Treatments involving radiotherapy are very carefully planned. This process involves a team of healthcare professionals with different skills.
Before providing any form of treatment the clinical team carry out a full assessment. This is more than knowing the diagnosis – the type of tumour, but also how quickly it is growing, the size of the tumour, whether it has spread into nearby tissues, or lymph nodes, or to other parts of the body.
Providing the right treatment requires more information about you: how your illness is affecting you, other medical problems you may have and your own preferences about treatment. It’s about giving you the best advice about the right treatment for you.
So at this stage your treatment will be discussed with surgeons, medical oncologists (specialising in chemotherapy), pathologists and radiation oncologists, who will advise you on what treatment, or combination of treatments will be best for you. It is often not a choice between one or another form of treatment but deciding on the right combination and the order in which they should be given.
The aim of radiotherapy is to deliver a dose that will kill the tumour, or as many of its cells as possible, without causing permanent damage to the surrounding tissues.
Most tumours are deep inside the body so sophisticated scans are used to build a 3D image of the tumour so that treatment is delivered to all parts of it. For this, simulators – machines that reproduce treatment conditions - are often used.
The shape of the radiation beam, the dose of each treatment or fraction and the number of fractions are all calculated by a team including a medical physicist, radiologist, radiation oncologist and a radiotherapy technician/radiographer/nurse.
Making sure that the patient is in the right position throughout treatment is important – a slight shift to one side might mean that the radiation misses the tumour altogether. There are various ways to ensure that patients are always in the right position, which may involve making a mould to hold the patient in exactly the right position during treatment.
There are different types of machines for giving external radiotherapy, which are described in more detail in the Brief Guide to Radiotherapy section. Different machines are used for different forms of treatment. Treatment usually lasts just a few minutes on each visit, but it can take some time to be sure that everything is set up correctly before treatment starts.
As treatment progresses the tumour can change in size and shape, so it will be regularly monitored (usually weekly), as your treatment progresses and if necessary changes will be made to the way the treatment is given.
Whether you are an inpatient or an outpatient, you will get to know some of the team members well. If you experience any problems it is important to tell them so if they cannot help you they can call someone else who can. It is normal to feel anxious about your treatment, usually it gets easier after the first few treatments, but don't be afraid to talk about any fears or worries – often a quick explanation of what is happening and why, is the best way to deal with anxieties.