St. Luke's Cancer Centre

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Radiotherapy - About us

St Luke’s provides radiotherapy services at both the Royal Surrey County Hospital and at the East Surrey Hospital, and covers a population of 1.2 – 1.4 million. Over 3000 new referrals are seen in the centre each year, and on average 200 – 250 patients are undergoing radiotherapy at any one time.

We focus on giving our patients the best outcomes of care and an excellent experience whilst in our hospital.

We are a teaching department and provide clinical training for therapy radiographers, with close links to Kingston University and London South Bank University. The radiotherapy physics department hosts medical physics students from the University of Surrey. 

The radiotherapy department is open Monday to Friday, and the core opening hours are 8:00-18:00.  Occasionally we run services until 7pm and also on some Saturdays and bank holidays. 

Services provided: 

Location: 

The Radiotherapy Department is located on Level A in St Luke’s Cancer Centre.

SAT NAV: Use Egerton Road - GU27XX

What is radiotherapy?

Radiotherapy uses carefully calculated doses of radiation to treat cancer as well as some non-malignant conditions.

It is painless and only takes a few minutes to deliver.

Radiotherapy can be used alone or with surgery, chemotherapy, or both.

It’s used to:

  • Attempt to cure cancer (radical radiotherapy)
  • Control/slow down the growth of cancer
  • Relieve cancer symptoms (palliative radiotherapy)

The type of radiotherapy you’re given will depend on the type of cancer you have and your individual situation:

  • External Beam – delivers radiation from outside the body using a Linear Accelerator (Linac).
  • Internal Radiotherapy – Brachytherapy delivers radiation to body cavities or tissues internally using a specialist machine.

How does radiotherapy work?

Radiotherapy destroys the cancer cells in the treated area by damaging the DNA within these cells. Although normal cells are also affected by radiation, they are better at repairing themselves than the cancer cells.

Radiotherapy is often delivered in several small doses, over a specified period of days or weeks. The prescription written by your Consultant Clinical Oncologist will define the dose and number of treatments (fractions). Both short and long-term side-effects are possible and these are thoroughly discussed with you prior to starting treatment as part of the consent process.

For more information please visit Macmillan Information and Support.

What happens before my treatment can begin?

Before your treatment commences, we will ask you to attend the radiotherapy department for a pre-treatment appointment. This will be in the Computed Tomography (CT) Scanner or Mould Room.

These appointments allow us to gain important information that will be used to plan your treatment, and to decide on the best way to position you for your treatment. These appointments usually take a little longer than a treatment appointment.

If the treatment you are having requires special preparation, this will be discussed during your pre-treatment appointment. Depending on the area we are treating, you may receive additional instructions in the post with your appointment letter. If you haven’t been given any instructions, don’t worry – it means you don’t need them.

When you arrive in the department, report to the radiotherapy reception. A radiographer will show you to somewhere more private and explain the procedure to be carried out. Please feel free to ask if you have any questions. It may help if you come with a list of questions that you have thought about at home.

You will be asked to confirm that you are still willing to proceed with radiotherapy. If you have any queries or concerns about consenting to treatment a doctor will come to discuss them further.

You will be asked to change into a hospital gown or your own if you wish to bring one with you.

At the time of your scan, tiny permanent dots (tattoos) may be put on your skin. This will help with replicating your treatment position later.

If you have a pacemaker, please inform a Radiographer when you arrive so that we can ensure the necessary arrangements have been made. 

Female patients may be asked if they are pregnant. If you suspect you may be pregnant, please inform a Radiographer as soon as you arrive.

Once you have had your CT planning scan you can go home. We will be using the data we have gathered to produce a treatment plan specifically for you. You should expect to wait approximately 10-14 days between your planning scan and the start of treatment.

What are Fiducial Markers?

Some men, who are having their prostate treated, may be required to have fiducial markers inserted.

The prostate is an organ which can move slightly when you breathe or in relation to the changes within your bowel and bladder. To help us identify the prostate whilst planning your treatment, and each day before we give you your radiotherapy, a specialist radiographer or doctor will place gold fiducial markers into the prostate gland. This is usually done 7 days before your CT scan.

The markers are used as a guide to make sure that each beam is just applied to your prostate. This will reduce the risk of side effects and damage to surrounding organs.

These gold markers are permanent but you will not be aware of them, and they will cause no harm.

 

What is Image Guided Radiotherapy (IGRT)?

Image Guided Radiotherapy uses imaging scans and X-rays to make sure the radiotherapy treatment is as accurate as possible.

Imaging panels on the linac are able to take pictures before or during your treatment. These images are to ensure that you are positioned correctly and that the treatment is accurate. This helps reduce the dose of radiation given to the healthy tissue around the tumour, and reduces side effects.

What is Intensity Modulated Radiotherapy (IMRT)?

Intensity Modulated Radiotherapy can shape the radiotherapy very closely around the tumour. The radiotherapy machine aims the beams at the tumour from many different directions. This gives very precise doses to the cancer or to specific areas within the tumour.

Intensity Modulated Radiotherapy uses small beams to help lower the dose of radiation to normal healthy cells nearby. It can also vary the strength of the beams across the tumour.

What is Stereotactic Ablative Radiotherapy (SABR)?

This treatment uses many small beams of radiation to precisely target the tumour. It allows us to deliver very high doses of radiotherapy to very small areas of the body, which helps to reduce the side effects of treatment. A course of stereotactic radiotherapy is normally given over 1-5 treatment days.

What is Superficial Radiotherapy?

Superficial treatment is used to treat lesions that do not require a dose of radiation to a great depth, such as skin and bone cancers or scars. This type of treatment can be given using either kilo-voltage x-rays on the superficial machine, or using electrons on a linac.

Sometimes a thin lead shield may be placed near the area to be treated in order to protect any healthy tissue. The machine is fitted with an applicator which is moved to rest gently over the treatment area. This should not cause any discomfort.

The treatment can usually be delivered the same day.

What is Brachytherapy?

Internal radiotherapy implants are radioactive metal wires, seeds, or tubes put into your body, inside or close to a tumour. The radioactive metal is called a ‘source’ and is left inside the body for a period of time.  In many types of cancer the source is taken out after a few minutes.

In some types of cancer, small metal implants, or seeds, are left in the body permanently. These implants are made of radioactive gold or contain radioactive iodine. They give a very high dose of radiation to the area of the cancer cells. For most types of implants the radioactivity only travels a few millimetres through body tissue and so it can’t be detected outside the body.

How will I receive my appointments?

Before attending for radiotherapy you will receive your appointments by post or by telephone. Please make sure we have your correct contact details.

If you have any questions regarding your appointments, please contact the booking team on 01483 571 122 ext 6632/2570.

How do I check in?

You will have been asked to attend the St. Luke’s radiotherapy department at either the Royal Surrey Hospital or the East Surrey Hospital. Please bring your appointment letter with you and show it to the reception staff when you arrive in the department.

receptionist

The reception staff will show you how to use our self-check-in service.

You will then be directed to a waiting area. A member of the radiotherapy team will then come to talk to you.

Any specific instructions you need to follow will be detailed in your appointment letter. Please read your letter carefully.

What happens on my first day of treatment?

Upon arrival a radiographer will explain the procedure, discuss any side-effects of the treatment, and give you a current list of appointments. Please feel free to ask if you have any questions, or if there is something that you do not understand.

During this discussion you will be asked to confirm your name, address, date of birth, and to provide a telephone number if we do not already have one for you. You will also be asked to confirm that you are still happy to proceed with radiotherapy; this is called ‘confirmation of consent’. If you have any queries or concerns a doctor will come to discuss them further.

For female patients, if there is a possibility that you might be pregnant, please ensure you inform a radiographer when you arrive.

If you have a pacemaker, please inform a radiographer when you arrive so that we can ensure the necessary arrangements have been made.

You may be asked to change into a hospital gown before a member of staff takes you into the treatment room. You can bring your own dressing gown if you prefer.

What happens in the treatment room?

The treatment machine you will be treated on is called a Linear Accelerator (LA). The treatment room is large with the machine to one side and a couch in the centre.

Linear Accelerator

You will be asked to get onto the couch and lie in the same position as you were for your pre-treatment appointment. If you require any help getting on or off the couch, please do not hesitate to ask.

Pen marks might be put on your skin, highlighting any tattoos, to help us see them when the room lights are dimmed.

The couch will move up and along to go under the machine. It may be necessary to move you, which the radiographers will do. These small adjustments are to ensure you are in the correct treatment position. You may be aware of the bed and machine moving. Don’t worry, nothing will touch you and you won’t fall off.

When everything is ready for your treatment to start, the radiographers will tell you they are leaving the room, but they will be able to see you at all times. When the machine is on it will make a buzzing noise, but you will not see or feel anything.

Linear Accelerator

It is important that you breathe normally and remain relaxed. You must keep still until one of the radiographers says it is safe to move. Please do not attempt to get off the couch until you are instructed to do so.

On average you will be in the treatment room for about 10 to 15 minutes, with the treatment itself only lasting about 2 minutes. However, this is dependent upon your specific treatment plan.

Images may be taken either before or during your treatment to check that your treatment position is the same as when you were planned.

Will my appointments be on time?

We aim to see everyone in time order. Whilst you are waiting for your treatment, it may appear that some patients are seen before you. This could be for a number of reasons:

  • Some patients have specific preparation to do in order for their treatment to be more accurate and have to be treated within a certain time.
  • Some patients are having Chemo-radiotherapy and have to be treated within a specific time.
  • Some patients are emergency cases and are planned and treated on the same day.

While we make every effort to see patients on time, occasionally unavoidable delays occur. We will do our best to inform you if there are any delays.

Who will look after me during my radiotherapy treatment?

Throughout your radiotherapy you will be looked after by a dedicated team of Doctors, Specialist Radiographers, Nurses and other members of the hospitals support network.

You will be given details of these appointments at your first treatment visit. These appointments usually take place shortly after your treatment appointment has finished for the day, and you will be directed where to go by a radiographer.

The patient support team are a specially trained group of radiographers who look after patients having radiotherapy. They run weekly clinics within the department and you will be booked into one. These appointments will be on your list. The team monitor and manage any side effects that you may have both during and for a few weeks after your treatment.

The review radiographers work closely with the doctors, nurses and other support professionals within the Trust to ensure you have the best possible care.

You will meet your specialist review radiographer during your first week of treatment, and the team are available every day to assist with any problems or concerns you may have.

You can reach them on the following numbers:

What side effects should I expect?

Radiotherapy can cause some side-effects. Details of these will be discussed with you by your Consultant Clinical Oncologist prior to starting your treatment, as part of the consent process.

It is important to remember that these side effects do not affect everyone and are dependent upon the area being treated.  Additionally, everyone is an individual and will react to radiotherapy differently.

The two most common side effects are detailed below. For all other side effects please refer to your patient information booklet or ask a radiographer.

Skin reactions: 

Skin reactions are caused by inflammation to the skin and only occur in the area we are treating. They are not burns.

Skin reactions vary from person to person and many people are not affected. However, some people will experience a change in skin colour/tone and the skin can become tender or itchy. This tends to become noticeable after 10-14 days and gradually builds up. It will continue for 1-2 weeks after your radiotherapy has finished, and then will start to get better.

We will give you advice about how to look after your skin when you come for treatment. Any reactions you may have will settle down a few weeks after you have finished your treatment.

Advice:

  • Moisturise the treatment area twice a day from your first appointment. We recommend that you don’t use anything too heavy or perfumed. You will be given advice about suitable products on your first visit, and a number of suitable creams can be purchased at the St Luke’s pharmacy. If you have a product you would like to use, please discuss the ingredients with a radiographer.
  • Wash normally and pat the area dry. You do not need to use a special washing product. We only advise that all soap is washed away thoroughly.
  • Unless we are treating your armpit, it is ok to use deodorant.
  • Keep covered in the sun.
  • Drink 1.5-2 litres of fluid per day (this does not include tea, coffee or alcohol). Keeping hydrated will help reduce the severity of side effects.

Tiredness:

Some people can feel quite tired during treatment and this is due to a variety of reasons, such as having to travel to the hospital daily as well as the treatment itself.

Plenty of rest and drinking at least one and a half litres of water a day can help. You should find that your energy levels improve a few weeks after your treatment has finished.

If you are worried about your tiredness, please speak to your review radiographer or Clinical Nurse Specalist. They may be able to help.

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