In order to develop the most effective treatment plan for you, we need to carefully define the location of your tumor or previous tumor site, the locations of other areas that may be involved with microscopic amounts of tumor, and the locations of sensitive normal tissues that must be protected from the radiation.
Treatment planning begins with Simulation, a planning session using the Simulator that may take one to two hours to accomplish. This session is scheduled after you meet with your Radiation Oncologist for your initial consultation. Some complex treatment plans may require a specialized CT scan, and some may require a second simulation session.
During simulation you will be asked to remain very still. Specialized immobilization devices are sometimes used to help you maintain the treatment position. Your doctor will use fluoroscopy (video x-ray) to set your treatment fields, or preliminary fields if a planning CAT scan is scheduled. A radiation therapist, under the direction of your doctor, will take x-rays and measurements and mark your skin to delineate the determined borders. These skin marks will aid in reproducing your exact positioning each day for treatment. Photographs will be taken for identification and positioning purposes. In some cases, a plaster contour (outline or shape) may be taken of the part of your body that will be treated.
When simulation is completed, the therapist will give you an appointment for your daily radiation treatments, which will usually start within a few days after the simulation.