Radiation Simulation Steps
- A radiation team will determine the correct position for you to lie in during treatment — back, side, or stomach
- Special devices, including cushions and masks, will be used to hold your body in this position, and then used for each treatment
- A CT scan will map the areas of your body to be targeted
- Permanent marks — from a marking pen or more commonly tiny tattoos — will direct technicians to ensure that treatment is precisely delivered each time
Dr. Chelsea Pinnix, a radiation oncologist at MD Anderson Cancer Center, says that many people are unnecessarily frightened by the prospect of this treatment. “Radiation for patients typically is a big black box and very scary, initially,” she says. “You read a lot of things online and you see a lot of the older studies that have demonstrated toxicity with radiation.”
Read MoreFirst, the radiation team has to decide — along with you — what position your body should be in for the treatment. The position needs to give the machine the best access to the radiation target areas. But it also has to be a position comfortable enough for you to remain immobilized for as long as each treatment requires (generally just a few minutes).
You might be lying on your back, your stomach, or your side during treatment, and a variety of special cushion-like devices will help keep you in the exact same position for each treatment. If your head or neck will be receiving treatment, a special plastic mask is molded to your face and then fixed to the table so your head doesn’t move while the radiation dose is delivered. “We have a lot of fancy devices that we use for setup because we’re able to target down to the millimeter,” says Dr. Pinnix. “It’s really important to be in the same position every day [you receive treatment], given how focused our radiation therapy is now.”
Once you’re positioned and immobilized, you’ll receive a CT scan of the areas to be treated. These scans help the radiation team pinpoint the areas to receive radiation.
The radiation team will then mark your body, with permanent marker or tiny tattoos (about the size of a freckle) so that the correct areas will receive radiation every time you have treatment.
The entire simulation process can take up to an hour, and is a good opportunity for you to ask any questions you might have about the treatment, how it works, and what you may experience.
Starting Your Treatment
When your treatment begins (on another day), you’ll be placed in the exact same position you were in for the simulation, with the same mobilization cushions or devices to make sure you don’t move and that radiation is delivered accurately only to the areas that require treatment.
For non-Hodgkin lymphoma, the number of treatments depends on the stage and aggression of the disease. For patients with early stage or indolent — non aggressive — NHL, two treatments may be sufficient to wipe out the cancer. For patients with later stage or more aggressive NHL, treatment may be given a few days a week for several weeks. The treatment itself only lasts a few minutes, but getting you positioned correctly each time can take a bit longer.
Radiation therapy is usually painless, although there may be side effects from the treatment, which can include skin blistering, fatigue, nausea, and diarrhea. Your doctor can give you advice on how best to handle these symptoms.
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