During your first visit to a Center, you will see a radiation therapy nurse, who will review your basic medical history. Next, you will see the Radiation Oncologist, who is a physician specialist in the field. This physician will review your medical records, x-rays, scans, any biopsy results, and all laboratory results, and will perform a medical evaluation and exam. He or she will be the sole authority for determining whether or not you will receive radiation treatment.

Certain additional tests or x-rays may be recommended by the Radiation Oncologist in order to complete the evaluation or aid the process of radiation therapy localization for your particular situation.

This evaluation period normally takes about an hour, although longer periods may sometimes be required.

Localization and Treatment Planning
Once radiation therapy is recommended, the preparation process begins with a “simulation.” Using scans and x-rays, the area to be treated is localized. Exact localization of the target area is necessary so that the entire cancerous area can be covered by the radiation treatment, while sparing as much of the healthy tissue as possible. A specialized x-ray or CT scan, obtained with a machine called a simulator, is used to localize the tumor.

Specialized masks, molds, or immobilization devises are fabricated with you in the treatment position. Once special x-rays or CT’s have been obtained, markers are placed on the skin, using a magic marker or colored dye, to outline the target area. These marks enable us to exactly reproduce the treatment at each subsequent session. These marks, or a small permanent tattoo, will need to be maintained throughout the entire treatment course. Do not rub or wash off these marks, or the entire localization procedure may have to be repeated!

This localization and treatment planning process is technically complex, and is usually performed within several days of the initial consultation. The process normally requires one hour or less of your time in the clinic. Most of the action then takes place after you leave the department: Our Centers now use Virtual Reality Planning almost exclusively—we can spend lots of time here working on the “virtual you” inside our computers, while you are comfortably at home!