This information will help you prepare for radiation therapy to your head and neck. There are additional steps that need to be taken before we start radiation therapy.
Read this resource before starting radiation therapy. Use it to get ready in the days before your treatments. Bring it to your simulation appointment and all future visits with your radiation oncologist. You and your care team will use it throughout your treatment.
Table of Contents
Dental Oncology Evaluation
Before starting radiation therapy, you will have a pre-evaluation with a dental oncologist. This specialist will check your teeth, gums, and mouth. They look for any problems that might get worse with radiation. They may take X-rays and make a plan to protect your oral health. This might include fixing cavities, removing unhealthy teeth, and giving you tips on how to keep your mouth clean. The goal is to prevent infections and other issues during your cancer treatment. Taking care of your mouth is very important for your overall health and comfort.
Additionally, you might need a dental tray. This tray is made to protect your teeth and gums. The dental oncologist will make a mold of your teeth. They use this mold to create a tray that fits your mouth perfectly. You might need to wear the tray during treatments. It can hold fluoride gel to keep your teeth strong and prevent decay. Wearing the dental tray helps keep your mouth healthy and comfortable during radiation therapy. This is an important step to ensure your teeth stay protected throughout your treatment.
Additional Imaging - MRI and/or PET/CT
Sometimes, doctors need extra imaging like MRI and/or PET/CT scans for radiation planning. These scans give detailed pictures of your head and neck. MRI scans show soft tissues and help doctors see the exact size and shape of the tumor. PET scans show how active the cancer cells are and where the cancer may have spread. Both scans help doctors target the radiation more precisely. This means they can better focus on the cancer while protecting healthy tissues. Getting these scans helps make your treatment as effective and safe as possible.
Nutrition Evaluation
Before starting radiation therapy, you will have a nutrition evaluation. A nutritionist will check your diet and eating habits. They want to make sure you are getting enough nutrients to stay strong during treatment. Radiation can make it hard to eat, so the nutritionist will give you tips on what foods are best. They might suggest high-calorie and high-protein foods to keep your energy up. They can also help with meal planning and finding foods that are easier to swallow. Good nutrition is important for your healing and overall health during cancer treatment.
Also, we may recommend G-tube placement depending on your nutritional status and potential difficulty with eating and drinking.
CT Simulation Scan
A CT simulation scan is an important step before starting radiation therapy. These images are required for radiation treatment planning. We cannot use your prior diagnostic CT, MRI, or PET to perform treatment planning. You need to lay very still during your scan. If you are anxious, you can ask your doctor for anti-anxiety medication during the scan and for each radiation treatment. If you are in pain, take your “as needed” pain medication 30 minutes before your scan. If you need medication, ask your doctor. No tattoos or marks will be made on your skin.
1. Getting ready.
- You will lie on a flat-top carbon fiber table.
- Bring your custom dental tray for your radiation treatment.
- Wear comfortable clothing.
2. Forming custom mask.
- A radiation therapist will use a mesh like plastic to create a custom mask that will keep your head still and shoulders down.
- The mask will feel warm and wet.
- If there is any pain or discomfort, let your therapist know and they can modify the mask and cut out openings for eyes and nose.
3. During the CT Scan.
- The CT machine will take detailed pictures of your head and neck.
- You need to lie very still while the machine works.
- We may use IV contrast during the scan to help with radiation planning.
- The scan itself is painless and usually takes about 2-3 minutes.
Treatment Planning
Radiation treatment planning is a detailed process that happens before you start radiation therapy. Your prior diagnostic CT, MRI, and/or PET/CT will be fused to this CT simulation scan. Here’s what you need to know about it:
1. Gathering Information
- Your medical team collects information from CT scans, MRI scans, and sometimes PET scans. These scans give detailed pictures of your tumor and surrounding tissues.
2. Creating a Treatment Plan
- Radiation oncologists use specialized computer programs to draw the target. Dosimetrists and Physicists will then take the target and plan your treatment.
- It may take up to 10 business days to plan your treatment depending on the complexity of the plan.
3. Review and Approval
- Your radiation oncologist reviews the treatment plan to ensure it’s accurate and safe.
6. Preparing for Treatment
- Before starting radiation therapy, the plan will be checked on the treatment machine using a phantom. This will ensure the planned dose is delivered correctly.
Radiation treatment planning is crucial for successful therapy. It ensures that you receive the best possible care while targeting the cancer effectively. Your medical team will guide you through each step to make sure you are prepared and comfortable during your treatment journe