What to Expect
When you attend a Genesis CancerCare centre for radiation therapy there are several tasks that need to be completed before you can receive treatment. These tasks are performed in a set order by a multidisciplinary team led by your radiation oncologist.
The exact process required to prepare and administer your treatment depends on the type of radiation therapy prescribed and where it needs to be applied. The information below outlines the patient care pathway for external beam radiation therapy including modern IMRT and VMAT / RapidArc techniques.
Step 1: Initial consultation
The initial consultation is the first step towards receiving radiation treatment. This is where one of our radiation oncologists will review your medical condition and conduct a physical examination. They will then discuss your treatment options, side effects and care requirements. Usually, this process takes around 1 hour to complete. It is a good idea to write down any questions you may have about your care prior to this appointment so they can be addressed during your consultation. You will need to bring an up to date referral to this appointment if one has not already been sent to us and any relevant X-rays and pathology results.
Step 2: Discuss fees & payment
After your initial consult, a member from our patient services team will discuss the fees associated with your proposed treatment and outline your Medicare reimbursement entitlements. They will then provide a fee estimate and advise you about payment options. If you have any questions or concerns about financial matters relating to your radiation therapy, please direct these to our patient services team.
Step 3: Planning simulation
If treatment is recommended and you decide to proceed, an appointment is then made for simulation. This is where your radiation oncologist and a radiation therapist work together to determine your treatment position and to obtain information about your treatment site. This may involve a CT scan, placement of tattoo markings, creation of a mask and or other personalised treatment aids. The simulation procedure takes around 1 hour to perform and incorporates a short radiation therapy education session with our nursing staff. A start date and time for treatment will also be arranged before you leave the centre.
Step 4: Planning dosimetry
After attending your simulation appointment, the information obtained is then used in a process called dosimetry. This is where your radiation oncologist, radiation therapist and medical physicist work together to construct a plan detailing how your radiation treatment is going to be administered. The dosimetry procedure does not require your attendance at the centre and may take several days to finalise depending on its complexity. All treatment plans are checked by a senior radiation therapist or medical physicist and reviewed by your radiation oncologist prior to starting treatment.
Step 5: Treatment & verification
Once your dosimetry is finalised, the next step is treatment. This procedure is performed by a team of radiation therapists as directed by your radiation oncologist. Usually treatment appointments run to schedule so it's important to arrive at your allocated time.
When you arrive at the centre and check in at reception, a radiation therapist will meet you in the waiting area and escort you to the treatment room. Prior to entering this room you may be asked to change into a hospital gown, depending on where the radiation needs to be applied.
The treatment room is a specially designed space built to house a machine called a linear accelerator. This machine is used to administer your external beam radiation therapy. Upon entering the treatment room you will be asked to lie down on a motorised bed that is integrated with the linear accelerator. A team of radiation therapists will then position you and align your treatment area with this machine using your planning information and simulation marks as a guide.
In order to administer your treatment, the radiation therapists must leave the room to activate the linear accelerator. During this time you are remotely monitored via a video camera and intercom system.
Before initiating the treatment, the radiation therapists check your plan details and may take digital X-ray images to confirm you are correctly aligned. X-ray images may be taken periodically throughout your treatment course for this purpose.
Once the setup is confirmed, the linear accelerator is activated producing a loud buzzing sound while a dose of radiation is administered. Depending on your treatment plan, the linear accelerator may rotate around you and deliver radiation from multiple planned angles.
When your treatment session is complete the radiation therapists return into the room and assist you down from the bed. In most cases each session takes around 10 to 20 minutes and is usually administered daily (Monday to Friday). The total number of treatments required is determined by your radiation oncologist based on your disease type and stage.
Step 6: Evaluations & follow up
As part of providing best practice care, your radiation oncologist will regularly see you throughout treatment to evaluate and discuss your medical management. These free evaluations usually take around 15 mins and may be performed on a weekly basis. If for any reason you need immediate care or advice related to radiation therapy the nursing staff can be approached without notice at the centre you are attending.
After course completion your radiation oncologist may want to see you periodically to review your response to treatment. These post treatment appointments are known as follow up. The timing of your follow up appointments depends on your disease stage and type and maybe shared between your general practitioner and/or referring specialist.