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For patients

The treatment

The radiation itself takes only a few minutes and is not felt or seen. The staff will take the best care of you and make sure your treatment goes as smoothly as possible.

How to do it – the step-by-step process

Step 1. Preparations at the university hospital

To receive proton beam therapy at Skandionkliniken in Uppsala, you need a referral from an oncology clinic at one of our seven university hospitals. If you belong to a county hospital and your doctor believes that proton radiation may be a treatment option for you, he/she will write a referral to the university hospital to which you belong. You will then be invited to the university hospital and all preparations for proton beam therapy will take place there.

Reception visits

At your first doctor’s visit, you will receive information about proton beam therapy and the preparations that need to be made before the treatment. You will also be given practical information about what applies to, for example, travel, meals and accommodation during your treatment period. As the regions have different rules on what compensation applies, it is important that you find out what applies to you.

Manufacture of fixation

To help you stay in the right position during treatment, fixations, or positioning aids, may need to be made and attached to the treatment table. For example, if you are receiving radiation to the head, a mask is used. If you are receiving radiation to the abdomen, pillows shaped to your body are used. The fixation is manufactured at the university hospital and then sent to Skandionkliniken before your treatment.

Computed tomography, CT scan

Another part of the preparation at the university hospital is to undergo an X-ray examination called computed tomography (CT). If you are in pain, it is a good idea to take your painkillers before the scan, as this may make it easier to lie still. Talk to the staff if you think you need additional pain relief.

For some patients, the nurse makes small tattoo marks on the skin before the examination. These are then used during the radiation treatment so that we can find exactly the same position as in the X-ray examination.

COPYRIGHT/PHOTO: Melker Dahlstrand
melker@dahlstrand.se
+46-70 630 20 88

Target drawing and dose planning

The next step in the preparation is for your doctor to decide which area to treat and how much radiation to give. ‘Target’ means goal, so the doctor decides the target for the proton radiation. Then, specialist nurses and medical physicists plan how this area should be irradiated to achieve the best results.

Handover to Skandionkliniken

Once the treatment plan is completed and approved, all information is sent to Skandionkliniken and we start our preparation process. If you are going to use fixation, positioning aids, this is also sent to the clinic.

Step 2: Preparation at Skandionkliniken

Well before the start of treatment, you will receive an invitation by post. It contains dates for your first visits to Skandionkliniken.

Arrival call

A few days before, or in some cases on the same day, you will have a meeting with the oncology nurse responsible for you during your treatment. You are welcome to bring a relative or friend.

You will then sit down in a separate room and go through how your treatment period is planned, what times apply, etc. At the meeting you will learn more about how your treatment will work. If you have any questions or concerns, you can raise them at this meeting.

Control with computer tomography

After the arrival call, you will have a CT scan, a kind of X-ray, to check that we are properly prepared for the treatment – that everything looks as planned and that any fixations, positioning aids, fit.

In the vast majority of cases, you will receive your first treatment one or two days after this first visit. But in some cases the treatment starts the same day.

Step 3. The treatment starts

Every day when you are due to receive treatment, you report to the reception desk in the entrance square of Skandionkliniken. There you will find out if there have been any changes to your treatment schedule or if the treatment has been delayed. When it’s time for treatment, a nurse will pick you up. If you need to change, she/he will show you to a changing room. You will then be allowed to lie down on the treatment table and in the fixation, if you are going to use one. There are always at least two oncology nurses at each treatment session.

Positioning

To ensure that you are in the correct position during treatment, we use a positioning laser that we align with the markings on the skin or the fixation made at your local hospital. You may have several markings drawn on your skin so that we can position and adjust the beam field correctly. It is important that you leave these markings in place during the treatment period. Be careful in the shower! Remember that the paint used for markings can stain your clothes. It is therefore advisable to wear loose clothing close to the part of the body to be treated.

Image capture

Before we start the treatment, we check that you are in the correct position using imaging. We do this before each treatment. During the imaging, the nurses go to a control room just outside the treatment room, but they can see and hear you at all times using a surveillance camera and speakers. During treatment and imaging, no one but the patient is allowed in the treatment room.

Treatment

After imaging, it is time for treatment. It can be done from one or more angles and the device may make a noise when it changes position. It is important that you lie perfectly still and try to relax as much as possible. The radiation itself takes only a few minutes and is not felt or seen. You have an alarm button in your hand during the treatment and it is possible to stop the radiation if you start coughing, for example.

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