Prior To Radiation Therapy & Treatment in Orange County California

When you schedule your initial oncology appointment for you may be asked to bring records, especially pathology reports, X-ray and scan reports, and often the original films or a CD of the films to be reviewed by the physician at the time of the consultation. Having the information available at this time assists the physician to make a recommendation whether or not radiation treatments should be given. It can take up to 15 days for most medical offices to supply you with copies of your records, so filing a timely request is important. If the information is not available, the final decision may be delayed. Sometimes we have been able to obtain the appropriate information ourselves, and won’t ask for your help.

Upon Arrival

You will meet with our receptionists, who will guide you in completing the necessary paperwork, answering your questions regarding insurance, and getting you in to see the physician in a timely manner.  The people you meet for the first time will leave a lasting impression.  These receptionists will always be looking out for you and will be helping you throughout your course of treatment.  

Detailed consultation with your physician
Your consultation appointment will require you being with us for approximately one hour.  Our physicians will go over your previous medical records, examine your x-rays and lab work, and perform a physical examination.  They will be especially interested in how your diagnosis was established and will want to see the pathology reports from your biopsies or surgeries.  They will provide you with their impression and recommendations.  The physician will spend quite some time explaining the benefits and potential side effects, if any, of the treatment.  They will most likely speak with your referring physician while you are here in the office to see if the referring physician has any recommendations or will be giving chemotherapy at some point in your treatment.  At that time, you will be able to make a decision regarding your future options and will have the opportunity to commence with scheduling your radiation therapy.

Treatment Planning

If you and the physician are in agreement, then a CT scan for planning purposes will be scheduled in most cases.  This scan will allow the physician, physicist and dosimetrist how best to treat your particular tumor.  It will be scheduled 1-5 days after the initial consultation, depending on insurance restrictions.

Your CT Scan

No injections of contrast are required for this scan. At the time of the scan tiny tattoos probably will be placed to allow precise replication of the CT position when actual treatments are given. Certain tumor locations require a mesh facial mask to be fitted to ensure perfect immobilization so that we treat tumors near vital structures such as spinal cord or salivary glands with a better chance of avoiding damage to the normal structures nearby.

After the CT scan is completed the information is fed into a computer and a dosimetrist or physicist works with the physician to create a plan which delivers the most radiation to the tumor, and the least to surrounding tissues. This planning requires 5-7working days. You will be given a tentative start date at the time of the CT scan, but this is only an estimate.

The Next Step: Simulation

When the treatment plan is completed and approved by the physician, you will return and be placed placed on the actual treatment table (linear accelerator), marks will be made by either pen (which washes off) and/or tattoos (little tiny dots), so that you will be in perfect alignment every day for your therapy. If a mesh mask was made, it will be put on as well. For some tumors of the head and neck region, a dentist may have made plastic molds for your teeth; these molds should be brought and put on for the simulation. At this time X-ray exposures will be taken to make sure the actual treatment position is exactly the same as the CT position, so the radiation goes exactly to the tumor. These exposures will be reviewed by the physician, and if approved the treatments will begin, usually the next day.

You will be treated Monday through Friday for approximately 6-8 weeks.  The total time for treatment is approximately 30 minutes.  The actual treatment only takes a minute or two, but we need to make sure you are in the exact position each day.  

As you continue through your therapy, the physician and physicist will be monitoring your treatment dose and will be made aware of any side effects that you might experience.  You will have a visit with the physician each Monday or Tuesday, but upon request you may see the doctor any day.  If you have any problems, the sooner we know about them, the sooner we can get you appropriate medication or skin care.  

Treatment

When you come for treatments, you will sign-in at the front desk, then go to the waiting room in the corridor. Family or others with you should sit in the front office, as space in the waiting room is limited. We have wheelchairs available if needed for transfer to and from your car, to be returned to the office after use.

You will usually be in and out of the office in about half and hour, barring any unforeseen scheduling problems. The treatment will usually take only a few minutes, but for some complicated cases special radiation treatments called "IMRT" or "IGRT" will be used, and these may take 10-15 minutes to complete. Ask the technologist who gives the treatments if you have questions.

Normally you will leave right after treatments, but at least once a week, (usually Monday or Tuesday) you will be seen by a physician to review your treatments, answer questions, check for side-effects and examine you. He can give advice on skin care, prescribe or renew medications and try to relieve concerns you may have. However, if you have problems at other times during the week, notify any office staff personnel, and you can be seen by the physician then as well.

When your treatments are completed, you will be given a follow-up appointment, usually in 3-weeks, but sooner if you have significant side-effects. You will be seen by us periodically usually for a 3 month period, at which time you will be released to your other physicians for long-term care. If, however, you do not have regular medical follow-ups, we may follow longer, until you establish long-term care with another physician. Make sure you have our card to call us for questions at any time before, during, or after treatments are completed.

Follow Up

Once you have your graduation day, we will ask you to come back in approximately three weeks, so that the physician can check your progress, make sure you skin is healing appropriately and talk to you about any future treatment that might be required.  You will then come back six weeks from then and finally at approximately 90 days from treatment.  These follow-up visits are at no charge to you and are extremely valuable as preventative care.  

Most likely, at the end of the three month period, you will be ready to return to your primary care physician or medical oncologist for any future follow-up.  We will always remain available if you have questions or concerns.

We know dealing with serious diseases can be stressful, and physically draining. We may not be able to make the treatment process pleasant, but we can make it tolerable, and we try hard to become part of the solution to your treatments, not part of the problem.