Radiotherapy Treatment for Soft Tissue Sarcomas
Radiotherapy involves using radiation to try and stop tumour cells replicating and growing. Sarcoma patients may be offered radiotherapy before or after their surgery to help prevent recurrence. Each person's treatment will vary, based on the size, location and grade of their sarcoma. You will be provided specific information to your case during your clinic appointments.
Radiotherapy is provided in the Princess Royal Suite, located on level -2 of Bexley Wing at St James' Hospital. During radiotherapy you will be supported by radiographers, radiotherapy specialist nurses, social workers and occupational therapists as needed.
What is Radiotherapy?
Radiotherapy is the use of high energy X-rays and other types of radiation to treat cancer. The organs and tissues of the body are made up of tiny building blocks called calls. Radiotherapy causes damage to the cancer cells in the treated area. Although normal calls are also affected, they can repair themselves and are able to recover.
Radiotherapy is a local treatment. This means it only affects the part of the body that is treated. Radiotherapy is painless and does not make you radioactive. It is perfectly safe for you to be with other people, including children, throughout your treatment.
Radiotherapy is given by therapy radiographers who are highly trained in the accurate planning and delivery of radiotherapy treatment. You will see you radiographers at each treatment session and they will be happy to answer any questions you may have.
Planning Your Treatment
Your first appointment for radiotherapy will be a planning appointment. This will be used to gather all the information we need to accurately plan your treatment. You will be contacted by phone with an appointment for your planning session. Some tests and scans may be required to help plan your treatment.
You will meet your Clinical Oncologist at this appointment. This is an ideal opportunity for you to ask questions. If you wish to go ahead with treatment, you will be asked to sign a form to give your consent.
Radiotherapy involves the careful positioning of the radiation beam. You may have a customised bean bag made to support the area being treated. This helps you to stay still. The radiographers will then draw some marks onto your skin, to be used as a reference for your treatment. You will then be scanned, which will only take a few minutes. At the end of the scan, these marks will be replaced by permanent marks. These marks are no bigger than a freckle and will be used during each treatment to ensure you are positioned accurately each time. The permanent marks mean that you can wash as normal, without worrying that your marks will come off.
Once your planning is complete you will be able to start your treatment, this may be in a few days or weeks time. The radiographers will talk to you about any further appointments you have.
Having Your Treatment
A course of treatment may last 2-6 weeks. When you arrive for your treatment you should go to the reception at the entrance of the radiotherapy department. You will be given directions to your treatment machine. The radiographers will explain what will happen and answer any questions that you may have. The number of treatments you will be having will be confirmed and you will be given a list with all the appointments you need.
Treatment is normally given daily, Monday to Friday, however your treatment may start on any day of the week. Whenever possible you will be treated a t the time of day that suits you, but this cannot always be arranged or guaranteed. There may be occasions when you may have a longer stay in the department or be asked to attend at a different time, e.g. to see your oncologist.
Although you have small permanent marks on your skin, the radiographers may need to draw around them each time you come for treatment. This is part of the quality checking procedure for your treatment, If you have pen marks on your skin you may prefer to wear older clothing as the marks may discolour fabric. It is also generally advisable to wear loose clothing around the treated area.
Treatment times vary from 10-20 minutes each day depending on the type of treatment you are having. The treatment machine is only switched on for a fraction of this time. For most of the time the radiographers are carefully placing you and the machine in the correct position for your treatment. The machine will move around you, but does not touch you.
Once you are in the correct position the radiographers will leave the room to switch the machine on. You will only be alone for a few moments at a time. The radiographers will be watching you via cameras, and have a two-way intercom system so that they can talk to you and you can talk to them if needed.
Although you have to lie still, you can breathe and swallow normally during your treatment. The machine stops automatically after your prescribed dose of treatment has been given. The treatment machines make a buzzing sound when they are switched on. You do not feel pain, heat or any other sensation.
Your Clinical Oncologist will see you once per week, usually on a Friday, to see how you are getting on. They will monitor any side effects.
Side Effects of Radiotherapy
Side effects can be divided into short term (acute) effects that happen during or soon after your treatment, and long term side effects occurring some months or years later. Some side effects are common, whilst others are rare. Side effects usually begin about half way through the course of treatment, may last for several weeks after it has finished and then slowly settle down. Please tell us how you are feeling, particularly if your symptoms worsen, so that we can advise and treat you.
Early Side Effects
- Tiredness - Radiotherapy can make you feel more tired than usual, especially if you have to travel a long way for treatment each day. Fatigue usually improves between six months to a year after treatment. Some people find that fatigue can last longer, up to two years or more.
- Skin Reaction - 10 - 12 days after starting your radiotherapy, the skin where you are having treatment may change. The radiographers will provide you with leaflets on how to care for your skin during radiotherapy. If you have any concerns regarding your skin reaction, you can speak to your radiographers or contact the nursing staff in the radiotherapy department on 0113 2067587
- Anxiety and emotional support - During treatment many people feel stressed, anxious, depressed and sometimes unable to cope. If you or your family feel that they need someone to talk to, we are able to offer help and advice. Please discuss any problems with your specialist nurse or doctor.
Late Side Effects
- Stiffness of limbs and reduced mobility - the combination of surgery and radiotherapy may affect how the affected area can move. This may happen soon after, or develop over the months following treatment. It is important to continue to move the area as much as possible. You may need to see a physiotherapist to help with this. The treated area may not recover the full sensation and function that it had before. This will depend on the site and the operation you have had. This means that your problems will also vary and the physiotherapist will make an individual care plan for you. Common problems include muscle weakness, muscle tightness, reduced joint movement and swelling.
- Lymphoedema - After surgery and radiotherapy for a sarcoma of a limb you may develop lymphoedema. Lymphoedema is a swelling caused by a build up of lymph fluid in the tissues. If you notice any swelling around your treatment area, you need to tell your consultant, specialist nurse or physiotherapist. You will be referred to a team of nurses who will be able to help you control the swelling.
- Secondary Cancers - As radiotherapy is an x-ray treatment, there is a very slight risk that it could cause a cancer to develop in the treatment area in the future. This risk is very small and is far outweighed by the benefits of its ability to prevent the sarcoma coming back in the future.
- Weakness of the Bones - There is a small risk of bones in the area being treated becoming weak and more likely to break. This can happen many years after treatment.
After Treatment Has Finished
Your consultant will see you in the clinic approximately six weeks after your treatment. You will then be seen at regular intervals for up to five or ten years, depending on your type of sarcoma.