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Rectal/Colon Cancer: Before Start of External Beam Radiation Treatment (EBRT)

What Happens During A Planning Session Before Your First Radiation Treatment

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There will be a planning session at the radiation facility (generally the department of radiation oncology) which may take several hours.

During the planning session:

  • You will meet the technicians and other personnel who will be involved in giving the treatment. For the identities of the professionals, see the above section. (You may not meet all the medical professionals. Some may just work behind the scenes.)
  • You will be asked about metal in or near your body, such as pacemakers, surgical staples and clothing with metal zippers.
  • You will lie on a table. 
  • The treatment site (treatment ports) will be marked to ensure that the treatment beam is aimed accurately and in exactly the same place every treatment session. The mark will either be permanent or temporary.  
    • Permanent marks are tiny dots tattooed around the field to be radiated. These dots are hardly noticeable because of their small size. They are made permanent in case you need additional radiation at a later date. Other radiologists will know where the previous radiation was given so the two don't overlap.
    • Non permanent marks are made with colored ink. If a non-permanent mark is used:
      • Do not wash off the mark unless it is made permanent. 
      • If the mark begins to fade, rather than make it darker yourself, tell the technician.
      • Ask if the mark can rub off on clothing and other material. If so, wear older undergarments that will cover the mark.
  • The radiation therapist will determine the settings of the machine.
  • Staff may make a special shield or block to shape the radiation beam to match your tumor's shape exactly, or the shape of nearby surgical scars.  The purpose of the shield or block is to narrow the radiation beam to the silhouette of your tumor. This avoids radiating nearby healthy tissue. 
  • There will generally be a mock session (known as a simulation) when you and the technician will run through a radiation treatment. A beam of laser light substitutes for radiation. The purpose of the mock session is to make sure everything is correct (some people refer to this as a "dress rehearsal.")  A simulation can take an hour or more.
  • There will likely be another simulation after all shields and blocks are made and your skin is marked.

None of the preparations are paintul. However, they may be embarrassing or unpleasant depending on your particular situation. For example, it may be embarrassing if the doctor decides that the best access to a rectal tumor is by taping the buttocks into an open position. Or you may be asked to drink a solution containing barium to clarify the position of the small intestine.

NOTE:  As treatment progresses and your tumor shrinks, new blocks and shields will be made to fit the new size. A simulation may then be repeated.

Ask your radiologist about whether you can eat and drink prior to treatment. Generally you can, except for patients who take radiation to the abdomen.
 



 





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