Having radiotherapy for breast cancer – Part One: Preparing for Treatment

Having radiotherapy for breast cancer – Part One: Preparing for Treatment


I was told I would need radiotherapy
after surgery but the cancer had spread to my lymph nodes so I needed
chemotherapy in between so I was new radiotherapy was on the cards it’s
something that kept me going through chemotherapy I knew that this was the
last little hurdle so I was keen to get going as quick as I could
I think having survived and gone through chemotherapy
I knew that radiotherapy was going to be easier than that radiotherapy is using
high-energy x-rays to try and get rid of any remaining cancer cells risk of
breast cancer returning is halved thanks to doing radiotherapy after the
surgery the decision to treat any patient is done jointly between the
group and that’s the multidisciplinary team that includes a group of surgeons
oncologists radiologists and pathologists depending on your
particular surgery and the findings at the time of the surgery the pathology we
design a treatment program that’s personalized to you based on the best
evidence available we put all that together and come up with suggested
pathway of treatment which is a recommendation that then has to be
tweaked or adjusted depending on your views and also on your other health
issues because nobody you know it’s not a question of one treatment fits
everyone we need to make this individualized for you when you come to
the oncology clinic for the first time you’ll get to meet oncologist it’s
really important that the oncology doctor knows your full medical
background because it may have an influence on the radiotherapy and that
you bring a list of all your medications with you so that the doctor can see that
they will explain to you what it involves what potential benefits is
which is reducing the risk of cancer coming back and the possible short-term
and long-term side effects when you’re happy with all of that then together you
and the oncology doctor will sign a consent form we will fill in all the
necessary paperwork we will pass that on to our colleagues in radiotherapy
scheduling and one of them will give you a telephone call to let you know when
you’ve got to come up for your preparation scan
and to let you know when the treatment is going to begin when you first come in
for your planning appointment we’ll talk about the planning process we’ll also go
through the treatment appointments and what we do at treatment and then we’ll
talk to you about the side-effects that you may encounter while you’re on
treatment after your pre-planning appointment you’re given all of the
appointments at once so that you can plan around them I think it was it was
four weeks for me because it had spread to my lymph nodes you see an end date to
it all as well after we’ve had the discussion we take you into the CT room
we will ask you your name date of birth and your address just to confirm that
we’ve got the right person we’ll also take a photo ID of you and this will be
used as a positive way of identifying you whilst you’re on treatment there is
a changing room in the corner where we will ask you to undress and then we’ll
give you a little cover to cover you up while you walk to the bed the whole
planning the scan usually takes between ten and fifteen minutes and you don’t
feel anything at all it shows us the insides of you in 3d and we use that 3d
imaging to actually place the radiotherapy beams so that we know
exactly where the radiotherapy is going to go we will be using what we call a
breast board and that just allows us to position you correctly each day because
we record all the positioning of this board which will be replicated when you
have your treatment we will leave you on your own but we are watching you through
the glass window so if you need to talk to us there’s an intercom and we can
hear you all the time sometimes for left sided breast treatment we ask patients
to do a deep inspirational breath-hold scan we ask you to take a deep breath in
and hold it for about twenty to thirty seconds so that the front of the chest
wall is away from the heart if we plan you with the inspirational breath hold
then that will continue while you have treatment as well
if you struggle to do the deep inspirational breath hold then what we
do is we have a practice a few times and if you don’t manage it there
we just revert back to free breathing scan and we use other methods to avoid
your heart once the scan has been completed we will put permanent marks on
your front of your chest and on the sides of your chest and these are tiny
little pinprick tattoo marks I thought she’d scratched me so I nearly went to
swear at her and then and then I said aw when he doing the UM tattoos and she
said I’ve already done them so you really yeah you really don’t notice it
at all it’s no it’s not particularly hard it’s to make sure that the machine
is in the right place for you because the breast cancer can be at any part of
anybody’s breast so that they know that they’re getting there zapping the right
bit but you don’t want to zap this that don’t need zapping we usually start your
treatment within a couple of weeks we’ve got the information that we need from
the CT scan that you’ve had done but then we need to actually do a
custom-made plan from having the CT and having the dots put on ready to line you
up was about two weeks from that point that appointment to to the actual
radiotherapy starting you

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