|
 Planning for cancer treatment is a necessary and vital step before treatment takes place.
Several procedures are undertaken to ensure accuracy, safety and reproducibility.
Consultations with the Radiation Oncologist
Consultation is the first step in the radiotherapy process. During consultation a detailed examination of the patient is performed.
The patient’s clinical history, diagnostic and laboratory reports are reviewed. At this stage, determination is made by the radiation oncologist as to whether or not radiation therapy is indicated for the patient. The approach that should be used in planning the patient treatment is also determined. Consultation is generally preceded by preliminary assessment made by our radiotherapy nurse. Simulation
Simulation is critical for the proper planning and treatment of patients. Conventional Simulations
At the Radiation Oncology Centre of Jamaica, each patient undergoes simulation before receiving radiation therapy. Simulation is performed using a Varian Ximatron CX simulator. During simulation the area to be treated is marked on the patient’s skin or on an immobilization cast with a special ink to ensure that treatment is administered in the same place throughout the course of therapy. Indexed and graduated immobilization devices are used to ensure reproducibility. CT Simulations
For 3-D Conformal Radiation Therapy, simulation is performed using a multi-slice CT Simulator. In addition the Centre now has the capability of performing Virtual Simulation.
Medical Physics & Dosimetry
The Medical Physics Unit uses the information from simulation to plan the technical aspects of the treatment using a 3-Dimensional computerized treatment planning system: Here calculations are done to determine the exact dose of radiation necessary for treatment, the size, shape and angles of the radiation beams to be used. Special shielding blocks are designed to shape the radiation beams in order to minimize the dose received by surrounding normal tissues while optimizing the radiation dose to the cancer site.
Fabrication of Customized Shielding Blocks & Immobilization Devices
Also done in the planning phase is the fabrication of treatment devices to be used in External Beam Radiation - such as blocks to shield areas close to the treatment site in order to minimize radiation effects to surrounding tissue. Immobilization devices such as facial masks for persons with head and neck cancers are also fabricated in the planning phase.
Treatment Planning Verification
Before the execution of the treatment plan the patient revisits the Simulator Room where the plan designed for treatment is verified.
Full Course Of Daily Treatment - lasting 3 to 7 weeks.
For External Beam Radiation the treatment requires just short daily visits from Monday to Friday for 2 to 8 weeks, depending on the location and stage of the cancer. How long it lasts depends on the type of cancer, the stage of the cancer and how well the patient responds to the radiation treatment.
Portal Images for Verification
Portal or verification films are regularly done over the course of treatment to ensure that the set-up is the same throughout the treatment – that the volume being targeted is in fact being treated and the shielding blocks are effectively shielding neighbouring organs and tissues.
Consultations with the Nutritionist
Consultations with our nutritionist are also an integral part of the treatment process and recommendations are made regarding diet. This ensures that the patient maintains a good nutritional status during treatment. |
