Radiation Therapy

Treatment Plan

Before your treatments can begin, your radiation therapy team needs to plan every part of your treatment.

Your Appointment

You will get a phone call with the date and time of your appointment, to prepare for treatment planning.

Depending on the area of your body receiving radiation, the first step will either be:

• Making a facemask (shell) or body mould (cradle). These will be used to hold your head or body in the proper position during your treatments.
• Or, a simulation appointment. A simulation appointment is a practice session before the actual radiation treatment begins.

On Arrival

When you arrive for your appointment, a radiation therapist will explain the planning procedure and will take you to a special type of machine called a CT simulator.

The radiation therapists along with other team members take measurements needed for the detailed planning of treatment. The treatment area on your skin may be tattooed and marked with an ink marker. This is the area that will be used when setting up for daily treatments.

This appointment usually takes between 30 minutes to an hour to complete. 

Frequency

Once treatments begin, your appointments will be every day, or every other day, depending on the type of treatment you are receiving. Treatments are scheduled Monday through Friday. A treatment appointment may be 15 to 45 minutes long. There are no scheduled treatments on weekends or statutory holidays.

Length

A treatment appointment may be 15 to 45 minutes long. Most of this time is spent getting ready for the treatment. The actual amount of time the radiation beam is on is typically 3 to 5 minutes.

The Team

While on treatment, the radiation therapists leave the room but will watch you on a TV screen and listen by intercom. The radiation can be stopped at any time to allow staff to enter the room and will switch off once the treatment has been given.

During a review appointment the nurse will meet with you to ask if you have any questions or concerns.

During your last week of treatments your follow-up plan will be confirmed.

Follow up include:

• Physical Examination
• Imaging
• Bloodwork, if required

For patients who will continue to be followed by the radiation therapy department, your radiation oncologist will conduct follow-up visits for typically 5 years after treatment.

Image guided radiation therapy is a method that uses real-time imaging of your tumour and surrounding normal structures in order to deliver ultra-precise radiation beams to the target.

Images are captured both before, during and often after treatment is complete. This ensures your position and the radiation beams are precisely adjusted to target the tumor.

Intensity Modulated Radiation Therapy is an advanced mode of high-precision radiotherapy that utilizes multiple beams from many different angles around your body to precisely target tumour and minimize the dose to surrounding normal tissue.  

Volumetric Modulated Arc Therapy is an advanced form of IMRT that enables the treatment machine to rotate around the patient during treatment at different speeds and angles. This  allows the radiation beam to be continuously reshaped and modified in intensity while the beam is on.

Advantages of VMAT are improved accuracy, shorter treatment times, and lower overall dose of radiation.

Respiratory Gated Treatment delivers radiation as a patient breathes.  This is very helpful delivery method, depending on the tumour location, as sometimes the tumour moves during the treatment process - such as tumours located in the lungs, the chest or abdomen.

During this process, treatment will be delivered during a particular 'window', allowing radiation to be applied when the tumour enters the targeted 'window'.

Stereotactic Body Radiation Therapy is a method to deliver very high ablative doses  of radiation to tumours with very minimal dose to surrounding structures. These treatments typically last  between 3 to 5 days in total, and are delivered on alternate days of the week.

This type of treatment is usually delivered to early-stage lung cancer, prostate cancer,  pancreatic cancer, and other cancers that have spread to the lung, liver, adrenal glands, lymph nodes, or bone.

Watch this video to learn more about how lung cancer is treated with SBRT.

Watch this video to learn more about how prostate cancer is treated with SBRT.

Radium-223 is a naturally radioactive element derived from the metal radium.  Ra-223 is used to treat metastatic  prostate cancer that has spread to the bone, as Ra-223 behaves like calcium when it enters that body, and naturally gets absorbed into bone. Once absorbed, Ra-223 delivers radiation to the bone to treat cancer.

These types of treatments are done by injection into the blood stream. Injections are done every four weeks, for a total of 6 injections. 

You will require bloodwork prior to each injection, which will be reviewed by your Radiation Oncologist prior to treatment, to ensure you are able to recieve each dose safely.

Side effects from Ra-223 can include:

• Nausea
• Diarrhea
• Vomiting
• Swelling of the arms or legs
• Low blood cell count

We try to keep all appointments when they are scheduled but changes can happen. We will give you as much notice as we can if any of your appointments need to be changed.

If you need to change an appointment, please call the oncology clinic at: 905-682-6451

If you are unable to attend or will be late, please call between 9 a.m. to 5 p.m. at: 905-682-6451

If possible, please give us 24 hours notice.

Please follow these instructions during your radiation treatments and for 2 weeks after treatments are done:

• Do not scrub or scratch the area being treated
• Gently wash the skin in the treatment area with warm water and a mild non-deodorant soap such as Dove or baby soap while bathing or taking a shower.
• Pat dry with a soft towel.
• Protect the treated skin from all sources of hot or cold such as hot water bottles, heating pads, ice packs or saunas. Protect the skin from direct sunlight or harsh cold.
• Do not use creams or lotions on the treatment area unless directed by your health care team.
• Talk with your primary care team before swimming or exercising.
• Eat and drink to keep your nutritional levels up.
• Take rest periods during the day if needed and pace your activities