ExplainingRadiationTherapyExplaining your cancer

Explaining Radiation Therapy 1

Finding out that you have cancer can be overwhelming. There is a lot to learn and many decisions to make. But there is nothing about your cancer that you won’t be able to understand as long as it’s explained to you. And once you understand what’s going on, you’ll probably feel more comfortable making decisions about what to do next.

This booklet gives you some straightforward information about radiation therapy. If you have any questions that aren’t answered here, speak to your Chris O’Brien Lifehouse care team.

What is radiation therapy?Radiation therapy targets high energy x-rays at cancer cells to damage or destroy them. It is delivered in small doses from a machine, similar to an x-ray machine, called a Linear Accelerator.

Sometimes radiation therapy is used to stop the spread of cancer cells or to get rid of cancer altogether. It can also be used to control symptoms and improve quality of life for people whose cancer cannot be stopped.

Depending on the type of cancer you have, and the state of your health and fitness, radiation therapy might be the only treatment you receive, or it might be used in combination with other treatment such as surgery or chemotherapy.

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What are the side effects of radiation therapy? Radiation therapy is pain-free, but it can have some side effects depending on the area of the body being treated and the type of treatment given.

Radiation therapy is very targeted. You may experience some side effects but they will only be related to the area that has received the radiation. Please refer to our range of radiation patient information booklets, which explain the side effects you may experience depending on the part of your body receiving the radiation.

Most patients get through radiation therapy without any significant side effects, but the experience can vary from patient to patient. Your Chris O’Brien Lifehouse care team can give you some idea of what to expect based on what kind of radiation therapy you’re having and what part of your body is affected by cancer.

If you are feeling any sort of discomfort or irritation during your radiation therapy treatment, speak to your Lifehouse care team. They can talk to you about strategies, products or services that will help relieve the condition.

Who will handle my treatment?The person in charge of your treatment is a doctor known as a Radiation Oncologist. Your Radiation Oncologist has specific training and expertise in the treatment of malignant disease using radiation.

Once the Radiation Oncologist has prescribed the treatment, the radiation therapy is planned and delivered by a team of Radiation Therapists. A Radiation Therapist is an accredited and registered professional who has completed either an undergraduate or post-graduate qualification from university. The Radiation Therapists are responsible for the day-to-day administration of the treatment prescribed by the Radiation Oncologist.

The Radiation Therapists will introduce themselves and ask you to confirm your identity by asking you to state:

• your full name;• date of birth;• address and;• the area on your body that will receive treatment.

This will be repeated when you have your treatment to ensure that the correct treatment is delivered.

How is my treatment planned?Modern radiation therapy techniques can direct radiation at cancer cells very accurately, causing minimal damage to the surrounding healthy tissue. However, it usually requires a lot of time and patience from everyone involved to ensure that the delivery of the radiation is as precise as possible.

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Before you start radiation therapy, your Chris O’Brien Lifehouse care team will plan your treatment. Every radiation therapy treatment is individually planned. Your planning appointment will take around an hour to complete and may involve a variety of X-rays, CT scans and body measurements.

The results of these scans and measurements will be carefully studied by your care team and it may take as many as two weeks for your individual radiation therapy plan to be finalised. It is possible that you will be recalled for some additional scans and measurements, either before or during treatment, to make sure that you are getting the best possible treatment for your situation.

Immobilisation devices Depending on where your cancer is located it may be necessary to use a frame or some other piece of equipment to hold a part of your body still during treatment. This is called an immobilisation device.

Skin markings After your scanning and measurements are completed, your Radiation Therapists will make some markings on your skin. Some of these markings will be in the form of a discrete permanent tattoo dot, similar to a small freckle. Once you start your treatment, you can wash the skin in the marked area with tepid water and a mild soap, but don’t scrub as this can irritate. After bathing, gently pat the skin dry with a soft towel.

If you have any questions about planning procedures, immobilisation devices, skin markings or any other part of your radiation therapy treatment including possible side effects, just talk to your Chris O’Brien Lifehouse care team.

What will treatment be like?Each treatment session you have will begin with a procedure called “set-up”. During the set-up, your Radiation Therapists will help you to lie down on a treatment couch in the same position that you were in during your planning session. Your Radiation Therapist will then move the couch and the machinery around you. Once you are in position, it’s important that you focus on keeping perfectly still and maintaining normal breathing.

Your Radiation Therapists will move machinery into position so that the radiation beam is aligned precisely to the targeted area of your body. When everything is in place, the Radiation Therapists will leave the room so that the machine can be turned on and treatment can begin.

Set-up can take up to 20 minutes but treatment may only last a minute or two. Some linear accelerator machines, which are the machines that administer the external beam radiation, can be a bit noisy, but you will not feel or see anything.

During treatment, you will be in the room on your own, but you will be closely observed via a closed circuit television system and an audio connection. Your Radiation Therapist can communicate with you if necessary and the machine can be stopped at any time.

As soon as the radiation has been switched off, your Radiation Therapists will come back into the room to help you off the treatment couch. It is important that you do not move until the Radiation Therapist tells you it is OK to do so.

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At the end of the session, confirm the date and time of your next appointment. It helps to write it down in a diary, or type it into a smartphone or other digital device.

Your doctor will see you once each week during the course of your treatment. This is a great time to raise any questions or concerns you have about your treatment. But you don’t have to wait until your doctor’s appointment to have a question answered. If you need information or support at any time, just speak to someone in your Chris O’Brien Lifehouse care team.

Things to do during radiation therapy treatmentCertain habits and behaviours can make you feel more comfortable during treatment. These include:

• wearing loose-fitting, comfortable clothes over the treatment area.

• avoiding direct sun exposure on skin in the treatment area.• avoiding direct exposure to heat on skin in the treatment area.• eating well and drinking plenty of fluids to avoid dehydration.• resting more than usual.• being open with your Radiation Therapists about all medications

you are currently using.• asking questions whenever they come up.

More detailed information specific to your needs will be given once you have attended your treatment planning session.

Things to avoid during radiation therapy treatmentYou will have a more comfortable experience during treatment if you remember to avoid the following:

• do not scrub the treatment area.• do not use powders, perfumes, soap or deodorant in the

treatment area, unless otherwise advised.

If you have any questions that aren’t answered in this publication, or if you want to know more about your cancer and your radiation therapy treatment, speak to someone in your Chris O’Brien Lifehouse care team.

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What support is available?At Chris O’Brien Lifehouse, we believe that the best way to support people with cancer is to place them at the centre of a group of passionate and committed carers.

Your Chris O’Brien Lifehouse care team will include clinicians such as Radiation Oncologists, Radiation Therapists, pathologists and specialist nurses who have expertise in caring for people having radiation therapy treatment for cancer. It will also include healthcare professionals such as dieticians, occupational therapists and counsellors who know how to support you physically, mentally and emotionally.

Nursing care team Specialist nurses with experience in radiation therapy treatment will give you care, support and reassurance. They will help with treatment sessions, administer medications, dress wounds and generally care for your physical health, as necessary. They also have a great depth of knowledge to share, and will be happy to answer your questions and help you understand your treatment better. The nurses are available from 8am to 5:30 pm, Monday to Friday. Nurses can put you in touch with Community Care teams and Palliative Care teams if support is needed after treatment. There are also Nursing Care Co-ordinators responsible for Head and Neck, Gynaecological, Melanoma and Breast Cancer patients. The nursing care team contact number is 02 8514 0504.

Dietitian Nutrition is an important aspect of your treatment, and people who are well nourished tend to cope better with radiation therapy. Our Chris O’Brien Lifehouse dietitian comes from a science background and can provide you with expert advice on food, nutrition and weight levels during your treatment.

Some people who have radiation therapy treatment experience side effects including nausea, loss of appetite, weight loss, diarrhoea and difficulties with swallowing. Our dietitian can help you make the right food choices for your particular needs. You may be eligible for subsidised sessions with our dietitian and exercise physiologist under a GP management plan. To be eligible, your GP will need to fill out a referral form as part of this process. Head and neck cancer patients will receive a dietetic review as part of their standard clinical care. The contact number for the dietician is 02 8514 0038.

Social worker Radiation therapy treatment places big demands on your body. It also puts a strain on your heart and mind and can put considerable pressure on your relationships. Some people find it helps to talk to a social worker about these feelings. Chris O’Brien Lifehouse social workers can help you and your family manage and understand your treatment and put you in touch with other health professionals and services that may be of assistance. Social workers can help you with very practical issues, too, including accommodation, transport and finance. They can also help you prepare for the time when treatment finishes, putting you in touch with community-based care and support services. Chris O’Brien Lifehouse social workers adhere to a strict rule of confidentiality in dealings with patients and their families. The service is free of charge. Social Worker contact number is 02 8514 0473.

Speech pathologist Sometimes, people who have radiation therapy treatment in the head and neck area start having difficulty swallowing, or suffer from a chronically dry mouth, or experience voice changes. Speech pathologists are trained in the assessment and management of swallowing, speech, voice and communication issues. They can give you advice, suggest simple strategies and inform you about any products that may help relieve the condition.

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To get in touch with a speech pathologist through the Royal Prince Alfred Hospital, call 02 9515 9845.

Occupational therapist Cancer and radiation therapy treatment can have big physical impacts. You may find that you are much weaker than you used to be, or that you have less energy, or that you are experiencing pain. Occupational therapists can help you identify those changes and develop strategies to overcome them so you can continue to carry out the everyday tasks that matter to you. That might include modifying your home or moving to a different kind of residence, buying or hiring useful equipment, simplifying physical tasks, managing stress and learning relaxation techniques. Occupational therapists can also help you access wigs and turbans if you are worried about hair loss, and can give you information and support around the management of lymphoedema. To get in touch with an occupational therapist through the Royal Prince Alfred Hospital, call 02 9515 9925.

Palliative care team Palliative care is all about supporting you to have the best possible quality of life while you deal with your cancer. It’s available to anyone who is not responding to cancer treatment. The palliative care team can support you to manage your symptoms and keep pain under control. They can also put you in touch with community-based support if necessary. To get in touch with the palliative care team through Royal Prince Alfred Hospital, call 02 9515 7755.

Chaplains Treatment for cancer can be an emotional challenge as well as a physical one. Some people find comfort in spirituality. The chaplains provide support to anyone who needs it, including you and your family. The chaplains represent denominations including the Anglican Church (Church of England), the Catholic Church,

the Salvation Army and the Uniting Church. Representatives from other faiths also visit Chris O’Brien Lifehouse on request. To get in touch with a chaplain or other spiritual leader, please ask your Chris O’Brien Lifehouse care team.

Pharmacy is located on Level 1 of the main Chris O’Brien Lifehouse building opposite the Day Therapy reception. It is open from 8.30am until 5.00pm each weekday and from 9.00am until 12.00pm on Saturdays. The pharmacy keeps a limited range of over-the-counter medicines for the management of common ailments and cancer treatment side effects. It can dispense prescriptions for patients of Lifehouse, including Radiation Oncology patients, and has experienced staff on hand to provide advice and medicines-related information. You can contact the pharmacy during normal working hours by telephoning 02 8514 0015 or visit the pharmacy team in-person.

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If you need assistance to manage the symptoms and side effects of your treatment, the LivingRoom team is here to help. The LivingRoom is a purpose-built centre for supportive services, education and treatments that can be used in partnership with clinical care to help relieve stress, reduce pain and anxiety and manage side-effects of treatment.

The LivingRoom provides the best possible support by offering integrative medicine as part of the overall package of cancer care and by guiding patients towards treatments with evidence-based benefits, overseen by practitioners with specific experience in treating cancer patients. Therapies include:

• massage • meditation • pilates • qigong • yoga

Side-effect of treatment LivingRoom service/s that may be of benefit

FatigueDietitian, Counselling, Exercise Physiology, Acupuncture, Massage

Depression/Anxiety Counselling, Exercise, Massage , Meditation

Loss of flexibility Massage, Exercise Physiology, Yoga

Pain Massage, Reflexology, Acupuncture, Exercise Physiology

Weight Loss Dietitian, Exercise Physiology

To find out more about complementary therapies that might assist you manage your symptoms and side effects, contact the LivingRoom team on 02 8514 0038 or email: livingroom@lh.org.au.

• acupuncture • counselling• reflexology • nutrition/ dietitian • exercise physiology programs

Managing symptoms and side effects

When are appointments held? The Radiation Therapists looking after your treatment will do their best to make your appointments at times that suit you. Please bear in mind, however, that this is not always possible.

In general, appointments are available between 8:00am and 5:15pm. There are no appointments available on weekends and public holidays.

The linear accelerators are serviced one day a month to maintain the quality and accuracy of their work. No appointments are available on the day a machine is serviced.

Please try to avoid missing any appointments. If you are unable to come to one of your appointments, for example, if your radiation therapy appointment clashes with another appointment, please let your Radiation Therapists know as soon as possible.

If you need to contact your Radiation Therapists about appointments, please use the numbers below:

Treatment room 1 Taronga Zoo 02 8514 0498Treatment room 2 Blue Mountains 02 8514 0509Treatment room 3 Harbour Bridge 02 8514 0508Treatment room 4 Opera House 02 8514 0507Treatment room 5 Botanic Gardens 02 8514 0515Treatment room 6 Bondi Beach 02 8514 0516Treatment room 7 Darling Harbour 02 8514 0518

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Where will my appointment be? Your radiation therapy treatment will take place in the Radiation Oncology Department, adjacent to the main Chris O’Brien Lifehouse building. Please refer to the map on page 16 to find out where you go.

When you arrive for your first treatment session, check in at the main reception desk in the Radiation Oncology Department. The staff there will let your Chris O’Brien Lifehouse care team know that you have arrived. They will also tell you the best place to sit until a member of your care team comes to collect you for treatment.

MIS

SEN

DEN

RD

Chris O'Brien Lifehouse

main building

ENTRANCE

Chris O'Brien Lifehouse Radiation Oncology Department

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How do I get to Chris O’Brien Lifehouse? Chris O’Brien Lifehouse is located across the road from the Royal Prince Alfred Hospital on Missenden Road, Camperdown, just three kilometres from the Sydney CBD. Chris O’Brien Lifehouse is easy to get to on foot, by car or on public transport.

Travelling by carChris O’Brien Lifehouse is located on Missenden Road, between Parramatta Road, Camperdown, and King Street, Newtown.

Free parking is available for radiation therapy patients for the duration of their appointment only. You will still need to drive through the boom gates and collect a ticket but this can be validated at the main reception desk in the Radiation Oncology Department after your appointment. Don’t forget to get your ticket validated as this will ensure you don’t need to pay for your parking. You will also need to get a parking permit from the Radiation Oncology main reception, which will be organised during your planning appointment. It’s really important you display your parking permit on the dashboard of your car where it is clearly visible, otherwise you may be fined. Other parking options, which will require you to pay, include:

• Chris O’Brien Lifehouse parking station, entry via Susan Street.• King George V parking station, entry via Missenden Road.• RPA Medical Centre parking station, entry via Carillon

Avenue.• You can also look for metered or un-metered parking in

surrounding residential streets but remember that these may have time restrictions.

If you’re travelling by taxi, you will find a taxi rank located outside Royal Prince Alfred Hospital near McCafe or one can be ordered for you at Radiation Oncology reception.

Travelling by trainIf you live on a train line, you might prefer to come to Chris O’Brien Lifehouse by train. The nearest station is Newtown Station.

• Newtown Station is located on King Street, Newtown and is serviced by the Inner West Line and the South Line. The station has lift access direct to the platform. If you get out at Newtown Station, you can take the one kilometre walk down King Street and Missenden Road to Chris O’Brien Lifehouse. To make the walk shorter, you could cross the road and catch the 422, 423, 426 or 428 buses as far as Missenden Road.

Travelling by busIt’s easy to get to Chris O’Brien Lifehouse using public buses. For detailed information about timetables, fares and bus stop locations, go to www.sydneybuses.info or call 131 500.

Bus route 412 stops outside the main entrance of Royal Prince Alfred, directly opposite Chris O’Brien Lifehouse. The 412 starts at King Street Wharf and travels down George Street and Parramatta Road before turning into Missenden Road where Chris O’Brien Lifehouse is located. It then travels on through the suburbs of Camperdown, Petersham, Marrickville, Dulwich Hill, Earlwood and Clemton Park before finishing its run at Campsie Station.

Bus routes 436, 438, 439 and 440 run from Circular Quay along George Street and Parramatta Road before travelling on to Chiswick, Abbostford, Mortlake and Rozelle respectively. If you get off at the corner of Parramatta Road and Missenden Road, you will have a

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short walk of just a few hundred metres up Missenden Road to the front door of Chris O’Brien Lifehouse.

Bus routes 422, 423, 426 and 428 run from Circular Quay along Castlereagh Street and then through Railway Square and City Road to King Street, Newtown before travelling on to Kogarah, Kingsgrove, Dulwich Hill and Canterbury respectively. Hop off at the corner of King Street and Missenden Road, you will have a short walk of just a few hundred metres up Missenden Road to Chris O’Brien Lifehouse.

Need help getting here? If you think that you may not be able to attend a radiation therapy session because of transport difficulties, please speak to your Chris O’Brien Lifehouse care team. They may be able to help you with alternative arrangements.

Need somewhere to stay?If you live outside Sydney and you need to stay somewhere overnight to attend a treatment session at Chris O’Brien Lifehouse, your Chris O’Brien Lifehouse care team can help you find suitable accommodation.

If you live more than 100km from Chris O’Brien Lifehouse, you may be able to claim travel and accommodation costs through a government assistance program called the Isolated Patients Travel Accommodation Assistance Scheme (IPTAAS). Speak to your Chris O’Brien Lifehouse care team if you would like to know more.

Notes

www.mylifehouse.org.au