Radiation Oncology

The radiation oncology team is your partner in care. We hope that your experience here will exceed your expectations.

About Radiation Oncology

During radiation therapy, high energy X-rays are used to treat cancer by killing the cancer cells or making them unable to grow and divide. In external beam radiation, a machine called a linear accelerator is used to produce a beam of rays that is directed to the tumor or the part of your body that is being treated.

Your Radiation Oncology Treatment Team

• Radiation Oncologists
• Nurses
• Radiation Therapists
• Medical Physicists
• Medical Dosemitrists
• Medical Office Assistants
• Medical Assistant

CT Simulation and Your First Appointment

CT simulation is performed in the radiation oncology suite in the Cancer Institute. This is the first step in creating a personalized radiation treatment plan for you. The plan targets the affected area while minimizing the radiation dose to healthy tissues and organs.

What to expect

The CT simulation appointment lasts approximately one hour.

After checking in at the front desk, you are seated in the front waiting room directly next to the check-in desk. Within a few minutes, a radiation therapist escorts you to the CT simulation waiting area. Here we confirm your name, date of birth, treatment location and pre-treatment weight. We also take a photo of you for your file. This photo is loaded into your radiation record and then displayed each day at the treatment unit where you will verify your information prior to treatment.

The radiation therapist positions you on the CT table in a reproducible position. The team will attempt to make you as comfortable as possible, as this will be your position every day for your radiation treatments. During your CT simulation, the radiation therapists create immobilization devices to assist in reproducing your precise body positioning. Depending on your area of treatment, devices may include face or pelvic masks, or a ‘mold’ formed around the body part of interest.

After the scan is complete, you may be given tiny permanent tattoos in the treatment area that look similar to a freckle. The tattoos help to reproduce your exact positioning from the CT scan during each radiation treatment. Please continue to bathe as normal; these marks will not come off.

Your radiation treatments begin approximately one to two weeks following your CT scan. This allows the team enough time to create your personalized radiation treatment plan.

Block Check/ Dry Run Appointment

The Block Check/Dry Run appointment takes place in the radiation treatment room and occurs after your radiation treatment plan is complete. This appointment allows us to place you in your personalized treatment position using the tattoos that were given to you during your CT simulation. This appointment occurs prior to your first treatment to ensure that we are able to precisely reproduce your set-up on the treatment machine. This appointment lasts approximately 30-45 minutes.

What to expect

Your Block Check appointment lasts approximately 30-45 minutes.

After checking in at the front desk, you are seated in the front waiting room directly next to the check-in desk. A radiation therapist escorts you back to the gowned waiting room. You are instructed on where the patient gowns are located and how to properly change for your treatment. Please note: if wearing two gowns, the first gown covers up the front of your body and is open in the back, and the second gown covers the back of the body and is open in the front (like a robe).

From this point, the radiation therapist team escorts you to the treatment console where you verify your name, date of birth, face photo and treatment site. You are taken into the treatment room where you are placed in the same position as you were for the CT Simulation. The radiation therapist aligns you using the tattoos received during the CT Simulation. We ask that you remain as still as possible, as the radiation therapist will be moving you to get you in the exact position for the treatment plan. We appreciate that you would like to help; however, it is easier and faster for the entire team to allow the radiation therapists to move you.

After you are in the precise position on the treatment table, the therapist steps out of the room in order to take X-ray images. This enables the radiation therapists and oncologists to ensure that you match the created plan. You may feel the table you are laying upon move; this is normal. We ask that you remain still the entire time you are on the treatment table and breathe normally.

Once it has been confirmed that the treatment computer plan is working as intended, the radiation therapist will place a few more marks on your skin with marker. These are intended to aid in your positioning for daily treatment and help speedup the appointments. At this point, the radiation therapist takes digital photographs of the above mentioned marks for documentation to be placed in your treatment record.

Clear stickers will be placed over the marks. We ask that you try to keep these marks on. You may bathe as normal; we just ask that you do not scrub or pick at the stickers. Please do not be concerned if the marks do come off; it is not detrimental to you being treated correctly and precisely.

When your treatment is completed for the day, you are escorted to the gowned waiting room to change. There is no need to check-out at the front desk after you are dressed.

Prior to leaving, you will receive a schedule of upcoming radiation therapy treatment dates and times. Please follow this schedule for your radiation therapy.

Daily Treatment

The daily treatment appointment is when you receive the radiation therapy as prescribed by your radiation oncologist. The number of treatments and days you receive treatment depends on the treatment area and disease, as well as your radiation oncologist’s recommendation based upon your individual treatment plan.

What to expect

The daily treatment appointment takes approximately 15-30 minutes.

Each day of your treatment, you begin by checking in at the front desk at the ground floor of the Cancer Institute. You may then proceed to the gowned waiting room where we ask you to change into the gowns as explained during your block check/dry run appointment. A radiation therapist escorts you back for treatment. Each day, you verify your name, date of birth, face photo and treatment site at the treatment console. At this time, please notify the team of any changes to the treatment area.

You then move into the treatment room to be aligned for treatment. Once again, the team will position you using the tattoos. We ask you to remain still and allow the radiation therapists to move you. The team reads measurements and steps out of the room to begin treatment. Depending upon the orders your radiation oncologist provided, the radiation therapists may take X-rays prior to your treatment. This is used as another tool to ensure you are in the correct position. The imaging may or may not be used every day.

The treatment begins. The machine may rotate around you, but will not touch you. You are not able to see anything during treatment, but you may hear a buzzing and clicking sound. Please remain still and breathe normally until the radiation therapists come back into the room and state that the treatment is completed.

Once a week, you will be seen by a radiation oncologist for an OTV (On Treatment Visit). If you have any concerns in between these visits, please tell the radiation therapist at the machine that you would like to speak to a nurse.

Skin Care During Radiation Therapy

Skin within the radiation treatment area can become red, sore, and tender during treatment and for several weeks following treatment. Sometimes these skin reactions may seem to progress for a few days after treatment ends. Proper skin care during radiation therapy is essential for healing and comfort. General guidelines are listed below.

Skin Products

Lotions - only lotions, soaps, cream or deodorants that have been approved by your nurse or physician should be applied to skin in the area being treated. No lotions or creams should be applied for the four hours prior to your treatment each day. When using products, apply products in thin layers or as directed.

Sun Protection

Use sunscreen or keep skin in the treatment area protected from the sun with clothing or by avoiding exposure. Skin in the treatment area will always be more sensitive to the sun - even when treatment is completed.

Bathing

Use a moisturizing soap, such as Dove^® or Caress^®. Rinse well to avoid leaving any soap residue on the skin.

Shaving

It is preferred that you do not shave the hair in the treatment area. If you must shave, use only electric shavers. Please do not use straight razors. Avoid before or after shave preparations that contain alcohol.

Temperature

Avoid extremes of temperature in the treatment area. Avoid jacuzzi/hot tubs, and extremely hot or cold showers. Do not apply ice packs or heating pads to the treatment area.

Clothing

Avoid clothing that might be tight or restrictive in the treatment area. If a mark is left on the skin in the treatment area when you take the clothing off, then it is too tight.

Skin should be kept moisturized and open to air, but protected from the sun as much as possible.

Areas with skin folds may need to be separated so that the skin is exposed. These areas should be blotted dry as needed to prevent moisture build-up.

Skin reactions from radiation treatment generally start to improve two weeks after therapy is complete. Speak to your nurse or physician about any questions or concerns you have related to the skin in your treatment area.

For radiation oncology, please call 717-531-8024 during normal business hours (8 a.m. - 4 p.m.) and follow the phone menu prompts. If you have an urgent medical need after normal business hours, on weekends or holidays, please call 717-531-8521 and ask for the radiation oncologist on call.