The radiation simulation is the planning session you need to begin treatment. This will be your first experience in the radiation therapy department. The simulation consist of three parts.
- Radiation Simulation Procedure
The radiation therapist who will be taking care of you during your simulation will come to the waiting area and escort you to the dressing room and will instruct you how to change. During this time while walking or being wheeled (if you are in a wheelchair or on a gurney) into the dressing area, the radiation therapist will ask you for your name and birth date, these are identifiers that must be asked each time you come into the department for any procedure, it is for your safety to make sure you are the correct patient. The radiation therapist will take a face photo of you to put in your records, as another identifier that will be used on a daily basis.
Forms may be required that will have questions regarding your medical history. Additional preparation for the radiation simulation may be required.
- IV contrast
- a radionuclide for a PET
IV Contrast is used to provide higher resolution for the particular scan you need.
I had a patient that was extremely claustrophobic, even after taking the medication that should have helped calm her. I had to make a mask for her as we were treating her head. Before the the mask was formed I asked her to breathe in and out, slowly and to concentrate on her breathing. Once she was calm I told her to picture herself in a day spa getting ready for a luxurious facial. I explained to her that the mask would feel warm and wet, like a heated mask that is used at a day spa. I let her know each step I was doing and keep telling her to concentrate on her breathing and to envision herself relaxing at a spa. I made the mask and did the scan. Once it was done she was very grateful that I made her feel comfortable and that me talking to her helped her through the scan. After that for treatment she didn’t have a problem with the mask, she would just focus on her breathing and think she was some place else, all without medication! Just having someone take the time and really help her through it made all the difference.
Depending on the area that needs to be treated, you may need to have a mask or an alpha cradle. The procedure itself consists of 3 distinct part:
- Mask Formation
- Alpha Cradle Formation
- Radiation Scan
The mask is a plastic material that softens when put in warm water. The mask is then stretched across your face. The mask will feel warm and wet, much like a facial. The mask has holes, however the radiation therapist may make bigger holes for your eyes, nose and mouth if need be. If you are claustrophobic, the radiation oncologist is likely to give you some medication to help calm you. Also being prepared and knowing what will happen will lessen the anxiety you might be having. A mask is required when the head or upper portion of the body is treated. The mask is to help keep you in the same position each time for treatment.
Alpha Cradle Creation
For lung cancer and breast cancer patients an alpha cradle may be made for you. An alpha cradle is a plastic bag in which chemicals are poured and then the bag is sealed. The chemical reaction in the alpha cradle causes the alpha cradle to puff up and mold around your body. During the process time the alpha cradle gets nice and warm. After a few minutes the process stops and the chemicals in the alpha cradle harden and keep the shape of your body. This is used each day for your treatment. The mask is a plastic material that softens when put in warm water. The mask is then stretched across your face. The mask will feel warm and wet, much like a facial. The mask has holes, however the radiation therapist may make bigger holes for your eyes, nose and mouth if need be. If you are claustrophobic, the radiation oncologist is likely to give you some medication to help calm you. Also being prepared and knowing what will happen will lessen the anxiety you might be having.
All scans are painless. Once the mask or the alpha cradle are made then the appropriate scan is performed. If an IV contrast is required, the contrast will be injected during the scan, at this time you may feel warm, have a metallic taste in your mouth and perhaps feel like you have to urinate, all of this passes quickly.
Once the scan is complete, the radiation therapist may need to give you a few little tattoos. These tatoos are small permanent marks that are used daily to align your body the same way as when the scan was taken.(These can later be removed with a laser if you like.) A little bit of India Ink is placed on your skin, then the radiation therapist will use a small sterile needle to just pierce the skin. It feels like when you poke your finger with a needle, it does not go deep and the tattoo is quite small. The radiation therapist may mark the treatment field with semi-permanent ink. The marks will likely fade away over time, but they are needed until your treatment is finished, the radiation therapist will tell you which marks you can wash off and which ones may need to stay. Don’t use soap on or scrub the marks that the radiation therapist has said are needed for treatment.
Once the tattoos are done, photos will be taken to document the the simulation and the location of any marks or the tattoos. Once complete the radiation therapist will give you the date and time of your next appointment and then escort you back to the changing room, so you can change and be on your way. And ready to begin treatment.