In most cases we will apply tiny tattoo dots on your body, as reference markers, which work as start points for the Treatment Radiographers to position you consistently for subsequent treatments. Dependent on the area of the body being treated; we use site-specific immobilisation equipment, to ensure accuracy and reproducibility.
If anything is too uncomfortable, please let us know at your planning scan, we can adjust and use supportive equipment to enable you to hold your position. After your planning scan it can be difficult to change the immobilisation equipment as your treatment plan has been generated using the scan.
Your doctor may request you have contrast dye to enhance your planning scan. If so, you will be assessed at your CT appointment, considering any existing medical conditions or medications. You may need a repeat blood test (results must be within a month of the scan date) or if you have received your chemotherapy leading up to your CT planning appointment. We will also need to weigh you at this appointment to calculate your contrast amount. If you are given contrast, you will be prohibited from driving, for up to 1 hour after the contrast is administered.
Please ensure you have continued your normal routine before the planning appointment, continue to take any prescription medication, are well hydrated, and have eaten as usual (unless you have been asked to be nil by mouth). You MUST bring any medication you might normally use, during the appointment times, including pain relief and inhalers.
What to expect at your planning appointment
Below is information on what you can expect at your planning appoint depending on the specific area being treated.
- To create a shell, the plastic cut-out is immersed into a hot water bath for 5 minutes, which allows the plastic to become pliable and easy to shape to your face. The shell will be warm and wet whilst it dries and hardens on you for further 5 minutes.
- As you can see (picture) the shell material has plenty of small holes and a mouth opening to allow you to breathe normally whilst wearing it.
- For both your planning scan and treatment, you will need your arms up and above your head. A special ‘breast board’ will support your arm position. In preparation, it is essential you continue with your arm exercises, as recommended after surgery. Maintaining good arm motion, helps with mobility and reduces muscle tension that could impact your position for treatment. If you are unable to keep your arms up for approximately 15-20 minutes, please let the CT Planning Radiographers know, so they can make necessary adaptions to the equipment or allocate further support.
- Some treatments require you to hold your breath, this will be for a maximum of 20 seconds, and you will be coached during your CT planning scan appointment.
- To find out more information about how the radiotherapy is planned, watch the video below.
- Normally a week before you CT planning appointment you should receive a telephone call from our team, to discuss the preparations you will need to complete to maximise your planning session. There will also be a short general assessment on your general health and wellbeing, including hydration, exercise regime and diet.
- For the planning scan and subsequent radiotherapy appointments it is essential you have a full bladder and small (empty) bowels. This ensures the treatment radiation is focussed to your prostate will less radiation effecting your bladder and rectum. In turn this should reduce the expected side effects.
- To reproduce the rectum size, we will provide you with mini enemas, you should use an enema each morning, starting 2 days before your CT planning scan. When you arrive for your CT planning scan, you will be shown the facilities and asked to use 1 enema. A Planning radiographer may discuss with you about bowel gas, please do not be offended, this can be as impactive as a full rectum. You may be offered medications or supplements to help.
- Once both your bladder and bowels are empty you must drink 500mls of water (squash can be added). This process approximately lasts for 30 minutes to allow your bladder to fill. If you are well hydrated.
- Before the scan, the CT planning radiographer will confirm the size of your bladder with an ultrasound scan. All information is recorded for your treatment team to follow.
- When you return for your treatment, you will need to arrive 1 hour early to complete your enema and drinking preparation, in time for your appointment.
It is equally as important to have small (empty) bowels and rectum, you should try to empty your bowels naturally before you arrive to your CT planning appointment. DO NOT strain or force. If you require any assistance with emptying your bowels, please let either your doctor or a Planning Radiographer know.
If you are having treatment to your bladder, you will be asked to empty your bladder in preparation for your planning scan. You won’t need to drink the 500mls of water, but you will benefit from being well hydrated.
You may be provided with enemas or laxatives in advance of your appointment, if the doctor is previously aware of any problems.
If you are affected by bowel or rectal gas and often experiencing bloating, please don’t be embarrassed and let the planning team know and they may offer you some dietary advice or supplements to help.
For CT planning we will ask you to have your arms up, resting behind your head, to allow the intended radiation treatment openly to reach your chest. If you are unable to keep your arms up for approximately 15minutes, please let your doctor and the planning radiographers know, so we can either amend the equipment we use or consider a different setup technique. Please bring any pain medication to your appointment.
Radiotherapy immobilisation will vary dependent on the area of your chest your cancer has been located.
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If your tumour is in the upper area of your chest, we may use the shell (from above) to keep your upper body in a fixed and stable position.
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If your tumour is within the middle of your chest, you will be planned with your arms above your head, resting on specific chest immobilisation.
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For those whose tumour has been identified in lower chest region, we may use the abdominal compression belt. This device applies a little pressure across your abdomen to limit the movement of your diaphragm and in turn the reduce the movement of the tumour. In this situation you will be asked to be nil by mouth for 2 hours before the planning appointment.
Chest tumours are often particularly mobile and move in time with your breathing, to enable us to keep a track on the movement we will use specialised software, called RGSC, that monitors your breathing and generates a CT planning scan in tune to with your natural rhythm. On occasions when breathing is too fast or too slow, we may introduce some coaching devices to help.
You may be instructed to follow other specific guidance or have different equipment underneath you. If you have any questions, please do not hesitate to ask when receiving your Pre-assessment chat. If you are uncomfortable at any point extra equipment or techniques can be used to make you comfortable.