Radiation Oncology Process

Initial Consultation
During the consultation with a radiation oncologist, the physician will perform a detailed history and physical examination. The physician will also discuss their findings with other members of the multidisciplinary treatment team so that all treatments, such as surgery and chemotherapy, will be coordinated to ensure that you can receive the best possible care. The consultation will take about an hour. Please bring any X-Rays, laboratory tests, pathology reports and other tests that have been performed.

Informed Consent Process
If radiation therapy is recommended as a part of your treatment, the physician will review in detail the proposed treatment, the reasons for recommending the treatment, and the potential risks and side effects of such treatment. Once you feel that you have a full understanding of the proposed treatment, risks, side effects and other possible treatment options, you will be asked to sign a consent form. Even after you have signed the consent, your physician is always available to answer new questions or to provide additional information. You can withdrawal your consent at any time for any reason.

CT Simulation
A special computerized tomographic (CT) scanner will be used along with simulation to help plan some radiation therapy treatments. The CT scanning process will be performed in the Radiation Oncology Department. Information from the CT scan is used to precisely locate the treatment fields. The CT scanner is specially designed to work with the other equipment in the Department, and is not a replacement for other diagnostic scans you may have received.

Treatment Planning Process
After CT simulation, details from the procedure are forwarded to medical radiation dosimetrists and medical physicists. These professionals perform highly technical calculations that will be used to set the treatment machine (linear accelerator).

Several days after the simulation and after all calculations have been performed and custom blocks made, your treatment can begin.
The treatment machine (linear accelerator) is similar to the CT simulator. You will be placed on the treatment table in the same position as you were on the CT simulator. Proper positioning usually takes 10 to 15 minutes. Once in place on the treatment table, a set of X-ray films will be taken. These films will be matched with the CT simulation films to ensure that the treatment is going to be delivered the same way as it was simulated. Occasionally, the match is not optimal. In these cases, adjustments will be made and will be checked by the physician. In rare cases, more adjustments are required and treatment may need to be postponed. Once the films and positioning are approved, treatment may be delivered.

Daily Treatments
Once the initial set-up is completed, daily treatments normally follow. Treatments are usually given once a day, Monday through Friday, for a number of weeks. Each treatment generally takes only 5 to 10 minutes; however, you will likely be in our department for approximately 20 to 30 minutes per day.

On-Treatment Visit
Once a week, repeat X-ray films will be taken to re-confirm proper positioning. These films will also be performed in most cases where there is a change in your treatment field or treatment plan. The X-rays taken during the course of radiation treatment are not used to help measure your progress or response to the radiation. Rather, they are only used to ensure that the position and treatment arrangement is appropriate.
You will also be examined at least once a week by the physician. The examination day is generally on Monday, just before or after your treatment is administered. These examinations are important because they give your physician the opportunity to evaluate your physical condition, answer any questions that you may have, and plan and coordinate future treatments.

End-Of-Treatment Visit
Once your radiation treatments have been completed, you will have a final visit with your physician. This will occur just after your last treatment has been administered. During this visit, your doctor will perform an examination and discuss follow-up care.

Follow-Up Care
The first follow-up appointment will occur between 2 and 6 weeks after the completion of radiation therapy. You will have follow up appointments on a regular basis. You may be seeing many other physicians, but it is important that you participate in this follow-up process so that any radiation-related problems can be identified early and treated. Your medical oncologist and other referring physicians will be notified once you’ve finished radiation treatment.