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Planning radiotherapy

Find out what happens at your planning appointment for external radiotherapy for early oesophageal cancer.

Planning your treatment

The radiotherapy team plan your external beam radiotherapy before you start treatment. This means working out the dose of radiotherapy you need and exactly where you need it.

Your planning appointment takes from 15 minutes to 2 hours.

You usually have a planning CT scan in the radiotherapy department.

The scan shows the cancer and the area around it. You might have other types of scans or x-rays to help your treatment team plan your radiotherapy. The plan they create is just for you.

Photo of a CT scanner

Ink and tattoo marks

The radiographers make pin point sized tattoo marks on your skin. They use these marks to line you up into the same position every day. The tattoos make sure they treat exactly the same area for all of your treatments. They may also draw marks around the tattoos with a permanent ink pen, so that they are clear to see when the lights are low.

Radiotherapy tattoo marks
Radiotherapy treatment area marks.

The radiotherapy staff tell you how to look after the markings. The pen marks might start to rub off in time, but the tattoos won’t. Tell your radiographer if that happens. Don't try to redraw them yourself. 

Radiotherapy mould (shell)

Your treatment team might make a mould (shell) for you.

You wear it during the treatment sessions to keep you very still. The radiographers may also make marks on it. They use the marks to line up the radiotherapy machine for each treatment.

The process of making the shell can vary slightly between hospitals. It usually takes around 30 minutes.

Before making the shell

You need to wear clothes that you can easily take off from your neck and chest. You also need to take off any jewellery from that area.

Facial hair, long hair or dreadlocks can make it difficult to mould the shell. The radiotherapy staff will tell you if you need to shave or to tie your hair back.

Making the shell

A technician uses a special kind of plastic that they heat in warm water. This makes it soft and pliable. They put the plastic on to your face, neck and chest so that it moulds exactly. 

After a few minutes the plastic gets hard. The technician takes the shell off and it is ready to use.

Radiotherapy mask

After your planning session

It can take a few days or up to 3 weeks before you start treatment.

Your radiographers and doctors create your radiotherapy plan. They make sure that the area of the cancer will receive a high dose and nearby areas receive a low dose. This reduces the side effects you might get during and after treatment. 

Last reviewed: 
05 May 2016
  • Guidelines for the management of oesophageal and gastric cancer. British Society of Gastroenterology (BSG), 2011.

  • Management of oesophageal and gastric cancer. Scottish Intercollegiate Guidelines Network (SIGN), June 2006.

  • National Oesophago Gastric Cancer Audits. NHS Information Centre. Annual Reports 2010, 2012 and 2013.

  • Oesophageal cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow up. M Stahl, C Mariette, K Haustermans and others. Annals of Oncology. 2013. 24 (supplement 6) vi51-vi56.

  • Preoperative radiotherapy for oesophageal carcinoma. Cochrane Review. SJ Arnott, W Duncan, M Gignoux and others. In: The Cochrane Library, Issue 4, 2005.

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