The journey begins when a patient is referred for radiation therapy treatment by their provider.
The patient has an initial consultation with a nurse and the radiation oncologist who will direct their care. The consultation includes a review of the National Comprehensive Cancer Network (NCCN) guidelines for the treatment of the type of cancer they have and what their course of treatment and timeline of treatment would be.
Depending on their cancer, the patient may need one treatment or daily treatments for as long as eight weeks.
In the background, a number of people are evaluating other needs of the patient.
Unmet Needs Assessment
A social worker and the office coordinator evaluate any unmet social and financial needs the patient may have related to their cancer, and what resources are available to help meet those needs to ensure the patient can focus on their health.
A simulation technician works with the patient to develop a treatment simulation. This involves the patient lying on the table under the linear accelerator in the position they would be in during treatment, in a way that can be reproduced by the patient every day of their treatment.
When the position is determined, a computed tomography (CT) scan is taken. Depending on the type of cancer for which the patient is being treated, a four-dimensional CT may be used so radiation oncology team members can determine if a patient’s tumor moves as they breathe. If it does, that must be taken into account during planning.
Some cancers may also require creation of a head mask as a part of the simulation that will be worn during treatment to fix the patient’s position and target a very specific area in the brain.
Using a variety of sophisticated software programs, the patient’s radiation oncologist, the dosimetrist and the physicist contribute to each patient’s treatment plan. The radiation oncologist uses the CT taken during simulation to determine the boundaries of the tumor. This is called a contour.
Then, the dosimetrist fuses images of the patient’s tumor and anatomy with the contour to plan the direction and arcs of the radiation beam. The goal is to ensure maximum treatment to the tumor with minimal effects to surrounding, healthy tissue.
The radiation oncologist and dosimetrist review the treatment plan at this point. When the radiation oncologist approves the plan, the physicist conducts a quality assurance review, evaluating the dose of radiation and the radiation beam angles and arcs, to ensure treatment effectiveness and patient safety. The physicist’s review is reviewed again by the radiation oncologist.
In addition to the planning and quality review checks done by the radiation oncology team, a committee of specialist providers meets regularly in a multi-disciplinary cancer conference to evaluate the case of every patient receiving care at the Blessing Cancer Center. The committee reviews the care plan before a patient’s treatment begins and tracks each patient’s progress through treatment.
A radiation therapist works with the patient during each treatment. In the moments before the first treatment, the radiation oncologist, dosimetrist and physicist join the radiation therapist and patient at the linear accelerator. Additional images are taken so each member of the team can confirm the patient’s position matches the position determined during simulation.
The radiation therapist confirms the patient’s position on the linear accelerator table is accurate with additional imaging before each consecutive treatment begins.
The patient sees their radiation oncologist and a nurse on a regular basis during the course of treatment to evaluate progress and manage any side effects if needed.
After their last treatment, the patient receives a date for a follow-up with the radiation oncologist to review how their cancer is responding to treatment.
To learn more or refer a patient, please call (217) 223-1200.