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What to Expect

Radiation treatment may be one of the most intimidating parts of a cancer journey, as it’s hard to know what to expect in regards to what the treatment is like, if it hurts, how long does it last, and more.

At UPMC Whitfield Cancer Centre, we’re committed to giving you the knowledge, inspiration, and speciality care you need to boldly face your cancer. It’s because no diagnosis should stop you from doing the things you love, or from living each day to the fullest.

The infographic covers the key stages of the process from referral to UPMC Whitfield Cancer Centre to on-treatment evaluation.

  1. 1. Patient Referred to UPMC

    Once you have been referred to the UPMC Whitfield Cancer Centre by a consultant, our staff will reach out to you to schedule your appointment. Your first appointment might take place at the Cancer Centre or at one of the local hospitals.
    In most cases, along with your appointment letter, you will receive a registration and medical history form. It is helpful if you prepare this information in advance of your appointment and bring it with you on the day of treatment.

  2. 2. Initial Consultation Appointment

    At this appointment, the consultant will conduct a physical examination and review your medical history, including past and current diagnoses, surgeries, any allergies you may have, and a list of current medication.

    The consultant will discuss all treatment options and possible side-effects with you, including any alternatives to treatment. From this information and in conjunction with you, a decision will be made on the next steps in your care.

    There is a lot of information to take in at this appointment. We recommend that you bring a friend or family member with you if possible.

  3. 3. Simulation Scan

    If you and your consultant have decided to move forward with radiation therapy, your next visit will be a CT scan to be used to plan your radiation therapy treatment; this is known as a simulation scan. Please be aware that this is not a diagnostic CT scan, although the process is similar. There will not be any results from this scan; the purpose is to provide your consultant radiation oncologist with an accurate picture of your internal anatomy on which he and the multidisciplinary team can develop the best treatment plan customised for you.

    Sometimes, as part of this scan, some degree of preparation may be needed, such as a drink or an injection into your arm. If this applies in your situation, the procedure will be explained fully on the day of the scan or you may be contacted in advance of the scan.

    We will ensure that you are positioned as comfortably as possible for the simulation scan, as it is essential that you maintain your position for the duration of the scan and also during delivery of each radiation therapy treatment as well.

    Three small permanent reference marks or tattoos, which look like freckles, may be made on your body depending on which area your consultant radiation oncologist wants treated. This allows your radiation therapists to set you up in exactly the same position during your treatment.

    In order to help the radiation therapists ensure you are in the correct position, an immobilisation device may be used at your CT simulation appointment – this may be a mask if you are having treatment to the head or neck area, or it may be a pillow, known as a Vac-Bag, which is individually shaped to fit you. Your radiation therapist will explain the procedure for these immobilisation devices at your CT simulation.

    At this stage, we ask patients to let us know his or her requirements for travel to and from radiotherapy treatments, and encourage patients requiring transportation support to visit the website of the South East Radiotherapy Trust (SERT). SERT provides free and confidential transport for cancer patients who require radiotherapy living in the South East.

  4. 4. Treatment Plan

    Once this scan is complete, it will take some time to prepare your individualised treatment plan. It is not always possible to give you an exact start date at this point, although every effort is made to do so.

  5. 5. Verification Appointment

    Your next visit to the Cancer Centre will be your verification (trial run) appointment. At this appointment, one of your radiation therapists will explain the radiation therapy procedure in detail to you; for example, you may discuss what to expect to happen for the rest of your treatment, any preparation you need to do for your daily treatment, and potential side effects that you might experience. Any questions or concerns that you may have will be answered. Some patients find it useful to have a friend or family member accompany them on this day.

    Your verification is like a trial run of your treatment plan. The radiation therapists will position you on the linear accelerator treatment bed in exactly the same position as you were in for your simulation scan; to do so, the therapists will use the three reference marks that were put on your skin at that scan, if applicable.

    A series of measurements and images (like X-Rays) will be taken to ensure that everything is set up as expected based on your treatment plan. During this visit, you will hear the radiation therapists calling out a variety of numbers and measurements to each other as they move the treatment machine around. It is important that you lie as still as you can while this is going on — try to relax! You will not feel or see anything and it will not hurt.

    The entire verification process can take up to 30 minutes; this is the longest session you will have. Subsequent treatments usually last for 10 to 20 minutes each day.

  6. 6. Days on Treatment

    In most cases, your treatment will start the day after the verification appointment; occasionally, the first treatment will be given at the verification appointment as well.

    Consultant radiation oncologists design treatments to ensure the best possible result for each patient; as a result, the number of days of treatment and the type of treatment received will differ for everyone. At your verification appointment, you will be informed as to how many treatments you will be receiving: treatments may range from 1 to 45 treatments total, depending on the area of the body being treated.

    Your treatment is delivered during the week, Monday to Friday with a break over the weekends. It is important that you comply with the treatment designed by your oncology treatment team and attend your radiation therapy sessions daily.

  7. 7. On-Treatment Evaluation

    You will be examined weekly by your nurse and as required by your doctor to monitor your progress and to answer your questions. Care related to your cancer does not end when your radiation therapy is completed. You may need regular follow-up exams, laboratory tests, and X-rays.