Radiotherapy Planning

Having completed chemotherapy, it was time to start thinking about the next stage of my treatment which is radiotherapy. The first appointment was with the consultant at the hospital where I was given a brief run down of the plan. I was told I would have 20 sessions of radiotherapy over 4 weeks on Mondays to Fridays. This will take place at a local private hospital so no long journeys nor issues with parking. The doctor explained some of the side effects to expect, such as tiredness and sore skin. I wasn’t given a start date at this point but was told it would be 4 to 6 weeks from my last chemo session. The doctor and breast care nurse in attendance made it clear that I must wear factor 50 sun protection as well as cover the affected area (which will be right up to my collar bone) when I am out in the sun. They advised that I should avoid  swimming for 6 weeks after finishing treatment. This was disappointing to hear as I had hoped to have a holiday to recover from this nightmare. So I left the appointment feeling a bit down.

I was invited to attend my CT scan and planning appointment 10 days later at the private hospital. Everyone who had been there told that me this place was wonderful not least because you get free tea and coffee. As with everything else in life it would have been better if no one had said anything as my first experience wasn’t fantastic. First off, I was kept waiting for 40 minutes as there seemed to be some technical problems that day. It turned out that all of the radiotherapy equipment was broken and the staff were having to turn people away and send them off to Cambridge or Oxford. The patients were however provided with a taxi which was good. Unfortunately one poor lady who was there for her first session had to go back home and was told to come back 3 days later. So it was all a bit chaotic that day but true enough, there was coffee and tea and there were various snacks available.

When I was called through by one of the radiographers, things picked up considerably. We were taken to a comfortable room with sofas and she went through lots of information with us. I was given a start date of the 8th July and timings of my 20 radiotherapy sessions, along with a review appointment in between. The method of radiotherapy to be used is called ‘Surface Guided Radiotherapy’ and I was told that this method eliminates the need for tattoo markers. The radiographer explained that in addition, the ‘Image Guided’ technique means that the position is checked at every session so that the dose is always delivered accurately to the exact treatment site. I was told about the side effects again, as well as ways to cope, such as moisturising, light exercise and plenty of rest. I asked again about swimming and I was given quite a different response this time. The answer was maybe leave it a couple of weeks and then as long as my skin is not inflamed, I can swim but must rinse off chlorine as soon as I leave the pool. So better news this time. I suppose the difference in reponses from the consultant and the  radiographer is down to the fact that everyone is different and no one can tell how my skin will be affected until the treatment has been completed.

Next it was time for my CT planning scan. I was taken to the changing room where I was given a gown of superior quality to the usual ones, where you’re never quite sure which way round they should go and you invariably find everything hanging out. The gown is mine to keep for the duration of my radiotherapy so I have added it to my wardrobe for now. In the CT scanning room there were some questions to answer and then I was asked to lie down on the bed for the scanner. The 2 radiographers proceeded to measure where the beams would need to do their work – it really is an exact science. They were using rulers and quoting measurements, such as E8, while I had to lie very still with my arms above my head. Since radiation will take place on my lefthandside I will need to use the breath holding technique as part of my treatment. This is to reduce the risk of any damage to the heart. What followed next was several practice runs of me holding my breath for 30 seconds at a time. The radiographers were checking that my ribcage was in the exact same position each time. No pressure! I was marked up with pen and sent through the scanner while the 2 ladies noted down all of the information.

That concluded the planning appointment and I was free to go. Here’s hoping all of the equipment is fixed before my start date!