Head and neck cancer
Before treatment

Welcome to Cancer Care Services at the Royal Brisbane and Women’s Hospital.

You are here today to begin your journey through radiation therapy to the head and neck region.

A radiation therapist will come greet you in the waiting area and bring you through to one of
our radiation planning rooms.

Your radiation planning session is a critical component of your radiation treatment.

You will be required to remove the following before your CT scan – any jewelry from your head
and neck, dentures or plates, clothing from your upper body. And if you have a beard, we do require you have it trimmed right back.

The staff will start with you in a sitting position on the CT bed. We use a laser system to ensure you are straight and level when lying down.

Do your best to remain as relaxed as possible during the simulation process. When you are tense and stressed, you will hold your body in a much different position to when you are relaxed.

It is important to make sure we can position you exactly the same each day for treatment as you were in your planning session. We move you around until we get the ideal treatment position. Do your best to allow us to do these movements for you.

In most circumstances, we will create a personalized mold for you called a Vac bag. It is a beanbag that we mold to cast a defined impression of your head, neck, and shoulders. We mold the bag around you, then remove all the air, which will lock your shape into the bag.

This is not required for all head and neck treatments.

Your radiation oncologist may be required to come in and mark on your important areas of interest for your treatment using non-permanent pen. This may include marking a scar creating a wax structure or mouthpiece to open your mouth.

We may also need to tape wire onto your skin’s surface so that we can see the oncologist markings on your CT scan.

In the next step, we make a mask.

It starts out as a flat piece of plastic material. We heat it in hot water so that it can be molded. It has a hole for your nose and perforations throughout so you can breathe easily.

When the mask touches your skin, it will be soft, warm, and slightly wet. It will form a perfect cast of your head, neck, and shoulders. Its purpose is to support you and keep you in the exact same position for treatment.

We will cool the mask using ice packs, then place marks onto the mask so that we can set you up in the same position for treatment.

We will then move you into the CT scanner.

It is important to stay as relaxed and still as possible, and, of course, breathe normally throughout the scan. It only takes a few minutes.

Once the scan is finished, we will return to the room, remove you from the CT scanner, and record on paper and with photos all the aspects of your planning session.

At the end of your planning session, a radiation therapist will walk you back to the waiting area to book in your first treatment appointment.

You will leave today with your first appointment date and time on your appointment card, which you need to bring with you each day.

For further information regarding your treatment, please refer to other videos in this education series. Or feel free to speak with any
member of cancer care team.

Welcome to Cancer Care Services at the Royal Brisbane and Women’s Hospital.

You are here today to begin your course of radiation therapy to the head and neck region.

You will be treated on one our five treatment units. This is predetermined by your radiation oncologist depending on your individual clinical circumstances.

You will likely be treated in the same room each day while on treatment. However, you may be treated in the other identical treatment rooms from time to time.

Once our treatment room is ready, we will guide you into the room.

Each day we are required to ask you your full name, date of birth, and the area of your body you are having treated.

We have music playing in the room. But if you prefer no music or your own music played, please let us know.

We start by sitting you on the treatment couch and then carefully lay you down.

The radiation therapists will now reproduce your position from your simulation session. Do your best to remain as relaxed as possible during the treatment process. When you are tense and stressed, you may hold your body in a different position to when you are relaxed.

We will then secure your mask in place.

As we raise the treatment couch, we dim our lights and use lasers to reproduce your position.

Our adjustments to your position are very small. Do your best not to help and allow us to perform movements for you unless asked.

If it feels too tight or uncomfortable in any areas, let the team know.

Once happy with your position, we will advise you that we will exit the room. This will also be signified by an audible indicator.

[AUDIBLE INDICATOR SOUND]

It is your job to remain as relaxed and still as possible, as any movements you make will require us to restart your setup.

You may be in the room by yourself for up to 15 minutes daily, but this will vary from day-to-day depending on many factors.

From outside the room, we take a series of images that we use to accurately target your treatment site. We may re-enter the room to adjust your position physically or by moving the bed from outside.

We are now ready to commence your radiation treatment.

Whether you were treated on a linear accelerator or TomoTherapy therapy, radiation is delivered with the same intent, just with a different approach. Both machines will make different noises during the delivery of the radiation, and as the machine rotates around you.

You will receive the same amount of radiation daily as prescribed by your own oncologist.

You will not feel anything during the treatment.

Be sure to breathe normally at all times. We are watching you on closed-circuit cameras from outside the room while delivering your treatment.

If you need us for any reason, carefully wave your hand and we will come in to help you out.

Once completed, we immediately return to the treatment room, remove your mask and bring the bed down.

Please stay still until you are told it is safe.

Your treatment is now complete. You can dress yourself and head home.

You should not have experienced any pain or sensation from the radiation delivery, and it is safe to be out in public as you are not radioactive.

It is important to discuss with the treatment team any concerns or issues you may have during the course of your treatment.

You will have been given your next day’s appointment time and your estimated finish date for treatment.

For further information regarding your treatment, nursing care, or support services, please refer to other videos in this education series, or feel free to speak with any member of our cancer care team.