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Preparing for Radiotherapy

Step I: Consultation

Your first visit to the Radiation Oncology outdoor makes you meet the concerned doctor. This involves a detailed session of Q&A, the Physician tries to ascertain your symptoms, a thorough clinical examination and review of your medical history and relevant investigations. If you need to undergo radiation therapy, the Oncologist will succinctly explain you the entire process of radiation planning and delivery, duration of treatment and anticipated early and long term side effects of the treatment.

Step II: Radiotherapy Simulation

Once you reach the Radiation Oncology department on the scheduled day, you will be counselled again regarding various steps involved throughout the radiation planning. You may be advised to come empty stomach, if contrast enhanced CT or MRI scan is to be done. The simulation process begins with the fabrication of an immobilisation device, to reduce the unwarranted movement during the actual treatment. This takes half an hour approximately. Once done the patient will be taken for the radiation planning scans, as appropriate for the given site and advised by the treating Oncologist. After your scan is over, the intravenous cannula (if inserted) will be removed, old scans will be taken and an expected day and time of radiation starting will be advised.

Step III: Radiotherapy Planning

Your Radiation Oncologist along with his team of Radiation Physicists will create a unique plan over couple of days to conform the intended dose to the tumour/target and minimising the dose to adjacent critical tissues.

Step IV: Radiation Treatment

On the designated day, the Oncologist will counsel you regarding the expected duration of treatment, skin care, diet and other relevant instructions. Once the necessary radiation protocol is completed, the patient will be taken in the therapy unit for the actual treatment. Treatments are usually given five days/week and the time of the daily treatment is usually fixed after discussion with the patient and family members. Radiation Therapy Side Effects Patients receiving radiotherapy may experience some problems as a result of treatment. The side effects vary from person to person, site of the treatment, the technique used for radiation planning, co-administration of chemotherapy with radiation, among other factors. Some people have no or minimal problems and some may suffer from lot of adverse effects. Some of the common side effects are: Skin Changes – Dryness, Hyperpigmentation, Peeling and Blistering of skin Fatigue, Loss of appetite and altered taste. Depending upon the part of your body getting radiation, one can also have – Loose motions Nausea/Vomiting Pain/Difficulty in swallowing Hair Loss Urinary changes Mouth Problems Most of these problems are temporary and they gradually subside within two months of treatment completion. Late side effects usually come three months or more after the treatment and they vary by the part of your body and the dose received.

Skin Care
  • Avoid skin irritation in the treatment area
  • Wear loose fitting, cotton clothes over the treatment area
  • Follow the instructions given by your doctor regarding use of water, soap etc in the treated area
  • Don’t use oils, lotion, perfume or aftershave in the area being treated
  • Don’t shave your skin in the treatment area
  • Keep your skin in the treatment area dry. Use tissue paper to soak moisture or sweat. Don’t use handkerchief or a cloth to wipe out water/secretions from the treatment region.
  • If receiving pelvic radiation, use toilet paper preferably for ablution.
  • Avoid exposure to sunlight in the treatment area
  • Avoid swimming
  • If itchy, don’t scratch or rub your skin. Consult your doctor or nurse.
Dietary Instructions
  • Take plenty of oral fluids
  • Spicy, heavy fried food to be avoided
  • Take small but frequent meals
  • Both salt and sugar intake should be adequate (consult your doctor or dietician for advise)
  • High calorie, high protein diet to be taken under guidance of your doctor/dietician
  • Nutritional supplements as per recommendations by doctor/dietician
Swallowing Problems
  • Maintain good oral hygiene. Use non alcohol based mouthwash as advised
  • Soft foods are easier to swallow. Puree your food in a blender
  • Moisten your food with milk, curd or gravy to make it easy to swallow
  • Cool and sweet foods may have a soothing effect on throat
  • Avoid spicy food, fast food from restaurants
  • Avoid citrus fruits like orange, lemon and sweet lime.
  • Avoid tobacco and alcohol
  • Soothing agents, lozenges may be advised by your doctor
Abdominal Problems (Nausea, Vomiting, Cramps)
  • Avoid fatty, fried and spicy foods which tends to upset the stomach
  • Take plenty of liquids served at room temperature
  • Take small but frequent meals
  • Take adequate amount of salt in diet
  • Take anti-emetic medications thirty minutes before meal
  • Anti-spasmodic medications to be taken as per doctor’s advise