Radiotherapy to the Oesophagus

Transcription

1 The Beatson West of Scotland Cancer Centre 1053 Great Western Road, Glasgow, G12 OYN Patient Information Sheet Radiotherapy to the Oesophagus

2 This leaflet is for patients receiving radiotherapy for a cancer arising within the oesophagus (gullet). It describes the radiotherapy planning and treatment. It also explains the effects that you may experience during and after treatment and how best to cope with them. The effects of treatment vary from one person to another; therefore the information is a general guide and does not mean you will experience all of the effects described. Your doctor, radiographer and nurse will explain this further if necessary. Before agreeing to this treatment it is also important that you understand its nature and possible effects. If you are in doubt about anything or have any questions or problems, please let us know as soon as possible.

3 Preparation for Treatment Before beginning radiotherapy, the treatment must be carefully planned. The treatment planning is usually done at the CT simulator. This is a special x-ray machine similar to the units used to give you radiotherapy. You will be asked to undress to the waist. Depending on the exact area needing treatment, it may be possible to keep on underwear. Your radiographers will advise about this and will ensure your dignity is maintained by covering you up whenever possible. Your radiographers will then help you to lie on your back on the treatment couch. The couch top is a little hard but you will not have to be there too long and your radiographers will make you as comfortable as possible. You will be given a pillow or a special headrest to lie on by the radiographer. The radiographer will give you some barium to drink. This is a milky liquid that shows up on x-rays. It helps the doctor to see your oesophagus more clearly. Depending on the exact area needing treated the radiographer may then ask you to raise your arms above your head. If you have difficulty with this the radiographers will help you. It is important to stay as still as you can, but you should try to relax as much as possible and breathe normally. The radiographers will monitor you closely and assist you when necessary, so please don t worry about this. Once you are in the correct position, your radiographers and doctor will look at your chest on the X ray screen. This allows them to plan your treatment accurately. While this is happening you may feel the couch moving gently until you are in the correct position under the machine. An X-ray will be taken to finalise the treatment area and a little permanent mark, like a tiny freckle will be made on your skin. You will have treatment the same day or within a few days of your simulator appointment. This depends on the availability of the treatment machines.

4 Treatment You will have your treatment on a Linear Accelerator, which is a special type of x-ray machine that gives radiotherapy. When you come to start treatment your radiographers will position you just as you were in simulator. They have to leave the room while the machine is on but your treatment doesn t take long. You are also closely monitored on closed circuit TV while your treatment is being given. Your treatment radiographers will explain everything before treatment starts and check that you know how many treatments you will have. Your treatment is painless and the whole procedure usually takes around 5-10 minutes. After the first part of the treatment is finished the radiographers will come back into the room and move the machine into the correct position for the next part. Each part of the treatment only takes about a minute. You will feel no different immediately afterwards. Check with the radiographers if you have any questions or problems. Early Effects of radiotherapy Treatment Each patient is an individual and may experience the effects to differing degrees. Generally; You may feel tired and a bit washed out as the treatment progresses and for several weeks after the treatment has finished. Radiotherapy only affects the area being treated. If the upper part of your gullet (oesophagus) is being treated you may develop a sore throat or feel as if you have a lump there. It helps to drink more than normal by taking little sips as often as you can. This usually settles down fairly quickly, but if it is causing you a problem let us know. Your doctor can prescribe medicine to help you, particularly with getting your food down more easily. Your GP can prescribe this if you have finished treatment. If the lower part of your oesophagus is treated you may feel squeamish. If nausea is a problem your doctor can prescribe tablets or liquid to help with the feeling of sickness. Some patients notice a slight reddening of the skin in the area that has been treated. This should also settle down within a few days of finishing treatment. You may lose hair only in the treated area, but it will usually regrow a few months after treatment has ended.

5 General Advice during Treatment Skin Care Although you may be feeling off your food, it s important to try to eat to maintain your strength. Facing three large main meals a day can be very difficult if you feel this way. Try having smaller meals or snacks more often. It can also help to serve your food on smaller plates - it s less off-putting and you can feel pleased with yourself if you manage to finish it. There is a dietitian available at the Beatson, so please let us know if you re having problems. Also, you can obtain food supplements from your GP if you have completed treatment. Keep drinking plenty of fluids, as it s important that you don t become dehydrated. You might find thicker fluids such as milk or tomato juice easier to swallow than water It also helps if you avoid very hot drinks, rough foods, strong spices and alcohol until things settle down after treatment has ended. If your swallowing gets worse then your doctor may wish to look at other ways to help you to swallow more normally. So if you notice any changes that make swallowing more difficult, especially swallowing liquids then you should tell your radiographers. If you have finished treatment, please tell your own doctor (GP) or call your nurse specialist at your local hospital or at the Beatson. Try to get as much rest as possible. This is a time when you need to look after yourself so try to accept offers of help from family, friends and neighbours. This also allows them to feel involved in caring for you during this time. You may bath or shower during treatment, but don t have the water too hot (lukewarm). You may use a mild baby soap in the area but do not rub or scrub hard. Pat yourself dry with a soft towel. Don t use perfumed soaps, creams, deodorants and lotions on the treated area as these may irritate your skin.

6 What do I do if I feel ill? If you suddenly feel unwell and not able to come for treatment, contact your GP and also let your treatment unit know. If you feel able to come in to the department let your radiographers know you are unwell as soon as you arrive and they can arrange for a doctor to see you. Similarly if you are unwell and have completed your treatment you must contact your own family doctor (GP). After Treatment Ends Remember any symptoms that have developed because of the treatment will gradually settle down. The tiredness can take a good few weeks to leave you so please don t worry and think things are going wrong. It s also important to remember that the full benefits of your treatment may take a number of weeks to be felt, and it may be a little while before you feel better. Our hope is that you will notice a gradual improvement in the days and weeks after your treatment has finished. Your doctor will arrange to see you about 6 weeks after your treatment is completed. Continue to try to eat and drink plenty of fluids and do as much as you feel able. Where can I get help? Many people already have had a lot of information and support with their own Upper GI Cancer or Macmillan Nurse Specialist at another hospital or in the community. Remember that they can also help you with any worries or concerns at this time, and because you know them already, they can provide invaluable help and support during and after your treatment. So please remember to give them a call if you need to.

7 Information and Support All our staff are here to make sure your treatment goes as smoothly as possible and will try to help with any questions or problems you may have. Further specialist help and information in the Centre is available from: Clinical Nurse Specialist in Upper Gastro-Intestinal Cancer Tel: Macmillan Information Radiographer Tel: Information and Support Radiographer Tel: The Beatson West of Scotland Cancer Centre has a Radiotherapy Advice Line available for patients who have completed treatment. It is an answerphone service and if you leave your name and telephone number with a short message a radiographer will contact you. Tel:

8 Counselling and Clinical Psychology Service This leaflet deals with the physical aspects of your treatment, but your emotional well being is just as important to us. Being diagnosed with cancer can be a deeply distressing time for you and those closest to you. Within the department we have a counselling and clinical psychology service that can help with worries and difficulties you might be having. There is also a service for children and young people who are having difficulty coping with their relative s illness. If you think this may be helpful to you, please ask staff to put you in touch. There are also voluntary organisations providing information and support. These include: Oesophageal Patients Association Tel: Website: Offers leaflets providing guidance during and after treatment as well as telephone support and information from former patients. OCHRE: (Oesophageal Cancer has Reached Everywhere) Website: mailbox@ochre-charity.co.uk Cancerbackup: Tel: Offers telephone information booklets about particular cancers and also about how to cope. Macnillan Cancer Support: Tel: Develops services to provide specialist care at every stage of illness. Provide an information line and financial help through grants. TakTent: Tel: Provides information and support groups. Benefits Enquiry Line: Tel:

9 Notes

10 This leaflet is for general information only. For personalised information please ask a member of clinical staff. Leaflet prepared by L. Webster, Janice Japp and Alec McDonald Contact: L.Webster : Review Date: Nov Designed & Produced by Medical Illustration Services Tel.: