Medical Informative Booklets
Chemotherapy / Radiotherapy
Information for patients in the Radiotherapy Service of the Jules Bordet Institute (1rst part)
Introduction
Your doctor has just announced you that you have to undergo radiotherapy.
You do not know exactly what it is and you have many questions in your mind : what does this treatment consist of ? How will it be organized ? How long does a session last ? How do we perform radiotherapy ? Does the treatment have side effects ? How will I react ? How will I feel ? ...
This brochure does not replace the dialogue with doctors and nurses of the radiotherapy service. However, it can help you to better understand. If certain aspects of the treatment worry you, do not hesitate to talk to the team, which is ready to listen to you and to help you.
Définition
Recently, radiotherapy celebrated its 100 years. This kind of therapy has always been improved since it was invented. It consists of the utilization of different types of high-energy radiations, (X rays, gammas, electrons or others) in order to treat certain diseases and tumors. These radiations can reach tissues that are situated deeply in the organs.
How does radiotherapy act ?
The radiations prevent cells to multiply. This involves healthy and non-healthy cells as well. During the treatment, healthy cells keep their faculty to repair their selves whereas the others are progressively destroyed since they are more sensitive to the radiations.
In order to achieve this result, the radiotherapist has at his disposal two kinds of therapies :
- the curietherapy
- the external radiotherapy
The curietherapy consists in introducing into the organism radioactive sources that will remain a certain period of time in direct contact with the lesion. This kind of treatment can involve a hospitalization.
The external radiotherapy consists in settling the patient every day on a machine in order to irradiate a very precise part of the body.
According to the lesion's type, one or several machines that have their own characteristics can be used.
In order to save tissues that do not have to be irradiated, several irradiation fields can be introduced.
According to the cases, radiotherapy is used alone or is associated with surgery and/or chemotherapy.
The first consultation
During your first consultation by the radiotherapist (doctor who is specialized in radiotherapy), he examines you, asks you questions, looks at the results of the examinations that you have already undergone. He can advise complementary examinations that are necessary and appropriate for you :
radiography, isotopic examination, scanner, laboratory examination, etc...
When he has all information he needs, the radiotherapist decides which radiations type must be used, practical modalities of treatment and how long it will last. You will have an appointment for a simulation that means a technical preparation for your treatment.
The simulation
When you arrive at the simulator, a nurse who explains you the goal of the simulation welcomes you. She or he settles you in the chosen position for your treatment, takes your comfort and your demand related to the treatment into account (specific material can be used : a mask for the skull irradiation, adjustable headrest for the ENT area).
Thanks to the simulator's different functions, the radiotherapist can define with precision the areas to irradiate. This preparation lasts 30 minutes to 1 hour and is painless. For a maximum precision, you cannot move or breathe normally. At the end of the simulation, reference points are traced on your skin with a natural red colorant. These marks that you have to keep during the whole treatment help to reproduce your irradiations' field every day in the same way.
The scanner dosimetry
The dosimetry scanner is useful to define the density of your tissues, the exact position of different organs in order to be sure that irradiation paths perfectly "include" the area that is treated. This scanner can be realized before the first session or during the treatment. It is not required to be in a fasting state and lasts only some minutes. The dosimetry allows to check the different proposed irradiation fields, to chose the energy that will be used and to adjust the doses. It guarantees the quality of a personalized treatment.
The treatment
At the treatment station, a qualified nurse welcomes you. He (or she) explains you how the session takes place while he (or she) settles you in the defined position in simulation. When the geometric conditions of your irradiation field are set up and when it is oriented according the marks, he (or she) leaves the room, goes to his (or her) operating station and perform your irradiation session. It is very important to stay still during the time of radiations exposition and it is essential to keep the marks on the skin for the precision of the treatment. During the irradiation, you are alone in the room but there is a camera system that allows the nurse to see you, and an interphone allows to communicate. The treatment is very short : some minutes. Your waiting time and your settling are longer than the treatment.
The radiations are invisible and painless. They do not produce heat or vibration. The only thing that can be uncomfortable is your position on the table. The nurse will give you precious advice during the whole treatment. He (or she) will be the intermediary between you and your radiotherapist. He (or she) takes care of your later appointments according to your preferences.
Number of sessions
The total length of the treatment depends on the total dose to administer and on the splitting up of it. It can vary from several days to 7 weeks.
The total dose to deliver depends on the lesion that has to be irradiated, on involved treatments and on several factors that are taken into account by the radiotherapist.
The splitting up of the total dose per session is essential to protect your healthy tissues. This is the reason why radiotherapies are long.
It is common to deliver a session a day, 5, or 6 days on 7. Certain treatments can be administered 2 times a day.
It is essential that you undergo all planned sessions, with no interruption, except the W-E.
If you miss sessions or do not achieve the schedule, the dose you will be administered will not be appropriate to your treatment.
Treatment's machines
In order to have better results, one or several machines can be used. The choice depends on the lesion type and on its anatomic localization. Some machines are used to treat more superficial areas, others to irradiate organs that are deeply situated.
- The Cobalt 60 machine uses the radioactive substance as the radiation sources.
- The linear Accelerators produce their selves their own irradiation path. These machines are similar in their large size and in their capacity of moving to several directions. When they start working they can emit a noise. These machines can impress you, but do not forget that nothing dangerous can happen and cameras are always checking the patients. The physics laboratory regularly checks up these machines, so that the security is guaranteed.
Checks up and consultations during the treatment
During the treatment, you will have to go regularly to the therapist. These consultations are aimed to check your treatment and the reactions you have. The doctor can advise some examination to be performed, especially when your irradiation fields are large.
Your white blood cells are sensitive to the radiations. Blood examinations allow to check their number. If there are not enough white blood cells (this is rare), the treatment can be stopped until the number is normal again.
Other examinations like the scanner, radiography, echography ... show the therapist the evolution of your state of health and your reaction to the treatment.
The cost of the treatment and the journeys
- If you have a social security or insurance, you will not have to pay the radiotherapy. The journeys' costs are partially refunded. Indeed at the end of the treatment you will receive a document, which you have to send to your insurance, as well as train, metro tickets and taxi receipt stamped by the nurse.
- If you are able to go to the hospital by public transport, ask a transport certification to your radiotherapist.
Besides transport services that are paid by the insurance, other services exist :
Practical Information
- How to go the treatment ? click here
- Different transport services are at patients' diposal. If you have difficulties to go to the Jules Bordet Institute, you can ask help to different services :
-
Fondation contre le Cancer
Fondation d’utilité publique
Chaussée de Louvain, 479 à 1030 Bruxelles
Pour le service transport : 0800 15 803 (uniquement de 9h à 12 h) - numéro d’appel gratuitTel: 02/736 99 99
Dr. Didier Vander Steichel Directeur médical et scientifique
- Les Equipes d'Entraide
Avenue de la Renaissance, 40
1000 Bruxelles
Tel : 02 649 22 80
Personne de contact : Marie MICHALOPOULOS
- Le service de l'Aide aux Malades de la Mutualité St Michel
bd Poincaré, 78 à 1070 Bruxelles
Mr A. Reyland - Tel: 02/240 86 76
- Télé Service :
1) Service dépannage transport
rue du Boulet, 24 à 1000 Bruxelles
Mrs M. van Peteghem - Tel: 02/548 98 00 l
2) Service enfants gravement malades
Mrs B. de Villefagne - Tel: 02/548 98 00
3) Soins chez Soi
Rue de Stalle 65 bte 4 à 1180 Bruxelles
Tel : 02/420 54 57
www.soinschezsoi.be
info@soins.chez.soi.skynet.be
4) Bruxelles Assistance
rue Malibran, 53 à 1050 Bruxelles
Mrs M. Marchal - Tel: 02/647 03 66
Booklet realized thanks to the support of the Friends of the Bordet Institute.
LINK
- 2nd part = Effects and Reactions to Treatments
+32 2 541 31 11