Before Treatment
Consultation and Patient Education
From the initial meeting with the radiation oncologist to follow up visits after treatment, these are the steps that a patient can expect to happen at Innovative.
During your first visit, Dr. Amendola will perform a medical examination along with prescribing necessary diagnostic tests, in order to assess your disease. She will discuss with you appropriate therapy option(s), explain the benefits, risks and the expected results. Most importantly, she will listen to you and answer any questions you may have.
Simulation and Treatment Planning
Prior to configuring an individualized treatment plan for you, a computed tomography (CT) scan is scheduled and a simulation must be performed. The CT scanner produces 3-D images, which the doctor will use to visualize the exact location of your internal anatomy. These images help the oncology team outline the tissues to be treated and determine where the radiation beams should be focused. This process allows for precise targeting of the tumor while avoiding as much healthy tissue as possible.
Stimulation Process
During the initial simulation, you are placed in the treatment position, on the CT scanner table. If needed, immobilization devices (molds, or other devices) are formed to position you for treatment. The radiation therapist places temporary marks of the region either directly on the skin or on the immobilization devices. Once you are in position, a CT scan is performed. This process completes the first simulation visit.
The CT images are imported into the treatment planning computer, a dosimetrist combines the information from the CT scan with other imaging modalities (MRI, PET/CT, etc, if needed) and then designs a customized treatment plan. Dr. Amendola evaluates and approves the final plan, a physicist checks all the computations and details.
You will be contacted by a member of the staff to schedule a second simulation, which is performed 3-5 days later in the actual treatment room. Once again, you will be placed in the same position as at the first simulation. A cone beam CT and/or x-rays will be taken to verify the treatment target. Dr. Amendola will review the images for positioning and accuracy of the setup. After receiving approval from the doctor, the radiation therapist will permanently mark the treatment location and take pictures of the setup.
All this preparatory work takes time; therefore, treatments usually begin approximately 5-7 days after the initial simulation.
Treatment
External Beam Radiation Therapy (EBRT) is a non-invasive treatment procedure. Many patients are able to continue with normal daily activities during their course of treatment. You will be scheduled for radiation therapy 5 times a week, Monday - Friday and the course of care can continue between 6-9 weeks, although other schedules are sometimes employed.
You will be positioned for on the treatment table in the same position as when you were simulated. The radiation therapist may move the machine and/or treatment table in order to correctly aim the radiation beam to the precise location of the tumor. Once your treatment position is confirmed, the therapists leave the room during the actual treatment, but continuously monitor you from the control room with closed-circuit TV and can communicate with you through an audio system.
The prescribed radiation dose will be input into the system for delivery. The treatment itself lasts only a few minutes and most patients are in the room for less than 15 minutes. This timeframe includes positioning and treatment.
On Treatment Visit (OTV)
Dr. Amendola will follow your progress throughout the course of treatment. She will routinely meet with you to answer any question you may have as well as address side effects that may be occuring. If necessary, she will prescribe medication or recommend lifestyle changes to alleviate the problems.
After Treatment
Follow-Up
Once your course of treatment is complete, follow-up appointments are scheduled with the doctor so she is able to assess the long-term outcome of therapy. The first follow-up visit is typically in one month's time. However, if you should have any questions please call or visit the office, your radiation oncology team will always be available to you.