Radiation Oncology in Minnesota

The Treatment Process

From the initial meeting with the radiation oncologist to follow-up visits after treatment, patients at Mayo Clinic in Rochester follow a coordinated program that includes consultation with the radiation oncologist, treatment simulation and planning, treatment, patient education, and ongoing and follow-up visits.

Consultation with the Physician
The radiation oncologist takes a medical history, examines the patient and reviews pertinent medical images and test results. If needed, additional studies or visits with other specialists are scheduled. The doctor explains the treatment options and his or her recommendation. This critical decision-making is unhurried and thorough.

Preparation for Treatment: Simulation and Treatment Planning
Before treatments can begin, the individual patient's treatment beams must be designed and prepared. As the first step, the patient is placed on a special X-ray machine called a simulator that can duplicate the geometry of potential treatment beams. Devices such as molds or masks may be made to immobilize the patient and aid in subsequent positioning for daily treatment. Using fluoroscopy and X-rays or computed tomography (CT) scans to visualize the exact location of internal anatomy, the doctor decides what treatment fields will be used. Radiation therapists assist in this process.

The CT images are sent electronically to the treatment planning computer so that the doctor can outline the tissues to be treated and those to be avoided. With the computer, a dosimetrist combines the information from the CT scans and the simulation films and then designs a detailed plan. Each beam is custom-shaped to best conform to the target tissues.

After the physician evaluates and approves the final plan, a physicist checks all the computations and details. The settings for each beam are also entered into a special computer system that will automatically check and verify that every subsequent treatment exactly matches the treatment plan. This preparatory work takes time, so treatments usually begin several days to weeks after simulation.

Treatment
Radiation therapy usually involves five treatments per week, Monday through Friday, for two to seven weeks, although other schedules are sometimes employed. During each treatment, radiation therapists place the patient on the treatment table in the position determined during simulation. They adjust the treatment machine, called a linear accelerator (the "linac"), to deliver therapy according to the plan. The accelerator produces high-energy radiation beams that are suitable for cancer treatment. The therapists leave the room during the actual treatment, but maintain contact with the patient through closed circuit TV and intercom. Before the first treatment and periodically thereafter, the therapists take films to verify the accuracy using the treatment beams. The treatment itself lasts only a few minutes, is not painful, and does not make the patient radioactive. It is similar to getting a long X-ray.

Patient Education Session
During the first week of treatment, the patient meets with a nurse to learn more about what to expect from the treatments and how to recognize and manage symptoms that can accompany treatment. The nurse also describes other resources at Mayo Clinic that support cancer patients.

Visits with the Physician
Throughout the duration of the treatment, each patient is scheduled to see the radiation oncologist each week. This visit gives the patient a chance to discuss any side effects and ask questions. The nurses and physicians are also available to answer questions or concerns at any other time. The radiation oncologist will see the patient periodically after the course of treatment ends to assess the long-term outcome of therapy.