Behind every illness there is a person with their own unique medical history. Selecting the most suitable type of radiotherapy is therefore a highly personalised process. Here is a broad overview of the various treatments.
Once the patient has decided to go ahead with radiotherapy, they must be prepared for the treatment. The institute’s modern radiotherapy equipment ensures treatment with millimetre accuracy. What’s more, the amount of radiation applied to the designated body part can also be exactly calculated to within 1-2%. The art of radiotherapy lies in providing the necessary dose exactly where the tumour cells are (still) present and to avoid damaging those areas which are not affected by the cancer. It is also vital that each radiotherapy treatment be carried out under exactly the same conditions.
Once the patient is registered for radiotherapy by the attending doctor, they will receive an appointment for an initial consultation (either by post or telephone). On the day of the appointment, the patient must register at reception and will then be personally collected from the Hirslanden clinic waiting room by the attending doctor. It is advisable to bring along a family member, partner or friend to the initial consultation if possible.
During each radiotherapy session, the patient must assume the same position on the radiotherapy table to ensure the radiation is always applied under exactly the same conditions.
Assessing the present situation
In order to provide the correct treatment, the radio-oncologist must first precisely assess the current situation. Additional examinations may be required before the commencement of the radiotherapy treatment. It is also important to know whether the patient suffers from other illnesses which may influence the radiotherapy. In any case, the examining doctor will discuss all the details with the patient and explain any additional procedures that might be necessary. The examining doctor should also be informed of any medication currently being taken by the patient, as well as any other treatment the patient is undergoing.
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Individual positioning aid
To ensure the same position, an individual positioning aid is used at the very start of the therapy. This is generally a mattress that adapts to the form of the patient’s body thanks to a vacuum, so that an impression can be made. The lying position on the mattress is determined by the position required for the radiotherapy and, above all, what is most comfortable for the patient. The procedure is as follows: The mattress adapts to the shape of the body. A vacuum is applied to the mattress so that it becomes hard and retains an impression of the body. The patient always lies in this specially formed mould when receiving their daily radiotherapy treatment. This guarantees that their body is always in the same position during each round of therapy.
Calculation of the radiation plan
With the help of this mould, a (CT) scan is then performed on the area which will subsequently receive the computed tomography treatment. This CT scan makes it possible to accurately plan the radiotherapy. On each of the various CT images, the doctor indicates which regions are to be treated with radiotherapy, as well as which areas are to receive the lowest possible dosage. Using this information, the physicist and his team can then exactly calculate the radiation plan. The area to be treated is generally divided into several fields. The linear accelerator is set up so that it directs the radiotherapy at the tumour region from several different directions. In the radiation plan, the size of the fields and the position of the shields are calculated according to the specifications of the tumour’.
Once the preparatory work is finished, the routine therapy phase begins. Depending on the therapy concept and objective, the radiotherapy treatment is carried out between 10 and 40 times. Generally, one treatment per day is carried out on workdays from Monday to Friday. It is possible, however, that treatment is not carried out every day, or it may even be performed twice a day.
The first session
The first session is more time-consuming than the subsequent treatment, as all the details must once again be thoroughly checked. When the patient is lying on their individual positioning aid, the specially trained radiology assistants (MTRAs) and the physicist check the accuracy of the equipment settings. The physicist will only give the go-ahead once everything has been correctly adjusted. Thanks to the very latest systems used in the Hirslanden clinics, the patient can be sure that they will be treated with millimetre precision.
The various fields are then adjusted. During the first radiotherapy treatment another control image is taken for comparison with the image from which the calculations were made. Once again, the treatment will only be carried out once everything corresponds precisely. As a result of all these checks and controls, the initial treatment takes somewhat longer. Normally, this first session takes between 20 and 30 minutes.
Organising further appointments
After the first treatment, the following treatment program will be discussed with a member of the MTRA team and appointments will be made for the subsequent sessions. From the second treatment onwards, the sessions will follow a set routine. But here too, we are uncompromising in terms of quality. So before each radiotherapy treatment, the correct positioning will be checked and treatment will only begin once everything is absolutely perfect. From the second treatment onwards, treatment will only take around 15 minutes per day.
Should the patient have any questions, or if they experience any symptoms, the attending doctor will be happy to discuss these with them. Patients should contact the MTRAs or reception staff, who will immediately call the attending doctor. The doctor will then take time to discuss personally any concerns the patient may have.
Our radiotherapy centres are among the few radiotherapy institutes in Europe that offer the entire range of radiotherapy treatments.
- Stereotactic radiotherapy (image-guided, external radiation using the CyberKnife)
- Percutaneous radiotherapy (external radiation with a linear accelerator)
- Brachytherapy (internal radiotherapy involving the positioning of radioactive sources within the tumour)
- Intraoperative radiation therapy (IntraBeam)