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What is Pre-Treatment Radiotherapy?

Pre-treatment radiotherapy, also referred to as radiotherapy planning, involves developing a tailored treatment plan for a patient before they commence radiotherapy. This process requires collecting detailed information about the patient’s anatomy and the specific area being treated, which is then used to formulate an effective treatment strategy.

Consultation

Before beginning radiotherapy, you may have an appointment with your doctor and, in some cases, a specialist nurse to discuss your treatment options. This meeting is where you will provide consent for your radiotherapy treatment.

CT Planning Scan

Once we receive your referral form from your doctor, we will contact you to schedule a CT planning scan appointment. This scan is essential for planning your radiotherapy treatment and is not intended for diagnostic purposes.

A radiotherapy planning CT scan is slightly different from a regular diagnostic CT scan. It allows radiographers to obtain 3D images of the area being treated to create individualised radiotherapy plans. The scan itself will normally take between 10 to 15 minutes. However, sometimes there may be additional preparation for your scan, meaning that the appointment may last up to 2 hours.

All patients undergoing external beam radiotherapy must have a CT scan in the position they will be in for their treatments, so ensuring your comfort is crucial. Our large-bore CT scanner is specifically designed to capture 3D and 4D images with patients in optimal positions for treatment. In some cases, you may need to have an injection of a contrast agent (IV contrast during your CT scan, and some patients may need to drink a liquid before the scan (oral contrast). These help highlight important areas the doctors may want to treat or avoid.

During the planning procedure, measurements will be taken for your radiotherapy record. This process involves placing small marks on your skin using a felt-tip pen. At the end of the process, these marks will be made permanent, with your permission, by tattooing a small dot. This allows you to wash normally without losing the marks prior to and during treatment.

Mask Creation

Some patients may require an immobilisation device to ensure consistent positioning for both the CT scan and subsequent radiotherapy sessions. For areas like the lungs and limbs, a vacuum-formed bean bag may be utilised, while adjustable site-specific equipment may suffice for areas like the breast or prostate. If you are receiving treatment to the head and/or neck, a custom mask will be created during your CT planning scan appointment.

Depending on your treatment, you may receive either a small mask (covering only the head) or a larger mask (covering the head, neck, and shoulders). The process for making both masks is as follows:

• Positioning: Radiographers will have you lie on the CT scanner couch in a comfortable, stable position, using a supportive head pad.
• Mask Preparation: The mask starts as a hard sheet of plastic supported by a frame. Once placed in warm water, it becomes malleable.
• Moulding: The warm, damp mask will be draped and stretched over your face, gently moulded to your features as it cools. This process takes about 15 minutes to cool and harden completely. It’s important to remain still and breathe normally during this time.
• Contrast Administration: If the doctor requests contrast dye to enhance the CT scan images, the mask will be temporarily removed after hardening, and a cannula will be inserted. Once the contrast is administered, the mask will be repositioned on your face.
• Final Steps: If contrast is not required, the mask will remain secured until the CT scan is complete. The mask will be clipped to the bed for stability, and reference marks will be drawn on the mask to help the radiographers position you correctly during treatment.

This entire planning session typically lasts between 1 to 2 hours, depending on whether contrast is needed.

Tattoo Dots

To help reproduce your position for treatment, we may create one or more permanent ink dots (tattoos) as reference points. Prior to the scan, some pen marks will be drawn on your skin with a permanent marker, and small ball bearings will be placed on your skin to serve as markers. After the planning CT scan, the ball bearings will be removed and replaced by small permanent tattoo dots, made by injecting a small amount of black ink beneath the skin’s surface. These dots are about the size of a freckle, black, and permanent. If you have concerns, please discuss them with your doctor or one of the radiographers.

You will typically receive your first treatment appointment at the time of your CT scan. If this has not yet been scheduled, we will call you with the date. You will also receive a complete list of all your treatment appointments on your first treatment day, although treatment times may vary.

Planning

Our dosimetrists employ advanced planning systems to accurately map out radiotherapy treatments. The planning team routinely designs advanced treatments such as Intensity-Modulated Radiotherapy (IMRT), Volumetric Modulated Arc Therapy (VMAT), Stereotactic Radiosurgery (SRS), and Stereotactic Ablative Radiotherapy (SABR). Once the treatment plan is finalised, a series of checks are conducted before it is ready for use. This process can take between 1 to 5 weeks, depending on the treatment specifics.

Liaison

In the week leading up to your treatment, our liaison team will contact you to conduct a start-of-treatment review. During this call, a radiographer will discuss the treatment process with you and address any concerns or questions you may have. The side effects of radiotherapy can vary from person to person, depending on the area being treated. Following your start-of-treatment review, you will be prepared for your radiotherapy sessions.

The liaison area is where you will have appointments with radiographers, doctors, speech and language therapists, and dietitians to support you through the treatment process. These appointments may be routine or scheduled as needed.

Other Pre-Treatment Steps

Pre-treatment radiotherapy typically includes the following steps:

• CT Scan: A CT scan is often performed to generate 3D images of the patient’s body, providing clear visualisation of the tumour and surrounding tissues.
• Planning Appointment: Patients meet with a multidisciplinary team of therapeutic radiographers, oncologists, dosimetrists, and physicists during a planning session, which may last anywhere from 15 minutes to 2 hours.
• Skin Markings: Radiographers may place permanent marks on the patient’s skin to serve as reference points for precise treatment delivery.
• Digital Photograph: A digital photograph may be taken for patient identification and to ensure accurate record-keeping.

This comprehensive preparation is crucial in ensuring that your radiotherapy treatment is personalised and effective, giving you the best possible outcome.

This is the perfect time to work, with a strong demand for skilled professionals. By choosing MedicsPro, you'll have access to a wide range of opportunities and competitive pay rates.

Key Benefits:

• Access to a Wide Range of Opportunities: MedicsPro offers a broad selection of locum and permanent positions across various medical specialties.
• Competitive Pay Rates: The agency provides highly competitive pay rates to ensure you’re well-compensated for your skills and experience.
• Flexible Work Options: With locum and permanent roles available, you can choose work that suits your schedule and lifestyle, offering greater work-life balance.
• Dedicated Support: MedicsPro offers personalised support from a team of experienced recruitment consultants who are there to guide you through the job search process.
• Exclusive Roles: Many of the positions available through MedicsPro are exclusive, giving you access to roles that may not be advertised elsewhere.Ongoing Training and Development: The agency provides opportunities for continuing professional development, helping you stay current with industry standards and enhance your career prospects.
• Fast and Efficient Recruitment Process: MedicsPro ensures a smooth and streamlined recruitment process, minimising the time it takes for you to secure your next role.
• Nationwide and International Opportunities: Whether you're looking for work in the NHS, private sector, or overseas, MedicsPro offers positions across the UK and beyond.