The treatment process is similar for IMRT and IGRT.
First, we’ll schedule an appointment with a radiation oncologist. During this visit, we’ll perform a simulation of the treatment. You will be positioned on the treatment machine the same way you will be for actual treatment. The radiation oncologist will determine the need to use an immobilization device (such as a cast, mold or headrest) to keep you in the same position during treatment. Then, we’ll take a CT scan to precisely map your anatomy. Using information from the CT scan, the radiation therapist will mark the area(s) to be treated, either on your skin or on the immobilization device. Simulation sessions take 30 to 60 minutes and may be repeated at intervals throughout your course of treatment.
Next, your radiation oncologist and treatment team will design a treatment plan tailored to you. They will use information from the simulation session, anatomical maps obtained from the CT scan, previous medical tests and, in many cases, sophisticated treatment planning software.
For breast cancer, radiation therapy is typically administered 5 days per week for a total of 30 to 33 treatments. However, your treatment team will determine the best course of treatment for you. During each session, positioning takes from 5 to 15 minutes. Actual treatment time lasts about 10 minutes and is painless. The radiation is delivered using a machine called a “linear accelerator” which generates x-rays or photon radiation. The linear accelerator moves so that patients can lie comfortably without being re-positioned during treatment.
The treatment room is spacious, and you will not be completely enclosed by equipment. A radiation therapist will position you to ensure successful treatment then go to an adjoining control room. From there, he or she will monitor you closely during radiation treatment using video cameras. The therapist can hear you at all times, and the treatment can be immediately discontinued if you feel uncomfortable or ill. If IMRT/IGRT are employed, the therapist may move the machine or treatment table during treatment to best target the exact area of the tumor. Once each treatment is complete, you can return to your normal daily activities.
A follow up exam with your radiation oncologist will be scheduled after your last treatment to discuss side effects. From there, your physicians will determine the proper course of ongoing treatment.