Total Body Irradiation (TBI) What to Expect
Patient Guide Video: What to Expect
There are a number of steps that a patient must complete prior to receiving radiation therapy at Penn Radiation Oncology. These steps ensure that patients are receiving the most appropriate form of radiation therapy and that they are doing so in the safest, most effective manner possible.
- Consult Visit
When a patient is being considered for radiation therapy at Penn Radiation Oncology, the first step in the process is a consultation with a physician. During this meeting, which typically takes place within a week of the initial call, a care plan is developed for the patient. This may include radiation therapy alone, radiation therapy in conjunction with other techniques, or another option altogether.
If radiation therapy is chosen and approved, a series of planning sessions will be held, during which doctors and physicists at Penn Radiation Oncology develop an individualized treatment plan for the patient.
- Simulation Procedure
The CT Simulation appointment follows the initial consultation. During the simulation appointment, the radiation oncologist will obtain a 3-D picture of the patient's tumor using CT, MRI or PET scanning. These data and images are used to reconstruct the tumor and the adjacent normal structures. This allows for accurate and precise dose targeting to the tumor and projection of normal tissues.
Just prior to starting radiation therapy, patients participate in a "dry run." During this session, all aspects of the patient's prescribed treatment — positioning and dosages — are checked for accuracy. The dry run usually takes place in the room where the patient will receive his or her actual treatment. Typically, if all aspects of the dry run receive physician approval, a patient's first treatment will take place on the same or following day depending upon appointment availability and the type of cancer.
- Treatment Sessions
Radiation therapy offers patients a noninvasive cancer treatment option. There's no pain during the procedure (though some patients with physical limitations may experience some discomfort when positioned), very little noise, and no time spent inside small, confining spaces, as with some technology.
At the start of each session, a radiation therapist will spend 5 to 15 minutes positioning the patient for treatment and setting up the equipment as instructed by the radiation oncologist. X-rays are taken to insure that the patient is in the proper treatment position. Once the patient is in position, the therapist will enter the control room next door. From here, the patient is monitored throughout the treatment on a television screen and via voice communication. Should the patient have any concerns, or feel sick or uncomfortable, this may be expressed to the radiation therapist using the microphone located in the treatment room.
Depending upon the individual patient's circumstances, a course of radiation therapy usually runs five days a week for several weeks. Generally, the patient is at Penn Radiation Oncology for about an hour each day with the actual radiation therapy session lasting 15 to 30 minutes.
Patients are seen at least once a week by a Penn radiation oncologist. During this appointment, the radiation oncologist evaluates a patient's response to treatment. As needed, the amount of radiation administered to the patient is altered based upon the radiation oncologist's observations. Blood work and x-rays may also be ordered to see how a patient's body is responding to treatment. If a patient's tumor shrinks significantly, another simulation may be required. This allows adjustments to be made to the treatment so that the rest of the tumor is destroyed while sparing even more normal tissue.
- Prepare For Your Treatment
Once a patient begins a course of radiation therapy, he or she can usually expect to be at Penn Radiation Oncology five days a week for several consecutive weeks.
Depending upon where a patient is from, he or she may have to live away from home and may not be able to work during their treatment window. Therefore, it is important that patients make the appropriate arrangements with their family and employer prior to starting treatment.
Cancer treatment can be both scary and confusing. To help make the process easier for its patients and their families, Penn Radiation Oncology has several social workers on staff. These individuals serve as educators, navigators, coordinators and advocates for anyone receiving radiation therapy.
Social workers take a vested interest in patients' emotional wellness. Individuals undergoing cancer treatment often experience a wide range of emotions including anger, fear and anxiety. Penn Radiation Oncology social workers strive to help patients cope with these emotions in a variety of ways.
Penn Radiation Oncology social workers:
- Help patients access information that leads them to a better understanding of their diagnosis and treatments
- Can help patients apply for programs that offer financial assistance
- Can refer patients to counseling, support groups and educational programs
- Provide patients with access to a wide range of support groups to meet their varied needs.
- Follow Up
At the completion of radiation therapy treatment, patients are scheduled for an inspection visit with their radiation oncologist. During this appointment, patients have the opportunity to talk about any problems they are experiencing with pain or symptom management. Patients are also encouraged to discuss any other challenges they are experiencing (emotional, social, work/life, etc.) as a result of their diagnosis or treatment. The initial inspection visit does not require an additional referral and typically takes place a month after treatment ends.