Before your radiation treatments begin, you attend a simulation session. This appointment helps your care team locate and target your tumor and find the best position for you during your therapy. These preparations help us provide you the highest quality care.

Your simulation will include:

• Creation of a mask or other device to help keep you still during treatment
• CT and other imaging scans to map the precise location of your tumor
• Placing a mark or tattoo on your skin to target the radiation equipment to your tumor

Treatments we provide include:

• Image-Guided Radiation Therapy (IGRT) — We use imaging during radiation therapy to improve the accuracy of treatment delivery. IGRT treats tumors in parts of the body that continuously move, such as the lungs. Your doctor takes images of the tumor before and during treatment to target the radiation dose to the tumor. Images are taken every day that you get treatment to adjust for any tumor movements.
  
• Intensity Modulated Radiation Therapy (IMRT)  — We use linear accelerators to safely shape radiation to cover the tumor while reducing harm to surrounding normal tissue. With IMRT, the radiation beam can be broken up into smaller beams, each with its own level of intensity. 
• Stereotactic body radiotherapy (SBRT) — When we use stereotactic radiosurgery to treat body tumors, it's called stereotactic body radiotherapy. We use SBRT to treat liver, lung and spine tumors. SBRT allows radiation to be given in a safer and more effective way than other radiation techniques.
• Stereotactic radiosurgery (SRS) — We use this form of non-surgical radiation therapy to treat functional abnormalities and small tumors of the brain. SRS delivers targeted radiation in fewer high-dose treatments than traditional therapy. This helps spare healthy tissue.

Treatments are usually scheduled five days a week, Monday through Friday, and continue for multiple weeks. Your care team determines the number of radiation treatments you need based on your type of cancer, the goal of treatment, your general health and other medical treatments you receive.

When you come for treatment, we position you on a bed or treatment table. Once we achieve the right angle, your therapist leaves the room.

During the radiation therapy session:

• You may see or hear equipment moving around you.
• You may notice an odd smell caused by the ozone produced by a linear accelerator.
• You may see a colored light, especially if your brain is being treated.
• We monitor you on a television screen during each treatment.
• You can talk with your therapist through a microphone.
• We stop treatment if you feel sick or uncomfortable.
• We make changes to your position and radiation dose as needed during and between treatments. 

Your radiation oncology team works to maximize the cancer-destroying capabilities of your radiation treatment while reducing any impact on healthy tissues. Common side effects of this treatment include fatigue, skin problems at the radiation site — such as dryness, irritation, itchiness or swelling.

Other side effects may include:

• Diarrhea
• Eating and digestion problems
• Hair loss in the treatment area
• Headaches
• Mouth problems and difficulty swallowing
• Nausea and vomiting
• Soreness and swelling in the treatment area
• Urinary and bladder changes

We will call you with your treatment start day and time and will make every effort to accommodate your scheduling needs. If the time you request is not available, we will do our best to move you into your preferred time slot once it becomes available.

Many factors can affect the schedule, including other people requiring emergency treatments. We will make every attempt to notify you when changes occur that will affect your treatment time.

• Please arrive 10-15 minutes early for your appointment.
• A close family member may observe one treatment session by appointment only.
• To comply with hospital regulations, please wear a mask over your nose and mouth and use the hand sanitizer provided upon entering the room. If you do not have a mask, one will be provided. We thoroughly clean our equipment between each patient with sanitizing wipes for your safety.
• Only authorized staff are allowed in the control room unless you are escorted by your radiation therapist.

We closely monitor your health during and after your radiation treatments. While you are undergoing therapy, we regularly check the quality of your radiation sessions and perform weekly check-ups.

hen you complete your treatments, you attend a follow-up with your radiation oncologist to check your recovery. Your radiation oncologist works with other members of your team to:

• Ensure your cancer does not return
• Monitor your long-term side effects
• Order additional diagnostic tests as needed
• Share reports on your treatment with your other doctors

Over time, your follow-up appointments become less frequent.