The Radiotherapy Pathway: Treatment
External Beam Radiotherapy (EBRT) where appropriate is used to treat many forms of cancer including head and neck, cervical, rectum, lung, breast and prostate. Radiotherapy may be given on its own, or it may be used alongside other treatments such as surgery, chemotherapy or brachytherapy. EBRT is a treatment that uses a special machine called a linear accelerator which delivers high energy x-rays from outside the body to kill cancer cells inside the body. Whilst the treatment causes changes in normal and abnormal cells, normal cells are more able to repair themselves therefore more damage is caused to cancer cells. To maximise this effect, often a course of daily treatments called fractions are scheduled
Stereotactic Radiosurgery (SRS) is a highly precise form of radiation therapy developed to treat small brain tumours and functional abnormalities of the brain. SRS is a non-surgical procedure that delivers precisely targeted radiation at much higher doses, in only a single or a few treatments, compared to traditional radiotherapy. This type of treatment is delivered on our machine called Cedar.
Stereotactic Ablative Body Radiotherapy (SABR): Our department is the Peninsula lead department for hypo-fractionated treatment for lung tumours. This technique targets the tumour with precision accuracy and delivers a very high dose of radiation to a small treatment area, whilst ensuring healthy tissues receive a low dose.
Electron radiotherapy can be delivered by two of our machines (Beech or Cedar). Unlike traditional radiotherapy that uses photons, this treatment uses electrons with the result of being able to target more superficial lesions. For this type of treatment, a planning scan is not required, instead a clinical mark-up will be carried out by a therapeutic radiographer and doctor.
Brachytherapy is different to the other treatments listed above. Instead of the ionising radiation source being outside the body, patients have radioactive sources placed inside their body. This can be done in an operating theatre, or in the Radiotherapy Department.
This type of radiotherapy treatment is delivered by therapeutic radiographers using one of our 3 linear accelerator machines (Acer, Beech and Cedar). It may be that you are treated on different machines throughout your treatment but this is nothing to worry about. The radiographers will aim to get you in the same position as when you had the CT planning scan, using your tattoo dots and/or immobilisation devices to do so. The radiographers will have to leave the room whilst they switch on the machine. This will only be for a short while and you will be closely watched via cameras. We can also hear you and talk to you through an intercom system. If necessary, the machine can be stopped and restarted at any time. To ensure the accuracy of the treatment, the radiographers may take images such as x-ray or mini CT scans to check your position before delivering the treatment, this is called image-guided radiotherapy (IGRT). The time you are in the treatment room depends on your specific treatment and may range from a few minutes to three quarters of an hour. For most people, it is about 15 minutes.
At the end of your course of treatment, the radiographers will talk to you about what to expect and how to cope with the following weeks. You will be given a contact number for the liaison team should you have any problems up to 2-3 weeks after finishing your treatment. After this point we would advise you to contact your GP.
A follow-up appointment with the doctor will be arranged. The time you wait for this will depend on a number of factors, including your doctor and the treatment you are having, but it is usually between 3 and 6 weeks. You may get this appointment on the last day of your treatment, if not, we will send this in the post to you.