Treatment planning

Before radiotherapy begins

If your doctors recommend radiotherapy for you, you’ll see the radiotherapy specialist in the outpatient department to plan your treatment.

You'll usually be treated as an outpatient. If you think you'll have problems attending appointments, tell the radiotherapy staff. Transport can sometimes be arranged.

It’s important that treatment continues as planned and that you don't miss any appointments. If you have a holiday booked or think you won’t be able to attend for any reason, tell your specialist or radiographer.

It’s advisable to tell your specialist about any drugs you are taking or considering taking. This includes vitamin and mineral supplements bought over the counter. Scientific evidence about how safe it is to take vitamins is not clear. There have been a very small number of studies that suggest some anti-oxidants, such as coenzyme Q10, selenium and the vitamins A, C and E, could interfere with how well cancer treatments work, but with such little research their impact is not known for sure. As a precaution, the Royal College of Radiologists advises that patients should avoid high doses of antioxidant supplements during their radiotherapy.

Before starting radiotherapy skin care advice will be recommended, which you can discuss with your breast care nurse, radiotherapy clinic nurse or radiographer.

Planning your treatment

Treatment is individually planned for each patient, so don't worry if someone you know is having different treatment. Treatment planning identifies the exact area to be treated and the most effective dose of radiation. This means that radiotherapy will be given in the most effective way, causing the fewest possible side effects and the least possible damage to the surrounding healthy tissue.

An x-ray machine known as a simulator is used for treatment planning. This helps the specialist to see the treatment area clearly and set up the treatment accurately. This planning session lasts between half an hour to an hour. You’ll need to lie still during this time while measurements and x-rays are taken.

It is becoming more common to use a CT (computerised tomography) scanner for treatment planning. CT scanners use x-rays to take a series of detailed pictures across the body, combining images from different angles to create a 3D image.

It’s important that you have enough arm movement after your operation to allow you to raise your elbow to at least shoulder level so that you are comfortable in the treatment position. If you find this difficult, talk to your breast care nurse or ask to see the physiotherapist. Our DVD Getting fitter, feeling stronger demonstrates arm and shoulder exercises suitable to help regain arm and shoulder movement after surgery for breast cancer.

When the exact treatment area is identified, with your permission, small permanent marks will usually be made on your skin. This is the best way to make sure the radiotherapy is aimed at precisely the same place each time. If this is a concern for you, you may wish to ask your radiographer if there are any other options available.

 

Content last reviewed March 2012; next planned review 2013