Staff in Oxford explain exactly what radiotherapy treatment involves

The new radiotherapy unit at the GWH, which will be operated by the Oxford University Hospitals NHS Foundation Trust, will be a satellite of the Oxford cancer and haematology centre which is based at the Churchill Hospital in Oxford. 

In a bid to encourage more people to support the cause, staff have explained just what patients have to go through on a daily basis.

A cancer diagnosis is a hugely traumatic experience, with the impact on patients' lives being devastating and the strain placed on their loved ones enormous.

For most patients requiring a course of radiotherapy they must first attend a planning appointment, which involves them having a CT scan.

Here, patients are positioned on the scanner in the exact position that they will be in when they have their radiotherapy treatment.

It is essential that the images from the CT scan can be related to the patient’s body to ensure that when they receive the treatment their position can correctly be reproduced. To achieve this level of accuracy, small markers are placed on the patient’s skin.

Once the radiographers have completed the planning scan they will tattoo the position of the markers onto the patient’s skin. The tattoos are very small pin prick sized dots that can be quite difficult to see, unless you know what you are looking for.

Elisabeth Turner, manager for radiotherapy strategic development at Oxford, said: "Depending on the area of the body requiring treatment, it may be necessary for other preparation to be undertaken.

"For instance, patients requiring radiotherapy to the head and neck would normally have an impression made of their head and neck using thermoplastic material."

The thermoplastic impression, known as a shell, helps the patient to maintain the position required for treatment. The shell also allows ‘set up’ marks to be placed on it which aids positioning for treatment and also means that there is no need to put any tattoos on their face or neck.

In the period between the patient’s planning appointment and first treatment appointment, a team consisting of a therapeutic radiographer, clinical oncologists, radiotherapy physicists and dosimetrists produce a treatment plan tailored to the needs of the patient.

As Elisabeth Turner says: “In radiotherapy there is no such thing as a standard plan – all the treatment plans produced are patient specific.”

Elisabeth has worked closely with cancer patients for years, so she knows exactly what they have to go through.

“So many people have had to travel to Oxford from Swindon. The treatment they receive is excellent, but it’s the travelling that’s the problem. It impacts so much on their lives.

“What’s interesting is that patients cope in a variety of ways. It’s a very supportive environment and we try to keep as constant as possible, with patients seeing the same specialists throughout their treatment.”

Initially, there will not be a dedicated radiotherapy CT scanner in the satellite unit at the Great Western Hospital. It will therefore be necessary for all patients to attend the Radiotherapy Department, based in the Cancer Centre at the Churchill Hospital in Oxford, for their initial planning appointment.

Elisabeth added: “One of the things we see a lot is how willing the patients are to discuss their situation with others while waiting for their treatment. It’s like a mini support group in the radiotherapy department.”

Once the treatment plan is complete the patient then starts their course of treatment, which can be anything from a single appointment to 37 separate sessions.

Normally, radiotherapy is delivered on a daily basis for five consecutive days followed by a two day gap. Therefore patients requiring 37 treatments will be attending for a period of almost eight weeks.

Ninety-five per cent of people living in the Swindon area who require radiotherapy treatment will receive it locally in Swindon at the satellite radiotherapy unit. And, what’s more, patients treated in Swindon will receive the same standard of radiotherapy as at the Cancer Centre at the Churchill Hospital in Oxford, which is a centre of excellence for cancer services.

“Travelling can take over an hour each way, and when people come for up to 37 sessions that’s a huge amount of travelling,” said Elisabeth.

“Avoiding this daily will be of enormous benefit for the patient, their family and friends who all provide support during their course of radiotherapy.”

Patients visiting the GWH for radiotherapy will be greeted by the radiographer helpers who cover reception. The satellite unit will be led by therapeutic radiographers who will explain the treatment process, give information regarding potential side effects and their management and answer any queries the patient may have relating to treatment delivery.

Treatment is delivered by therapeutic radiographers using a machine called a linear accelerator. The radiographers position the patient before taking and evaluating x-ray images, including CT images to verify the accuracy of treatment prior to delivering it to the patient.

There is a small team of therapeutic radiographers assigned to each treatment machine and, as far as possible, the team remains constant to give the patients continuity of care.

During the course of treatment patients will have regular routine reviews undertaken by the therapeutic radiographers to ensure that any side effects or concerns they have are addressed.

There is already an information and support radiographer in post at the GWH who is able to support patients prior to them attending their planning appointments to help allay any concerns they may have relating to the radiotherapy process and side effects.

Unfortunately, children will still need to go to Oxford for treatment because they will need to have the support of a big children’s centre.

So far £1,190,834 has been raised for Brighter Futures towards the £2.9m goal. The team is very grateful for every single donation and wish to thank everyone for their support.

To donate you can send in the form published in the Advertiser every Thursday or visit www.brighterfuturesgwh.nhs.uk