Every patient’s treatment is different and the information provided on this website is only a general guide. The healthcare team looking after you will explain your treatment pathway in detail. If you hear words or phrases that you do not understand, please ask a member of our team to explain them to you. You can ask as many times as you like.
If you have any special requirements (physical, emotional, religious, cultural or medical), please inform a member of our staff so that we can try to meet your individual needs.
Step 1 – Consent
The consultant or a member of their team will explain your radiotherapy treatment:
- Which part of the body is to be treated
- What type of treatment your doctor has chosen
- The aim of the chosen treatment
- The benefit expected from the treatment
- Any potential side effects that may occur
You will be able to ask any questions, so it may be helpful to bring a list of your questions with you to this appointment. If you hear any words or phrases that you do not understand at any time, please ask your doctor or a member of your healthcare team what it means. It does not matter how many times you ask. It may be helpful to bring a friend or family member to this appointment to help you remember all the facts given to you by your doctor.
If you are happy to go ahead with radiotherapy you will be asked to sign a consent form. Your doctor will give you a pink copy of your consent form. You must bring this form to your first radiotherapy treatment appointment.
For women of childbearing age (12 – 55 years) it is important that you do not become pregnant during your course of radiotherapy. This is because radiotherapy given during pregnancy could harm a developing baby. Your doctor will discuss this with you during your consent and ask you to sign to confirm that you are not pregnant.
It is important to let us know if you have a cardiac pacemaker or any other implanted surgical devices. If you do have a cardiac pacemaker or another surgical device, please tell one of our staff as we may need to arrange some additional appointments for you.
After you have been consented for your treatment and before you attend for your planning appointment, you will receive a telephone call from a member of our booking office staff. During this telephone call, you will be asked the following questions:
- Do you need hospital transport to bring you to the radiotherapy department for your treatment? Unfortunately we cannot provide transport for everyone. Transport is only available for patients that cannot bring themselves or have no one that can bring them for radiotherapy.
- Do you need an interpreter?
- Do you need specialist support for your radiotherapy treatment?
We will tell you the date and time of your radiotherapy planning appointment during this telephone call.
Your appointments for radiotherapy may not be all at the same time each day and are subject to change. It is also possible that during your course of treatment you may miss a day’s treatment due to machine maintenance or bank holidays. It is therefore important to speak to a healthcare professional before booking a holiday immediately following your radiotherapy.
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 two 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.
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.
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 one to four. 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 tattoos we use are very small and look like a freckle.
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.
Step 3 – Treatment
Step 3 – External beam radiotherapy treatment
Starting treatment
Treatment is normally given daily, Monday to Friday, however your treatment may not start on a Monday. Whenever possible you will be treated at the time of day that suits you, but this cannot always be arranged or guaranteed. There may be occasions when you have a longer stay in the department or are asked to attend at a different time. Sometimes you will need to see your doctor or a nurse and your radiotherapy appointment will be arranged to accommodate these extra appointments.
Notice
You must bring the pink consent form that you doctor gave you to your first radiotherapy treatment appointment. If you do not bring this form, you may have to be re-consented which may result in a delay to your treatment.
When you arrive for your treatment you should go to the main reception at the entrance of the radiotherapy department. Radiotherapy is situated on level B-2 in Bexley Wing, St James’s Hospital. The reception staff will book you in and you will be given directions to your treatment machine. The treatment machines are called linear accelerators but we call them ‘Linacs’ for short.
The radiographers will call your name and collect you from the Linac sub waiting rooms. The radiographers will discuss your treatment plan with you and explain any side effects you may experience. Please ask any questions you want. It does not matter how many times or how many questions you ask. The number of radiotherapy treatments you will be having will be confirmed and you will be given a list with all the appointments you have in the radiotherapy department.
During treatment
You can expect to spend 10 to 15 minutes each day in the treatment room. For most of the time the radiographers are carefully placing you and the machine in the correct position for your treatment. The actual treatment time is for a couple of minutes and does not hurt.
Even though you have the 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. You may prefer to wear older clothing as the ink marks may discolour fabric. It is also generally advisable to wear loose clothing around the treated area. We may ask you to change into a hospital gown for your treatment. This depends on the area of your body that is being treated. The radiographers will let you know if you have to get undressed. Your clothes and belongings can be taken into the treatment room with you, so everything will be safe. If we do draw on you, it is ok to wash the marks off after your treatment as the tattoos are permanent, but don’t scrub at the marks as this may make your skin sore.
Once you are in the correct position the radiographers will leave the room to switch on the machine. You will only be alone for a few minutes at a time. The radiographers will be watching you on a closed circuit TV monitor and can see you all the time. The CCTV camera is not recording or saving any images. There is also a two-way intercom system so the radiographers can talk to you and you can talk to them if needed.
When you are having the treatment, the machine moves around you and does not touch you. The treatment machines makes a buzzing sound when they are switched on. You do not feel pain, heat or any other sensation.
On days when you have more than one appointment you can expect to be in the department longer than usual. Some days the radiotherapy department may be very busy and your appointment time may be delayed. We will keep you informed of any delays.
Regular service checks are carried out monthly to the Linacs. Generally you will be on the same machine for each treatment but you may be moved to a different machine if it is having its service check.
Specialist support
The patient support team is available to provide additional care and support during your radiotherapy treatment. The team are led by the Macmillan Specialist Radiographer and Nurse. The team provides expert support to help those with:
- Severe emotional distress
- Learning difficulties
- Mental health issues
If you need some support to get you through your treatment, please ask your radiographer or nurse to contact a member of the support team.
Step 4 – After treatment
When you have finished your treatment you will be sent a follow-up appointment to see your consultant or a member of their team a few weeks later. This will usually be at your local hospital. If you have not received your appointment within one month of the end of your treatment please contact your nurse specialist or key worker.
Specialist support and advice to help you recover from any side effects of your treatment will be provided through regular visits to Princess Royal Suite. Not everyone will need such intensive support.
Please contact Princess Royal Suite on 0113 206 7587 if you have any worries or concerns about your side effects. Your district nurses and GP will be informed of your treatment and any possible side effects.