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Planning
Following your initial consultation, we
will schedule a treatment planning or simulation session.
During this visit, we will establish a reproducible treatment
position. We often use diagnostic radiology examinations
to pinpoint the location and size of the cancer. You
will be asked to lie very still on a table while a technologist
uses a special machine to x-ray and locate the treatment
ports. These are exact places on your body where the
high-energy rays will be aimed.
Once the treatment ports are identified,
it is important to mark the area so that the treatment can
be given in exactly the same spot each time. These
marks are a permanent record of your radiation field. The therapist will mark your skin with very tiny tattoo
dots. We will use as few tattoo marks as possible.
They will look something like tiny freckles and will not
go away. The planning session usually takes about
one hour. Depending on the site being treated, some
patients may require a second planning appointment to verify
the treatment plan.
Working with the dosimetrists in treatment planning, we will use the information from the simulation visit to design an individual treatment plan for you. Our dosimetrist will use a treatment planning computer to map the best radiation plan for your particular problem. The plan will be checked by our physicist and by your physician.
It may also be necessary for us to design and make custom blocks cast from a heavy metal containing lead. These blocks will shape the radiation beam so that only the areas the physician indicates are treated. Shielding is often done directly by the treatment machine using multi-leaf collimation. The collimator consists of thick metal leaves which move in or out to block radiation to normal tissues as much as possible.
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