review of medical tests, which includes CT scans, MRI scans, PET scans, and completion of a thorough examination, the Radiation Oncologist discusses the potential benefits and risks of radiation therapy and provides an opportunity to have your questions answered.

To be most effective, radiation therapy must be aimed precisely at the same target or targets at each and every treatment visit. Obtaining precise measurement of the radiation site, and marking your skin helps direct the radiation beams safely and exactly to the intended location(s) and is a crucial first step in preparing for radiation treatment. This process is called simulation.

During simulation, the patient is placed on the simulation machine in the exact position required for an actual radiation treatment. The Radiation Therapist collaborates with the Radiation Oncologist to determine the area to be treated and marks the site either directly on the skin or an immobilization device. Immobilization devices are molds, casts, headrests or other devices that keep the patient in the exact same position during the entire treatment. The Radiation Therapist marks the skin and/or the immobilization devices either with a bright, temporary paint or a set of small, permanent tattoos.

The Radiation Oncologist may request that special blocks or shields be made for you. These blocks or shields are put in the external beam therapy machine before each treatment. They are used to shape the radiation beam to the tumor and protect the normal tissue. 

Treatment Planning
Once simulation is completed, the Radiation Oncologist and other members of the treatment team review the information obtained during simulation, and previous medical test results to develop a treatment plan. Often, a special treatment planning CT scan is needed to help with simulation and treatment planning. This CT scan is in addition to your diagnostic CT scan. Frequently, sophisticated treatment-planning computer software is used to help design the most accurate treatment plan. After reviewing all of this information, the Radiation Oncologist writes a prescription that outlines exactly how much radiation is necessary and the precise direction of the radiation beam to the tumor.

After treatment is complete, follow-up appointments are scheduled so that your Radiation Oncologist can ensure your recovery is proceeding well. The Radiation Oncologist order additional diagnostic tests as necessary. The Radiation Oncologist directs the reports about treatment and tumor response to the other physicians involved.

As time goes by, visits to the Radiation Oncologist decrease. However, the radiation oncology team is always available should questions arise.


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