Starting radiation can anyone help?

Different places have somewhat different procedures but generally --

Simulation / mapping is a data gathering session usually done with a CT simulator.  They position you on the simulator which replicates the treatment machine and take the CT.  This gathers data about the exact geometry of your anatomy and your tumor or the location where your tumor was and any other areas they want to target.  For me the specific targets were the clips left to mark the location where the tumor had been and the seroma filling the surgical cavity.  Then they put reference marks on you with dot-like tattoos or sometimes markers so that they can consistently replicate the exact position. 

Aftter this session and before your next session they take the data and develop the treatment plan, which means they simulate various arrangements of the radiation beams on a treatment planning system to create a planned dose distribution that delivers the amounts of radiation prescribed to the areas they want to treat while avoiding areas they don't want to expose, as much as possible.  At a second session after the treatment planning is done they mark the fields from the final plan and check everything.

The radiation oncologist and a radiation therapist should be present.  You should feel free to ask whatever you want about what they are doing. 

When I had a my simulation, toward the end, the technician outlined what would happen in real treatment. She told me they would tell me to take a deep breath, then tell me to breathe out and we practiced it a time or two. She had me hold my breath about one and a half seconds.



So I went for my first real treatment about a week later. I was aligned up and the equipment whirred and turned above me. Sure enough, over a speaker, the radiation therapist who leaves the room to hide in her lead lined bunker said "take a deep breath and hold it." The jaws of the mouth of the "beast" opened and there began a crackling, staticy noise. Fifteen suspense filled seconds later I was relieved to hear a voice say "now breath out."



There is a huge difference between 1 1/2 seconds and 15 seconds when you are not breathing! I just felt that was one of many little details that should have been better explained ahead of treatment. My facility practiced something called gating and I'm not sure everyone does the "hold your breath" thing.



I was also surprised to find men in the patient waiting area. I was accustomed to mammogram facilities where it is all women. I found it difficult to sit there in a surgical gown. I don't know if that is unusual.



During my simulation the therapist made many ink marks on my chest and breast but I did not get my tattoos until actual treatment began. The tattoos were really just tiny dots of ink and mine were (are) so small that one of the older (middle aged) therapists could never see them. I used a magic marker and circled them so she would be sure to line me up properly!



The radiation treatment room was always freezing! Even though I dressed in layers from the waist down, it did not help being naked from the waist up. It was just COLD!



If your schedule permits it, it is better to have your treatment appointment earlier in the day. The longer the day goes on the more complications arise and the farther behind their schedule can get. My treatment was at a hospital so emergency treatments sometimes had to be worked in which usurped other appointments. If my appointment was late in the day I learned to call before I went to see if they were on schedule.



There was nothing painful about receiving the radiation. It was just uncomfortable lying in the necessary position. Some days took longer than others and I never understood what made the difference.



At the end I asked my radiation oncologist for a letter detailing my treatment (how much radiation and what kind) for my records. I'm sure I'll never need it but just in case...



I took a tin of cookies to the therapists once a week. They appreciated it and It was a way for me to show my appreciation to them.



You'll probably be scheduled to see the doctor once a week but if you have questions or are having a problem, ask to see the doctor any time.



I guess there are a dozen little things that will surprise you. The therapists are so used to it all that they may not think to mention things. If your facility does not have a protocol for confirming exactly who you are as you enter the treatment area (I'm sure they will and that it is standard) but if they don't or If the therapist skips asking, make sure they know who you are and that the computer knows it is you about to lie down on the table!



Best wishes for a smooth course of treatment. It all seemed so overwhelming at the time but now I can hardly conjure up memories of the whole ordeal. . Tincture of time.