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Patients Guide to Radiation Oncology

This guide to Radiation Oncology will provide you with a general outline of radiation therapy at the Department of Oncology. In addition, we have listed below some commonly asked questions that may provide you with additional information about radiation therapy as well as resources that are available for you during your treatment. If you have more questions, please contact us via our feedback form, or by calling us at (919) 660-2100.
CT (Computed Tomography) Scans
CT if needed, is usually done prior to your simulation. This is a type of test that is done to see the location of your cancer in relation to your body position for treatment, you may lay on your back or stomach. You will be asked to lie still for 30 minutes to an hour while the special procedures technician runs the machine. You may or may not receive an IV, depending on whether or not you need to receive contrast prior to the test.
 
Simulation
A simulation is done before starting radiation therapy for the majority of patients. You will be asked to lie still on a table while the radiation therapist uses a special x-ray machine to mark the area of your body that will be treated. You may have a probe placed to help better visualize the area that is to be treated. This careful planning is done to limit the amount of radiation to your normal tissue and can take anywhere from 30 minutes to 2 hours. The therapist will use your head holder and alpha cradle as needed to do the markings.
 
Daily Treatments
 

You will be scheduled for treatment once a day (Monday through Friday, unless your doctor tells you otherwise). The time is noted on the card that you receive after your simulation. The treatment itself is only 2-5 minutes long, but you need to add time for changing into a gown and for the therapists to set up the machine.
 
Weekly Treatment Check
You will meet with your doctor and primary nurse once a week so they can see how you are doing. The nurse will check your weight, ask you questions about your treatment (side effects, how you are doing, etc.), and check any lab work ordered by your doctor. If you are having a problem on a day you are not to see your doctor, tell the therapist or nurse, so you can be seen by the doctor in clinic that day.
 
Follow Up
At the end of therapy, you will be given a follow up appointment. At your follow up appointment, the nurse will check your weight and blood pressure. The doctor will examine you to see how you are doing and review any test results with you.
 
Commonly Asked Questions
 Can I listen to music during my treatment?
Each treatment room, as well as the CT and simulation rooms, has a radio/CD player. You can bring your own music or choose from a selection available in the department.
 What is a head holder and alpha cradle? 
The head holder and alpha cradle are two different types of positioning devices. Usually patients have one or the other, not both. Each device is used to ensure you are positioned the same way for each treatment. These are typically made during CT or simulation.
 Can I wash the area being treated?
Yes, you may wash the areas being treated with a mild soap, but try not to scrub off your treatment marks.
 What are port films?
These are quality assurance x-rays that are taken to confirm the location of the beam. These x-rays are not of diagnostic quality and generally are not useful in providing information about any tumor changes.
 Are there any risks to my family if I receive radiation?
There are no risks to your family if you receive external beam radiation. If you are to receive another type of radiation therapy, you will need to discuss this with your doctor.
 What are blocks and how are they used in radiation treatment?

Blocks are used to reshape the standard rectangular radiation field to a custom shaped contour for a specific patient for radiation treatment. The blocks are made of a material containing no lead but has similar radiation shielding qualities, hence the name "block." The therapeutic irradiating field passes through the open area of the block in a shape specific to the prescription for that patient.
 What will the side effects be?
The side effects vary, depending on the part of your body being treated. Your nurse and doctor will review with you the side effects that may occur.
 Are there support groups available?
Duke offers a variety of support groups, visit the Duke Comprehensive Cancer Website for information.

Resources Available During Your Treatment
A dietitian is available to provide suggestions to help you eat well during your treatments. Let you nurse or doctor know if you are interested in seeing her.
A social worker is available to provide emotional support and to make referrals for financial support near home or in the Duke community. Let your nurse know if you are interested in seeing her.
The patient family resource center is located on the 1st floor of the Morris Building. You will find here a variety of cancer literature and tapes for you to use.
The Duke Cancer Patient Support Program (DCPSP) offers hospitality, emotional support and a variety of resources. Professional counselors offer individul or family counseling and facilitate support groups. Volunteers visit patients in the hospital and are in the clinics.
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