Radiotherapy
Truebeam Rapid Arc Radiotherapy
State of the art equipment, one of only 3 in Africa.
TrueBeam™ is an advanced image-guided radiation therapy (IGRT) system used to treat cancer with speed and accuracy while avoiding healthy tissues and organs.
Stereotactic Ablative Radiotherapy (SABR) OR Stereotactic Body Radiotherapy (SBRT)
This radiation surgery may provide new treatment options for patients with lung, pancreatic, liver, kidney and pelvic cancers.
Steriotactic Radiosurgery (SRS)
This is a common technique for the delivery of high doses of radiation treatment within the central nervous system. Radiotherapy is done in a shorter time and a higher speed for intracranial, head and neck cancers.
Radiation Therapy
- Radio-therapy is used to deliver precise, accurately measured doses of radiation (X-ray beams) directed to a particular area to treat cancer cells.
- In some cases, radio-therapy may be given together with chemotherapy. This helps to improve the efficiency of the radiation therapy.
1How is Radiotherapy administered?
Radiation can be administered either externally or internally. The treatment you will receive depends on the type, location and stage of the disease.
External beam radiation is the most commonly used form of radiation. A linear accelerator machine creates high-energy x-rays to the region of the patient’s tumour. The x-ray treatments are designed in such a way that they destroy the cancer cells while sparing the surrounding normal tissue.
When internal radiation therapy is used, the radiation source is placed inside the body. This type of radiation therapy is called brachytherapy. Some patients have both forms of radiation, one after the other.
2What does treatment planning mean?
Before starting with radiotherapy treatment, the precise treatment area must be
determined. A planning CT scan is used to determine the treatment area. The scanner is programmed so that each time you receive radiation therapy you will be in the same position. The planning CT is used to plan the radiation fields to deliver the maximum amount of radiation to the cancer mass while limiting the dosage to normal surrounding tissue. The treatment plan takes a few days to develop to determine the best possible treatment for the patient.
You will be asked to lie very still on a treatment couch while a radiotherapist uses the linear accelerator to treat you. Depending on the location of your cancer, single or multiple treatment fields may be necessary. Masks or other immobilisation devices may be used to prevent any movement during treatment. This apparatus is custom made according to the needs of each patient. Your custom device is used each time you receive treatment to ensure the correct treatment setup.
Small pinpoint tattoos (small dots) will be placed under the surface of your skin to define the treatment area. These dots are to ensure that treatment is delivered to the same area every day. The tattoos also enable one to determine areas where radiation has been delivered even years after treatment. Non-permanent pen marks will also be used to ease daily setup and treatment field determination. These pen marks must not be washed off. Before your first treatment, a set of special x-rays will be taken to confirm that the radiation is delivered to the specific area. These x-rays also serves as a record of your treatment. Throughout your radiotherapy x-rays will be taken to monitor your treatment.
3How long does treatment last?
Most cancers are treated with radiotherapy for five days per week over a period of 6 to 7 weeks. When radiation is given for symptom control only, shorter treatment periods are used, usually 2-3 weeks. The procedure usually takes between 10 and 20 minutes. The bulk of the appointment is used to set up the machine and position the patient correctly. The actual radiation therapy only takes a few moments. The use of smaller daily doses of radiation, given over a longer period, as opposed to few large doses over a shorter period, helps to protect healthy tissue in the treatment area. Treatments are scheduled during the standard work week, leaving time for tissue repair over the weekend. If you are receiving palliative radiotherapy i.e. radiotherapy for symptom control in advanced disease, your course of treatment may be shorter.
4What happens during Radiation treatment?
You are advised to wear comfortable clothes that are easy to get in and out of. The radiotherapist will use the marks on your skin to position you correctly and to determine the treatment field. You will be asked to lie very still on the treatment couch and, although you will be alone in the room during the treatment, there will be continuous monitoring through a closed circuit camera and intercom system. External beam radiation is painless, similar to the x-rays taken for diagnostic purposes. You will not hear, see or smell the radiation. The radiation will also not make you radioactive. After starting treatment, your doctor will see you at least once a week to monitor your treatment progress and your reaction to the treatment.
Leksell Icon Gamma Knife
Leksell Gamma Knife® Icon™ is the most precise radiosurgery (radiation surgery) device on the market, limiting radiation dose to healthy tissue. Icon is the only technology with microradiosurgery capabilities, allowing for the treatment of virtually any target in the brain with ultrahigh precision.
Icon introduces a number of new innovations, such as integrated imaging and software to continuously control dose delivery. It also makes it possible to treat patients without a minimally invasive fixation while assuring the same highest level of precision.
Addressing the growing radiosurgery market, Icon makes Gamma Knife radiosurgery more flexible and easier to use, allowing more clinics to build a cranial radiosurgery program.
Curo Oncology is a partner in the Gamma Knife Surgery at Millpark Hospital
Treatment Information
1Does my medical aid pay for Radiotherapy?
Talk to your health insurance provider about what costs it will cover. Questions to ask include:
- What will my medical aid pay for?
- What do I have to pay for?
- Can I see any doctor I want or do I need to choose from a list of preferred providers?
- Do I need a written referral to see a specialist?
- Is there a co-payment each time I have an appointment?
- Is there a payment gap (a certain amount I need to pay) before my medical aid pays?
- Where should I get my prescription drugs?
- Does my insurance pay for all my tests and treatments, whether I am an inpatient or an outpatient?
2How can I best work with my insurance plan/medical aid?
- It is important to read your insurance policy carefully before treatment starts to find out what your plan will cover.
- Keep records of all your medical costs and insurance claims.
- Send your insurance company all the paperwork it requires. They may need receipts from doctors’ visits, prescriptions, and lab work. Be sure to keep a copy for your records.
- If your insurance does not pay for something you think it should pay for, please find out why the claim was refused. Talk with your doctor or nurse about your case. He or she may suggest ways to appeal the decision or other actions you can take.
How can I cope with my feelings during Radiotherapy?
- Assign quiet time, think of yourself in your favourite place, breathe slowly or listen to soothing music. These techniques can help you feel more relaxed during your treatment.
- Many people find that light exercise helps them feel better. There are many ways for you to exercise, such as walking, riding a bike or doing yoga. Talk with your doctor or nurse about ways you can exercise.
- Talk about your feelings with someone you trust, such as a close friend, family member, chaplain, nurse or a social worker. Your may find it helpful to share your experience with other patients who are also receiving radio-therapy.
- By joining a Support Group, you will have a chance to talk about your feelings and engage with other people facing the same challenges they experience in coping with cancer. You can discuss how they cope with cancer, radiotherapy, and its side effects. Talk to your Doctor, Nurse or Social Worker, they will know about support groups near your home. Some support groups also meet online, which is helpful if you find it difficult to cope with your emotions.
Talk to your doctor or nurse about things that worry or upset you. You may want to ask about meeting with a counsellor. Your doctor may also suggest that you take medication if you find it very hard to cope with your emotions.
Frequently Asked Questions
1How long does a course of radiation treatment usually last?
Most radiation therapy treatments are daily, five days per week, for a specified period of one to eight weeks, depending on the disease and the plan your physician prescribes.
2Will I be able to drive after my Radiotherapy treatment?
Almost all patients can drive while receiving radiation treatment. However, with some types of cancer, driving may NOT be recommended due to fatigue or strong pain medication. Your physician will be able to advise you according to your particular case.
3Will I feel anything after my treatment?
Many patients continue with most of their normal activities during treatment – working, golfing, gardening, etc. Depending on the treatment area, there may be side effects, including fatigue, nausea, “sun-burnt” skin and diarrhoea. Your physician can discuss the likely side effects and prescribe medication for certain conditions. Make sure that you take care of your body’s needs. Maintaining your weight and getting adequate fluids and rest are important goals during treatment.
4How long does each treatment take?
Radiation therapists (under the direction of your radiation oncologist) will take the time necessary to ensure that you are accurately positioned for your treatment. The time when the radiation is “on” is only about a minute or two for each treatment field. Most of the time, patients are in and out of the department in less than 30 minutes. The team attempts to arrange that appointment are kept on time, but in some instances, there may be a delay because of an unforeseen circumstance or emergency.
5What is the difference between Chemotherapy and radiation therapy?
Chemotherapy involves medications that are administered by injections or pills for cancer. This type of treatment circulates throughout the entire body. Radiation therapy or radiotherapy is produced by a linear accelerator or another radiation source and is prescribed by a radiation oncologist. The radiation beams are focused on a specific area of the body and are highly localised.
6How does the physician know how much radiation to give me?
Through years of research and experience, there are ranges of doses that are recommended for each particular type of cancer. The oncologist thoroughly reviews each case, and a customised dose (as per protocol and treatment field) will be prescribed based on the cancer diagnosis, the cell type and the location of the patient’s cancer.
7Should I take vitamins and/or medications while receiving treatment?
Good nutrition is important during your radiation treatment. Taking a multivitamin during treatment is usually acceptable. Please make your physician aware of all medication and/or herbal products that you are currently taking, including large doses of any one vitamin. In some cases, mega-vitamins can be harmful. Discuss this with your doctor before you begin treatment.
8Should I avoid the sun?
As a general rule, the area that is being treated with radiation should NOT be exposed to direct sunlight for up to a year after treatment. Applying sunscreen to the area that has received treatment is highly advisable after treatment. However, sunscreen should not be applied to treated areas while undergoing treatment.
9How long will I have to come for follow-up visits after my treatment is completed?
Most patients are seen by their oncologist for some time after their treatment is complete. Your specific schedules will be determined by your radiation oncologist, in collaboration with your other physicians.
10Is it a problem if I missed a treatment?
If you miss an appointment during your prescribed treatment, it will extend your treatment course by a day. We strongly recommend that you attempt to make all appointments as prescribed by your radiation oncologist. Keep in mind that the treatments are generally given Mondays to Fridays. Weekend treatments are only given in emergency cases.
11Will I feel any pain from the radiation treatment?
There is usually no pain associated with the radiation treatment. It is very much like having an x-ray. Sometimes a sunburn effect may cause the area to be tender.
12Can I drive while receiving treatment?
Most patients drive their cars to treatment. For patients living far away, the CANSA association has a guest house (Tipuanha) for patients on treatment. Please inform us if you require accommodation during treatment.
13Will my medical aid/hospital plan cover radiation therapy costs?
We accept most forms of medical aid plans, as long as the appropriate authorisation has been obtained. We will submit the codes to your medical aid for approval and will wait for an authorisation number before starting with ANY treatment. You may be responsible for the balance of the account, depending on your medical aid cover. Please contact the medical administration clerk at the unit with any queries regarding billing and authorisation. Please note that you remain responsible for payment of the treatment should your medical aid fail to pay.
14How long will the consultation take?
Your initial visit with the radiation oncologist will take approximately an hour. At this time, the doctor will review your records and discuss treatment options with you. The risks, benefits and alternatives to radiotherapy will also be discussed at this time. If you wish, your spouse and/or family member may be present during your visit and may ask questions or take notes.
15While receiving radiation therapy treatment, how often will I see my oncologist?
In general, you will be scheduled to see your doctor once a week during your treatment. You will also be monitored daily by the radiation therapist who deliver the radiation treatments.
16Will Radiotherapy affect me emotionally?
Nearly all patients treated for cancer report feeling emotionally upset at different times during their radiotherapy. It is expected to feel anxious, depressed, afraid, angry, frustrated, alone or helpless. Radiotherapy may affect your emotions indirectly through fatigue or changes in your hormone balance, but the treatment itself is not a direct cause of mental distress. You may find that it is helpful to talk about your feelings with a close friend, family member, chaplain, nurse, social worker or psychologist with whom you feel comfortable. You may want to ask your doctor or nurse about meditation or relaxation exercises that might help you unwind and feel calmer.
