Meeting with a Radiation Oncologist: If radiation therapy is part of your child’s treatment plan, you will first meet with a radiation oncologist. Your radiation oncologist will discuss the role radiation has in treatment and answer your questions. You will also meet the nurses who will help during treatment.
Simulation: To be most effective, radiation therapy must be aimed precisely at the same target every time treatment is given. The process of measuring your child’s body and marking the skin to help direct the beams of radiation safely and exactly to their intended locations is called simulation.
During simulation, your radiation oncologist and radiation therapist will place your child on the simulation machine in the exact position that will be used during the actual treatment. Depending on what area of the body is going to be treated, simulation may include an immobilization device. Immobilization devices are used to ensure that your child remains in the same position every day during the entire treatment.
Treatment Planning: Once the simulation is finished, the radiation oncologist and other members of the treatment team review the information obtained during simulation along with previous medical tests to develop a treatment plan. After reviewing all of this information, the doctor will write a prescription that outlines exactly how much radiation is to be given and where. Once the treatment planning is complete, treatment will begin. The complexity of the treatment plan dictates how soon after simulation treatment will begin. Not all cancers are treated with the same amount of radiation; your doctor will tell you how long the treatment will last. This is based on the tumor type and sometimes, the age of the child.
First Day: After the simulation, before the first dose of radiation, treatment verification films (also called beam films or port films) will be completed in the Radiation Oncology Unit. These films verify that the area being treated is in fact the exact area the doctor planned. These films need to be approved by the doctor before the first dose of radiation is given.
Daily Treatments: Every day, the radiation therapists will assure correct position, including the use of the immobilization device if that is a part of treatment.. Once correct placement is assured, the therapists will leave the room and go to the control area to closely monitor your child on a television screen. There is a microphone in the treatment room so your child can always talk with the therapists. The machine can be stopped at any time if your child is feeling sick or uncomfortable. Each session is painless; you don’t see it, taste it, or smell it; it is just like getting an X-ray. Your child will be on the treatment table for 10-30 minutes; most of this time is spent setting you up.
The radiation therapist may move the treatment machine and treatment table to target the radiation beam to the exact area of the tumor. The machine might make noises during treatment that sound like clicking, knocking or whirring; this is normal.
Treatments are usually scheduled five days a week, Monday through Friday, and continue for one to 10 weeks depending on the type of cancer being treated.
Weekly Status Checks: During radiation therapy, your radiation oncologist and nurse will see your child regularly to follow progress. Be sure to share any questions or concerns that you or your child may have during these visits or anytime during treatment. They will evaluate whether your child is having any side effects and recommend treatments for those side effects (such as medication). As treatment progresses, your doctor may make changes in the schedule or treatment plan depending on response or reaction to the therapy.
Your radiation therapy team may also meet on a regular basis with other healthcare professionals to review your child’s case. This will ensure that treatment is proceeding as planned. During these sessions, all the members of the team discuss progress as well as any concerns.
Weekly Port/Beam Films: During the course of treatment, it is necessary to make sure the radiation beams are going exactly where they are designed to go. Once a week, the therapists will take port or beam films for the radiation oncologist to approve. These are the same type of films that were taken on the first day. In order to continue radiation, your radiation oncologist must approve these films. Your child may be on the table for a few more minutes than usual on the day of port/beam films. These films do not show the tumor’s response to radiation.
Follow Up: After treatment is completed, your radiation oncologist will work closely with the other team of doctors taking care of you to make sure recovery is proceeding normally
Reviewed and edited by the CureSearch.org Medical Editorial Board October 2006