Radiotherapy is the use of radiation, usually X-rays, to treat illness. Around four out of ten (40%) of individuals with cancer will have radiotherapy as part of their treatment. Sixteen per cent (16%) are directly cured by radiotherapy alone. Radiotherapy destroys the cancer cells within the treated area by damaging the DNA within the cells. Although normal cells are affected by the treatment within the area they are able to recover. Access to radiotherapy can provide good long-term outcomes, long-term palliation, and improvement of symptoms.
Radiotherapy is a course of treatments specifically made for each individual. Each treatment is known as a fraction (#) and will be delivered Monday-Friday depending on the amount of treatment required. Whilst receiving treatment patients will be required to visit the department on numerous occasions.
Linear Accelerators or ‘LINACS’ are the machines used to deliver treatments.
We offer the latest technologies and techniques within a comfortable, purpose built environment.
Our department is made up of an Elekta Agility head Linear Accelerator (often referred to as Agility) and a Siemens Somerton Sensation AS64 CT scanner. Agility uses intelligent beam shaping that is multifunctional with high-resolution beam shaping.
Agility meets the needs of a modern radiotherapy centre with the ability to take ‘on board images’. This ensures we are able to offer the latest technologies including IGRT (Image guided radiotherapy) and CBCT (Cone beam computed tomography). Such facilities enable us to provide the latest treatments such as Volumetric Modulated Arc Therapy (VMAT).
Our CT scanner is able to offer excellent picture quality without a reduced speed, ensuring accuracy of treatment delivery. Below is a picture of our CT scanner:
We are a friendly team of committed professionals dedicated to providing the highest care alongside clinical excellence. Here is an outline of some of the professionals you may meet and their roles:
Clinical Oncologists are doctors who will meet with patients in their clinics. They discuss and guide patients through treatment options. The clinical oncologist will prescribe and plan individual treatments.
Therapeutic Radiographers work within the department delivering, planning treatments, and ensuring patients are both supported and cared for during treatment.
Medical Physicists work within the department undertaking many tasks including maintaining the Linear Accelerator and planning individual treatments.
There are many other professionals within the team that you may meet on your journey through the department.
Patients receiving radiotherapy treatment will get clear directions and a contact number for any further information. It is important to inform us if a patient is or may be pregnant or if you have a Pacemaker fitted prior to your visit. Any instructions are individual and will be given before attending for a CT scan.
Every individual patient will have their own guided journey; however, here is an example of a pathway through the department:
Patients will have two appointments on their first visit to the department. During the CT chat the radiographer will be able to answer any questions and will go through the consent form. At the planning CT scan appointment patients will be required to lie still on a flat couch and breathe normally whilst passing through a large open hollow ring. Radiographers will put marks on the patients’ skin to ensure the position during the scan is recorded. Often we will seek permission to apply tiny ‘freckle’ size permanent marks on the skin surface. These marks are quite small but ensure we can reproduce the position the patient has been scanned in on future visits. The CT scan allows the doctor to see where the treatment needs to go, allowing an individual plan to be created.
There can be several days / weeks between the CT appointment and first treatment. This is because a dedicated team of radiographers and medical physicists will work alongside the consultant oncologist to look at the CT scan and create a plan which is personalised for each individual patient to achieve optimum results. Once the treatment plan has been created there are several checks that are undertaken, and the information is put into the treatment system ready for the first day.
When a patient comes for their first treatment they will have an appointment with a radiographer called a 'First day chat' where they will go through what will happen during the treatment, any possible side effects and will give you a list of all your appointments. We do not give you a complete list of all your appointments before the first day as there is a possibility that they may change before then. The patient will be asked to get changed, they can bring their own dressing gowns with them or they are welcome to use our gowns for each appointment. The department has excellent changing facilities that ensure all patients’ modesty and dignity is respected and maintained throughout visits. No patients would be expected to wait in the waiting room with a gown.
Once changed the radiographer will take the patient through into the treatment room and ask how the patient is doing since the last treatment. The patient will lie down on the treatment bed and be guided into the position they need to be in for treatment. During this part the radiographers take several measurements to ensure the patient is in the correct position. The lights in the room are dimmed to allow the radiographers to see the lasers against the patients' skin better. When the radiographers are happy with the position they will leave the room, as they exit you will hear siren sound for approx. 30 seconds. This is a safety feature to ensure that all the radiographers have left the room before any radiation is emitted from the Linac. For some treatments the radiographers will take an image to check the position before starting the treatment and sometimes a small monitor is put onto the patients skin as an additional safety feature. The radiographers will let the patients know when they will do this as it does not occur for every treatment.
During the treatment the patient will hear a loud buzzing noise, they will not see or feel anything. After the treatment the radiographers will take the patient back to the changing room, and the patient is free to leave whenever they are ready.
When patients sign the consent form with the consultant oncologist they will explain all the long term and short term side effects with them. The possible side effects are different for each treatment area so the radiographers will ensure that patients have all the information they need before starting their treatment. Before the CT planning scan and first treatment there will be another opportunity to discuss potential side effects and management of these with you. Radiographers assess patients daily and are always there to answer any questions. Patients are fully supported and cared for by the team while they are coming to the radiotherapy unit. In the department we also have a variety of MacMillan information leaflets which are free for you to keep.
Patients should continue with any medications or painkillers as usual throughout treatment unless asked to stop. Patients undergoing treatment for cancer are entitled to free prescriptions. Please ask the GP or pharmacy for an exemption certificate if needed.
Patients will not be radioactive during the treatment, it is completely safe for patients to be around children and pregnant women.
On the last day of treatment a radiographer will explain what to expect over the next couple of weeks and will ensure that the patient has enough information regarding any side effects including skin care management. Some patients will be given a follow up appointment with their consultant oncologist, this will be arranged by the consultant's secretary and the appointment should arrive in the post. If you have any concerns or questions regarding your radiotherapy treatment after you have finished please call the department on 01256 315059.