What to Expect While Receiving Radiation Therapy for Cancers of the Skin Princess Margaret Information for patients who are having radiation therapy for cancers of the skin Read this pamphlet to learn about: The main steps in planning radiation treatment How to manage common side effects What happens when you finish treatment Where to get more information For more information on Radiation Therapy, please watch our patient education videos at www.whattoexpectrt.theprincessmargaret.ca. These videos offer a step-by-step guide to the radiation therapy treatment process. They also explain how radiation works in the body and how your team works together to deliver the highest quality treatments. Please visit the UHN Patient Education website for more health information: www.uhnpatienteducation.ca 2014 University Health Network. All rights reserved. This information is to be used for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. Please consult your health care provider for advice about a specific medical condition. A single copy of these materials may be reprinted for non-commercial personal use only. Author: Radiation Medicine Program Created: 09/2008 Form: D-5547 (02/2014)
Your Radiation Oncologist, Nurse, Radiation Therapists and other health care professionals will provide you and your family with care, support and information throughout your treatment. Please ask any questions you have when you come each day. Your Radiation Therapists can try to answer your questions or let you know which members of your health care team can help. You may also talk to your Doctor or Nurse at your weekly review appointment. Interpretation is available if you speak very little or no English. Please let us know as soon as possible that you need help with interpretation. 2
Planning your Radiation Therapy Please check in at the reception desk on level 1B. We will take your photograph to help us identify you during your treatment. You can expect to be here for about 1 hour for this appointment. What happens during my CT simulation appointment For most treatments, the planning appointment is where we map out the area to be treated on your body. We take photographs and measurements to keep a record of the area treated and to gather information for the Doctors, Physicists and Therapists so they can develop a plan that is right for you. Here is what you can expect: Your Radiation Oncologist will measure and outline with a marker the area to be treated. You may be sent to the Clinical Photographer (on level 3B) to have a photograph taken of the area. Photographs may also be taken at the treatment unit. For more complicated cases, we will use a CT simulator to decide on the area of treatment. A CT simulator is a CT scanner with special computer software that gives us the detailed x-ray images we need to prepare your treatment. Here is what you can expect: The Radiation Therapists may draw marks on your skin, take photographs, or make devices to help position you. They may also give you a few small permanent tattoos using a fine needle. The Radiation Therapist will explain these procedures to you first. 3
Having your Radiation Therapy Treatment When will I know about my first treatment appointment? If you had a CT simulation appointment, you can expect a phone call at home a few days later with the date and time of your first appointment. Otherwise, you will receive your appointment at your skin clinic visit or treatment unit on level 1B.. Where do I go for my radiation treatment appointments? Your radiation treatment will be at Princess Margaret Cancer Centre. Treatments are given on either level 1B (1 level below the main floor) or 2B (2 levels below the main floor). Check in with the reception staff when you arrive. Can I schedule my radiation treatment appointments at times that are convenient for me? Because we treat so many patients every day we cannot guarantee your exact appointment time. Your Radiation Therapists will try to help you if there are special circumstances. What happens at the treatment appointment? If you are getting treatment on Level 1B, Unit 19: Your Radiation Oncologist is often with you at your first treatment to outline the treatment area on your body. Every day, your Radiation Therapist may put small pieces of lead shielding on the skin around the treatment area. These shields are not heavy and are only on your skin during the treatment. 4
If the area is close to your eye(s) or on your nose, more shields may be used. Your Radiation Therapist will explain to you what types of shields you need. Digital pictures of the treatment area and position will also be taken. If you are getting treatment on Level 2B: The Radiation Therapist will check the measurements from your planning appointment. They will take some X-rays to check that you are in the same position every day. Once your position has been checked and any changes have been made, you will have your radiation treatment. For these treatments, the machine does most of the work to shape the radiation area. How long is the treatment? You should plan to be at the hospital for 30 to 60 minutes each day. Your treatment will take about 30 to 60 minutes on the first day and about 20 minutes on other days. Most of this time is used to make sure you are in the right position for treatment. Will I see the Oncologist during my radiation treatments? You will meet with your Radiation Oncologist and Nurse once every week during your treatment. He or she will answer any questions or talk to you about any concerns that you may have. Tell them about any side effects you may be having. 5
Some common side effects to expect from radiation treatment Skin changes Your skin in the area being treated may feel irritated after about 1 week of treatment. It may become warm, red, dry or itchy. Your skin may also have dry, flaky or moist open areas. If the area being treated is open before treatment starts or is located where two folds of skin rub together, you may have blisters, moist discharge or bleeding. If you are having your treatment on unit 19: Your skin reaction may not happen until 7 to 10 days after your last treatment. Your skin may become irritated, blistered or may bleed. Keep following the care instructions given to you by your health care team. For example, apply the saline soaks to the treated area at least 3 to 5 times a day. If you have any questions, call unit 19 at 416-946-4501 extension 8819 or your Doctor. To learn how to care for your skin please see the pamphlet "Taking care of your skin during radiation therapy." Changes to your nose If your nose is being treated and is dry or bleeding, ask your Doctor, Nurse or Radiation Therapists if you could apply a water-based lubricant (such as Surgilube or E-Z Lubricating Jelly) inside your nose after your treatment. Hair loss The hair growing in the treatment area may fall out and it may not grow back. Your Doctor will give you information about hair loss and regrowth for your case. 6
Will I get tired while on treatment? Fatigue (feeling tired) can be a common side effect of radiation therapy. This varies with each person. It can increase gradually during treatment, and usually gets better over 1 to 2 months after treatment is over. Continue doing your usual activities if you feel well enough to do so. Do these things if you are feeling tired: Pace yourself, especially with activities that make you feel tired. Ask for help with activities you do every day and that you cannot manage. Pick a relaxing activity (for example walking) or hobby that you are able to do every day. Keep a regular sleep routine at night and rest as you need to during the day. Eat a balanced diet and drink plenty of fluids. Have healthy, easy to prepare food on hand. Eat meals at regular times through the day and snacks if you need them. 7
What happens when I finish treatment? Near the end of your treatment, we will give you a booklet titled What to Do When Finishing Radiation Therapy. At your final weekly review appointment you will be given a follow-up appointment to see the Doctor a few weeks or months after your treatment is finished. After treatment finishes, some of your side effects will carry on and may get worse before they start to get better. This is normal. Continue to follow your health care team s instructions until you feel better. Call the hospital once you are finished with your treatment, if you have any questions or concerns. Need more information? Please visit the Patient and Family Library on the main floor, or call them at: 416-946-4501 extension 5383. You can also visit the Princess Margaret Cancer Centre web site at www.theprincessmargaret.ca for more information and resources about your treatment and also services at the cancer centre. The development of patient education resources is supported by Princess Margaret Cancer Foundation. 8