Step 2 - Planning
In order to get the radiotherapy treatment correct for you, we need to plan what we are going to do. This normally involves an appointment in the planning department which is also called the Sim department. Here we use a Computerised Tomography (CT) scanner to take pictures of your body which allow us to see the cancer and plan your radiotherapy treatment.
Your appointment in the planning department may take up to 2 hours. The planning scan itself only takes a few minutes and does not hurt. You may want to bring something to eat or drink or something to read.
The radiographers will check your personal details carefully to make sure you are the correct patient. We will check you have signed the consent form for radiotherapy. We will explain everything that will happen and answer any questions you may have.
If you are female of child bearing age you will be asked if you could be pregnant.
To help identify you each day for treatment the radiographers will take your photograph. The radiographers that give you your radiotherapy treatment will see this to confirm your identity. We will also check your name, date of birth and address every time we see you.
For some planning scans we need you to have an empty bowel or a full bladder. You may need an micro-enema to empty your bowel or drink some water to make sure your bladder is full. If this applies to you, you will be given instructions prior to your planning appointment. If you are not sure whether you need to have any special preparation please ask one of our staff.
Sometimes we may need to give you a dye to see your tumour, blood vessels or body organs. This is done by drinking the dye or by injecting the dye into a vein in your arm. You may have had this done before in the Radiology department when you had a CT scan there.
The picture above shows a picture of one of our CT sim scanners. It looks just like a CT scanner that you will find in a radiology department except for a flat bed to lie on.
It is important to let us know if you have any allergies. Please tell the planning staff if you are allergic to anything.
The radiographer will make sure you are in a comfortable position on the scanner. You will have to be in this same position for your radiotherapy treatments. It may take a short time to get you in the correct position. Sometimes we have to use foam pads and vacuum bags to make sure that you are in the correct place. Patients that are having treatment to their head and neck may need a mask made in the mould room.
More information about the mould room can be found here
The radiographers will draw some marks onto your skin, to be used as a reference for your treatment. The marks do not show us where your cancer is, they help us make sure that you are in the same place every time for your treatment. At the end of the scan these marks will be replaced by tattoos. The tattoos are no bigger than a freckle and will be used each day for your treatment. The number of tattoos depends on the area of your body we are treating. It ranges from 1 to 4. The tattoos help us to reproduce your treatment with accuracy each day. It also means that you can wash as normal without worrying about your marks coming off.
If you are having treatment to your head and neck you will not have tattoos placed on your face. We will put pen marks on your mask which will allow us to make sure you are in the correct position for your treatment.
The time between your planning scan and your treatment may vary from a couple of days to a couple of weeks depending on how complex your treatment plan needs to be.
After you have had your planning CT radiotherapy scan, the doctors will draw on your images to show where they want to give the highest dose to your tumour. The number of radiation beams needed can vary. The doctors check the plans to ensure that the radiation beams cover the area needed.
Staff in the treatment planning department use state of the art computers to generate an individual radiotherapy treatment plan. This may take several hours or even several days. The technologists ensure that the dose goes to the tumour, adding an area around in case small cells have escaped the main tumour. They ensure that as low a dose as possible goes through the healthy parts of your body. Each radiotherapy treatment is very carefully checked before it is prescribed. and before it is sent to the treatment machine. When the prescription is received on the radiotherapy machine, an additional set of checks are made by the radiographers.
After you have had your planning scan, you will receive the time and date of your first appointment on the treatment machine, this may be in a few days or weeks time. The radiographers will also let you know details of any further appointments you have.
You will be able to drive your car or go to work after your planning scan.