Course of Treatment
At your first as well as each further visit, our secretaries will welcome you. A secretary will take all your personal data. Please provide her with all relevant medical information and reports: surgery report, histology findings, x-rays, and your aftercare schedule. If relevant information is not available during your first visit, it must be forwarded to us, which can lead to unnecessary waiting periods.
The secretary will inform you about practice procedure and give you a preliminary information sheet about radiation therapy for your condition.
After a radiation oncologist was able to peruse your medical history in detail, an extended personal consultation will be arranged. At this important first meeting, during which you get to know each other, the doctor and you will discuss at length all therapeutic options. The specialist will take ample time to answer all your questions. On this occasion you will also receive more detailed information material regarding your particular treatment as well as appointments for radiation planning.
The doctors meet daily to work out the individual treatment for each patient.
An essential component of modern radiation planning is usually a planning CT-scan. This is taken (without injection of contrast agents) in the same position anticipated for the radiation treatment procedure. All data from this CT-scan is automatically fed into our planning computer, which is why we cannot utilize your diagnostic scans for this purpose.
The radiation oncology specialist marks the region to be treated onto each CT-scan slice. Vulnerable organs in the vicinity of the tumor, such as lungs, bone marrow, or kidneys are marked as well.
Using a 3D planning system the radiation oncologists and medical physicists now establish a 3D radiation plan. In most cases, the treatment field will be irradiated from several directions (multiple-field technique) to ensure a sufficient radiation dose, and also to protect surrounding tissue as much as possible. Usually only a few days are required to establish the radiation plan.
In some cases the complete radiation plan will be tested in a simulator, in other words the radiation is simulated. At this time several small marks will be applied onto the body or mask, which will be necessary for the exact same positioning during the actual radiation course. These marks must stay in place during the entire course of treatment. Careful showering or washing in between daily treatments is permitted, but bathing, swimming, and sauna should be avoided. The radiotherapy technician can refresh the marks if necessary.
The first radiotherapy treatment takes place in the presence of the specialist, the physicist, and the radiotherapy technician. The settings are checked once again and field control images are taken. Because of this, the first treatment takes a bit longer than the following treatments, which last only a few minutes.
The
complete dose for a given condition is usually administered in several single
doses (fractions) in order to prevent damage to healthy tissue. The
radiotherapy course can therefore last between several days or several weeks.
Please discuss any schedule requirements with your radiotherapy technician. The
radiotherapy treatments should occur, if possible, without interruption.
However, occasional problems with the equipment sometimes cause delays. If this
happens, the missed treatments will be administered at the end of the treatment
course.
Whenever you visit our practice, please announce your arrival to reception and take a seat in the waiting area. You will be called up as soon as possible. Please also bring a towel for your daily treatments. This will help reduce our washing and protect the environment. During your course of treatment, regular controls are made, often without you being aware of it. Sometimes re-planning is necessary within a treatment course, for example if a tumor has shrunken. It then becomes possible to reduce the irradiated treatment area. In such an event further planning CT-scans and new simulations will be required.
During treatment side effects may occur. The underlying disease may
also be the cause of new problems. Please let us know if any undesired
symptoms occur. If necessary, we will administer appropriate treatment,
prescribe medication, organise parenteral nutrition, or admit you to
hospital. We continuously monitor our patients via regular
examinations, checking irradiated skin and using laboratory controls.
When the treatment course has been completed, the specialist will meet with you for a final consultation. Side effects, that may have occurred, will be discussed as well as their remedies. We may also discuss further treatment if necessary as well as aftercare. For this reason please bring your aftercare schedule to this appointment.
If your side effects are more serious, we will request that you return within a few days for a control check-up. Control check-ups normally occur 6 weeks after completion of radiation treatment. Should problems arise before this time, we will naturally be available at any time.
The specialist, who referred you to us, will usually supervise your cancer aftercare. According to radiation protection regulations, we, as radiation oncologists, are obliged to perform post-treatment check-ups at least 5 years after treatment. For this reason we will write to you and enquire about your condition (once annually). If your doctor keeps us informed about further developments, personal visits will not be necessary.