Radiotherapy usually involves several preparation steps before the first treatment. These steps allow the team to define the correct area, choose the dose, protect nearby healthy tissue and make sure you can be positioned accurately each time.
The exact process varies with the part of the body being treated and the type of radiotherapy.
Discussion and consent
A clinical oncologist or another appropriately trained professional should explain:
- the aim of treatment;
- reasonable alternatives;
- the proposed number of treatments;
- likely benefits;
- relevant short-term and long-term side effects;
- what may happen without the treatment.
Consent is a conversation, not simply a signature. You can ask questions and request more time where the clinical situation allows.
The planning appointment
For external-beam radiotherapy, most people have a planning CT scan. This is performed in the position intended for treatment. The scan is used to design the treatment, so it is not necessarily the same as a diagnostic CT scan.
You may be asked to follow instructions about eating, drinking, bladder filling or bowel preparation. These instructions help make the internal anatomy more consistent. Follow the information from your own department, as it varies between treatment areas.
Positioning and supports
The radiographers may use cushions, a shaped support, a vacuum bag or a mask to help you remain comfortable and still. A mask is used for some treatments to the head, neck or upper body. It fits closely but should allow you to breathe normally.
Tell the team if pain, stiffness, anxiety or breathing difficulty makes the planned position hard to maintain. Adjustments are often easier before planning is complete.
Marks, tattoos and imaging
Small permanent dots or temporary skin marks may be used to reproduce your position. Not every treatment requires them. Photographs or surface-guidance systems may also help with positioning.
MRI, PET or earlier diagnostic scans may be combined with the planning CT when they add useful detail.
Creating and checking the plan
After the scan, the clinical team outlines the treatment target and nearby organs. Planning specialists calculate how the radiation can be delivered. The plan then goes through technical and clinical checks before treatment begins.
This work explains why radiotherapy does not always start immediately after the planning scan. The interval is part of preparing the treatment safely and accurately.
Before the first treatment
Ask about medicines, skin products, transport, pregnancy precautions, implanted devices and what to do if you are unwell. Bring up any change in symptoms or health since the planning appointment.
Questions to ask
- Do I need to prepare my bladder or bowel?
- Will I need a mask or another support?
- How long will planning and each treatment visit take?
- When should treatment start?
- Who should I contact if my symptoms change before then?
Knowing the purpose of each preparation step can make the process feel less unfamiliar.