Taking Charge of Your Health

your consultant will decide what type of
radiotherapy you’ll be receiving depending on whether or not you’ve had
surgery or not you’ll be having a breast and potentially your nodes treated or if
you had surgery your chest wall and also potentially your nodes then depending on
which side we’re treating we will also be treating you with a deep
inspirational breath-hold which will require you to take a deep breath while we’re
treating you. The things that can vary are which areas we treat so we will
usually treat the breast or the area where the breast was if you’ve had a
mastectomy we may treat the lymph glands above the collarbone as well we may
treat the lymph glands in the armpit and for a woman who hasn’t had a mastectomy
sometimes we will give a bit of extra radiotherapy to where the cancer was a
small area called the tumour bed most of our patients or have three weeks of
radiotherapy where they’re given five sessions a week for three weeks of a total
of 15 sessions we will have some people having an extra one week of radiotherapy
afterwards five sessions to the area where the cancer was if they haven’t had
a mastectomy. Your radiotherapy appointment about 12 to 15 minutes the
majority of this will be time to set you up the treatment itself lasts about
three or four minutes. Your given five days on and two days off and that
doesn’t necessarily mean Monday to Friday with the weekend off it can often
fall over the weekend and the times can vary from I think the earliest was about
half past eight to two o’clock so they can vary quite a lot throughout the day
so you are kind of at the mercy of the appointment times it looks quite
daunting when you look at that sheet to start with but you did you fall into a
new habit of doing it and it becomes it just becomes part of your daily life
when you check in at reception we will then see that you’ve arrived and one of
the team will come down and meet you at reception we will then bring you up and
come into a side room and again like at pretreatment we’ll just run through the
treatment process from the second day you then check in and you’ll walk
straight down the corridor and we’ll meet you at the waiting room closer down
to the machines we try to keep you on the same machines for your treatment so
that you can get used to the same team however due to service capacity and
different reasons sometimes we do have to move between machines within our
treatment area you do have a side area where you can sit and you can get changed there’s a curtain you can draw and again we can
get provide you with a piece of paper to cover your chest my advice would be to
wear something that’s very comfortable and easy to get on and off you are naked
from the sort of a mid up but your dignity is is there the whole time
you can you can have a piece of paper that covers you to get you to the
Machine and when you get off the machine as well so it’s all very private it’s
all very confidential the first time you do it there is an element of I’m naked
but everybody is so nice and so friendly and you know it’s what they’re doing
everyday and that they’re there to do that specific task for you but after a
while you you forget that you don’t have any clothes on really we do have to have
you remove your clothing so that we can see the permanent marks that the
pretreatment staff have put on you but also the radiotherapy will react
with metal so we ask you remove any necklaces and the metal within the
Bra would also cause a reaction which we want to avoid the breast board that
we have is the same in the CT area and also in for treatment it’ll be set up
for you individually every day and that is specific for you and for your
treatment unfortunately the bed has no padding on it and there is a reason for
that if we had a mattress on that you would have roll around and because we’re
trying to achieve accuracy within millimeters that would allow you to
shift and that is what we’re trying to avoid we use the permanent marks that
have been put on and these help us to align you with laser tattoos we have in
the room we will move your arms a bit we might have to move your shoulders and
sometimes we have to roll your chest a little bit the best thing to do is try
to relax as much as possible sometimes you may find that this positioning
actually takes longer than the treatment itself they read out a lot of numbers to
each other a little bit like going to the dentist when they read out all the
things that you know in your mouth there’s all this kind of technology and
terminology that’s been said around you but yeah you think you don’t necessarily
see the lasers but you you’re aware of what they’re doing they ask you to try
and remain as still as you can and not to not to move yourself they will move
you to make sure they’ve lined you up in the right position if you’re not
comfortable at any point you can say you know my arms not quite comfortable and
and they’re readjust you they won’t do it unless you’re fully comfortable
because you obviously you’ve got to lay still I would try and pride myself on
being able to get on the bed as quickly as I could and line myself up it became
kind of a little bit of an obsession of mine towards the end when we’re setting
you up once we have you in that position it crucial you remain in that same place
if you need to sneeze just sneeze and relax again and your body will relax into the
same position however we ask you not to try to scratch which can be difficult
once you’ve been left alone so once we have you set up we will then leave the
room the energy that we’re using to treat you is stronger than a CT scan so
we’ll be behind another wall we can’t see you exactly but we have cameras that
watching you the whole time so at any point if you need someone to
come in we’ll stop the treatment we can see you if you wave your hands to us and
we’ll come in straight away we are giving you a treatment using deep
inspirational breath-hold while we’re setting you up in your correct position
we will have times we will ask you to take a deep breath and hold that we need
to try to get you to take the same amount of breath each time we will speak
to you over an intercom and this will tell you when to take a breath in and
when to release. The radiotherapy machine allows us to initially take an x-ray to
check we have you in the correct position from there we are able to
deliver a treatment and that moves around you and that will treat you at
two diagonal angles that allows us to miss your lung and your heart as best as
possible. It’s very noisy it’s little bit like waiting for the beeps that you get
at the end of a dishwasher cycle it’s kind of like that towards the end of the
process you get to know that where that what point that is of the treatment so
you know whether it’s the beginning the middle or the end so yeah there are
noises to let you know that something is going on but it’s completely painless
there’s no pain whatsoever no discomfort I’d lay there and plan what I was going to
have for dinner that night or shopping that I needed to be doing
the time would always go really quickly before I knew it it would it
would be finished when the treatments completed we will come in we’ll tell you
when it’s safe to get down and we’ll lower the bed from there you can get
dressed and go home you won’t be radioactive and you’re safe to be around
other family members and children you know theres been a huge a sea change in the
technology that we have available so the the shaping of the radiation beam to
limit the amount that gets to bits of you or of me that we don’t want to treat
is just a completely different ability nowadays to when I started
training in this area the other thing that’s changed is the
ability we have to ensure that each day somebody comes their treatment is
delivered absolutely accurately we also have much
better understanding about what dose of treatment is optimum
and how to give that in a way that that minimizes the risks so I’ve seen an
enormous change in the technology over my career to the benefit of my patients
which has been great I’m very good at compartmentalizing
things but when you are laid on the bed and you’re on your own and everybody’s
left the room and the machines whirring you are forced to appreciate and
understand what’s going on every day so that can take some getting
used to to begin with but the process is so
quick that by the time you’ve thought oh I’m here again this must mean I’ve got cancer this is quite serious you’re off the bed and you were
back on with your life again you

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