Radiation Oncology in Arizona

The Treatment Process

From the initial meeting with the radiation oncologist to followup visits after treatment, these are the steps that a patient can expect to happen at Mayo Clinic.

Consultation with the physician

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

Patient Education Session

Once the decision has been made to proceed with treatment, the patient meets with a nurse to learn more of what to expect from the treatments, how to recognize and manage symptoms that can accompany treatment, and what resources are available in the Clinic to support cancer patients.

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 position of potential treatment beams. Devices such as molds or masks may be made to immobilize the patient and aid in subsequent repositioning for daily treatment. Using fluoroscopy and X-rays, the doctor decides what treatment fields will be used. Radiation therapists assist in this process.

Frequently, the patient is then scheduled for a computed tomography (CT) scan in the treatment position, so that the exact location of internal anatomy can be visualized. The CT images are transported 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, taking advantage of all the capabilities of modern treatment devices. 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 intended plan.

All this preparatory work takes time, therefore, treatments usually begin approximately 5-10 days after simulation.

Treatment

Radiation therapy usually requires 5 treatments per week, Monday-Friday, for 2-7 weeks, although other schedules are sometimes employed. Radiation therapists place the patient on the treatment table in the same position as was used in simulation. They adjust the treatment machine, called a linear accelerator ("linac"), 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 with closed-circuit TV and intercom. Before the first treatment and periodically thereafter, the therapists take films using the treatment beams to verify the accuracy. 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.

Visits with the Doctor

Throughout the duration of the treatment, each patient is automatically scheduled to see either the radiation oncology physician (radiation oncologist) or the nurse practitioner (NP) each week. This visit allows the patient to have any questions answered and have any side effects addressed. The nurses, NPs and physicians are also available to answer questions or concerns at any other time. The radiation oncologist or NP will frequently see the patient periodically after the course of treatment ends in order to assess the long-term outcome of therapy.