When you schedule your initial appointment with us, 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 our physician at your first visit. In most cases, we already have the necessary records sent from your other doctors, and we may not need to ask for your help. If you're not sure, it's always a good idea to bring in any information you think would be helpful. When you first arrive at our office, our staff will help you in completing the necessary paperwork and answering your insurance related questions. It's normal to feel nervous or anxious before the first visit. But we're here to help guide you through this process.

You will meet with the physician and medical staff to begin discussing your treatment plan. We’ll go over the process of treatment and the potential outcomes that can be expected. We’ll review how your medical history, family history, and current state of health influences the planning of your treatment, and take time to answer any questions that you may have. We encourage you to ask any questions that you have, to ensure that you have all of the information you need. Once we go over the treatment strategy, the next step will be a set-up appointment, or a "simulation". This visit will involve creating molds to keep you comfortable and accurately positioned, and scans to map out your anatomy. Our team will work to create and design a personalized radiation treatment plan on our treatment system using state-of-the-art software and modern guidelines. Once the plan is ready, the next appointment will be to start your radiation treatments.

Radiation therapy involves using controlled, high-energy radiation, and is used to treat many types of cancers. This can be done in a few different ways, depending on the nature of your cancer. The most commonly used method is called external beam therapy (from a machine outside the body), which directs radiation at your tumor. Some types of cancer may require a technique of radiation therapy which is internal or direct, known as brachytherapy, either by itself or in combination with external radiation. Radiation therapy has been used safely and effectively for treating cancer for many decades. This therapy involves using various forms of radiation to damage the genetic material inside cancer cells which limits their ability to successfully reproduce. Once these damaged cancer cells die, they are naturally eliminated from the body. Although radiation therapy affects both cancer and normal cells, it has a much greater effect on the cancer cells as cancer cells are unable to repair themselves the way normal, healthy cells can. Our physicians carefully develop a treatment plan to ensure the radiation is precisely delivered to the tumor area and to protect as much of the surrounding, normal tissue as possible.

Although the radiation affects both cancer and normal cells, it has a greater effect on the cancer cells. Treatment aimed at cure will give the highest possible dose of radiation to the cancer area (within safe limits) to attempt to kill all the cancer cells. Sometimes smaller doses are used, where the aim is to reduce the size of a tumor and/or relieve symptoms. Depending upon your situation, your doctor may recommend using radiation cancer therapy in several different ways. When the end goal is to cure cancer, radiation therapy may be used to: • Destroy tumors which have not yet spread to other parts of the body. • Reduce the probability that cancer will come back once you’ve undergone surgery or chemotherapy by killing small amounts of cancer that might remain. • Shrink the tumor before undergoing surgery. In some cases, the goal is to reduce the symptoms caused by growing tumors and to improve your quality of life. This type of radiation therapy is called palliative care or palliation. In this type of case, cancer radiation therapy may be used to: • Decrease the size of tumors that are lowering your life quality such a tumor in the lung that is causing breathing difficulties. • Relieve pain by reducing the size of a tumor. • Prevent cancer from weakening a bone and causing pain or a fracture. During your first visit with us, your doctor will speak with you about your treatment so that you have a good understanding of your treatment goals and what to expect while spending time with us.

Every course of radiation therapy is designed to suit the particular needs of the person receiving it, so you will usually be asked to make a preliminary visit to the treatment center to have your course of treatment planned. The radiation oncologist and radiation therapists will do this (in conjunction with x-rays and scans, using a machine called a simulator). Your skin will be marked with coloured pens to define where you will have your treatment. In addition, some minute permanent marks will be made using a special dye and a tiny pin prick. These marks will enable the radiation therapists to identify exactly the right area at every treatment session. If a head mask has been made for you, the guidance marks may be put on the shell rather than on your skin. If you are having radiation therapy to your mouth and/or throat you will need a dental assessment at this stage as you may require some dental treatment before you start your radiation therapy.

Radiation therapy, when delivered externally, is given using a highly specialized machine called a linear accelerator. To receive the radiation therapy, you will lie on a table under the machine, and be asked to remain still during the actual treatment. Modern technology has enabled us to use these specialized treatment machines to deliver extremely precise and accurate treatments to the specific areas we need to target, while reducing the collateral radiation to the other organs that we need to protect.

Your radiation oncologist will tell you this once the appropriate treatment for you has been decided. Every radiation treatment course is personal and individualized. A course of treatment can last anywhere from a single treatment, to five treatments a week for several weeks, and depends on a number of factors, such as the type and extent of the cancer, the part of your body being treated, and the goals of the treatment. Most treatments are carried out daily between Monday and Friday. Every treatment recommendation is personal and individualized, and always follows the most up-to-date guidelines based on the latest research. The length of each session is variable, but advanced technology has enabled us to deliver treatments faster than ever before. Usually, the entire session will last for approximately 15 minutes or so for each site, but can be a bit shorter or longer at times. In some cases, however, such as brachytherapy, treatments may be less frequent but also much longer per session.

No. The treatment is completely painless. Radiation cannot be seen or felt while it is being given. In fact, one of the most commom uses of radiation is to help alleviate certain types of pain that is caused by cancer. However, in some situations there could be discomfort or pain from the body's reaction to radiation. Your doctor will go over what you can expect during treatment and thoroughly explain the details of treatment. If brachytherapy is used, there may be discomfort during the process of implanting the devices, but the actual radiation treatment portion of treatment is painless.

This will depend on many factors such as the area that is being treated, the dose of radiation, and if chemotherapy is used simultaneously. Everyone is different, and every situation is different, so your doctor will personally go over specific details on what types of effects you are most likely to experience.

Once you have completed your course of treatment, we will usually ask you to come back in approximately 4 weeks so that the physician can check on your progress and talk to you about any future follow ups or treatments that might be required.