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Planning external radiotherapy

The radiotherapy team plans 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

Before the scan

Before the scan you might need to empty your bowels and bladder.  Your radiographer might give you an enema to help you empty your bowels. You might need to drink a certain amount of water before you have the scan. They will tell you how much.

You put on a hospital gown. When you’re ready the radiographers help you into position on the scan couch. They tell you what is going to happen. You might have a type of firm cushion called a vacbag to help you keep still.

The CT scanner couch is the same type of bed that you lie on for your treatment sessions. You need to lie very still. Tell the radiographers if you aren't comfortable.

During the scan

Once you're in position the radiographers put some markers on your skin. They move the couch up and through the scanner. They then leave the room and the scan starts.

The scan takes about 5 minutes. You won't feel anything. The radiographers can see you from the CT control area where they operate the scanner. 

Injection of dye

You might need an injection of contrast into a vein in your hand. This is a dye that helps body tissues show up more clearly on the scan.

Before you have the contrast medium, the radiographer asks you about any medical conditions or allergies. Some people are allergic to the dye.

After the scan

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. 

The radiographers will then help you off the CT scanner couch and you can get changed back into your clothes. You stay in the department for about 15 to 30 minutes if you had an injection of the dye. This is in case it makes you feel unwell, which is rare.

You should be able to go home or back to work. You can eat and drink normally.

Possible risks

A CT scan is safe for most people but there are some possible risks. Your doctor and radiographer make sure the benefits of having the scan outweigh these risks.

Allergic reaction

Rarely, people have an allergic reaction to the contrast medium. This most often starts with weakness, sweating and difficulty breathing. Tell your radiographer immediately if you feel unwell so they can give you medicine.

Contrast medium

There is a risk that the contrast medium will leak outside the vein. This can cause swelling and pain in your arm but it’s rare.

Radiation

Exposure to radiation during a CT scan can slightly increase your risk of developing cancer in the future. Talk to your doctor if this worries you.

Pregnancy

Pregnant women should only have CT scans in emergencies. Contact the department as soon as you can before the scan if you are pregnant or think that you might be.

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: 
17 May 2018
  • External Beam Therapy (Radiotherapy in Practice)
    P Hoskin
    Oxford University Press, 2012

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