Radiotherapy frequently asked questions

How do I get to the Oncology Centre?

Cheltenham General Hospital

Sandford Road, Cheltenham, Gloucestershire GL53 7AN

Website: www.gloshospitals.nhs.uk/your-visit/travel-parking/hospital-locations-and-directions/

The Oncology Centre is situated off Keynsham Road and accessed opposite Sandford Lido.

Hereford County Hospital

The County Hospital, Stonebow Road, Hereford HR1 2BN

Website: www.wyevalley.nhs.uk/visitors-and-patients/county-hospital-(acute)/how-to-find-us-and-parking.aspx

Follow directions to the Macmillan Renton Unit.

Is there easy access to parking?

There are pay and display car parks on both sites. You will be given a parking permit allowing you to park free of charge within designated Oncology parking spaces for the duration of radiotherapy treatment.

Can I have hospital transport?

The patient transport service (PTS) is provided for patients who require the specialist support of an ambulance crew to travel. If you believe you qualify for the patient transport service (PTS) and need to arrange a journey for an outpatient appointment, you will need to contact your local Patient Transport Advice Centre to arrange your transport. They will check whether you are eligible and help you make travel arrangements.

We will provide you with the telephone numbers of your local Patient Transport Advice Centre.

You may be eligible for patient transport if:

• Your medical condition means you cannot use other transport without damaging your health.
• Your mobility means you are unable to access healthcare by any other means.
• You need the skills or support of clinically trained staff and/or medical equipment during your journey.
• Transport could also be provided to a patient's escort or carer where their particular skills and/or support are needed. This may be appropriate in the case of accompanying a person with a physical or mental incapacity, a vulnerable adult, or in the case of patients needing a translator. This would need to be agreed for each individual case at the time of booking the transport.

You will need to have ready:

• your appointment letter with your NHS number
• the name of the GP practice to which you are registered

If you need further guidance and support please speak to a member of staff in the relevant outpatient area, or contact your GP’s surgery.

How do I find the Radiotherapy Department?

Arrive at the Oncology Department at Cheltenham General Hospital or the Macmillan Renton Unit at Hereford County Hospital. Follow signs to the Radiotherapy Department. There are reception areas at both sites where you should check in.

How do I change an appointment?

If you receive your list of appointments and you need to change them prior to starting your treatment please contact the Radiotherapy Bookings Team on 0300 422 4471.

If you need to change an appointment once you have started your treatment, please ask the radiographers and they will do their best to accommodate any requests. However, please be aware this may not always be possible.

What is radiotherapy?

Radiotherapy is the use of ionising radiation to treat cancer and some non-cancerous conditions. Radiotherapy can be used alone or with systemic anti-cancer treatments, or both. It is 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 are 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.

How long will the treatment take?

The treatment itself only takes a few minutes, but more time is spent setting you up correctly and taking X-ray images or a CT scan to check your position.

Is the treatment different each day?

The treatment itself is the same each day, but we allow extra time for taking images to check your position.

Can you see my cancer on the scan?

We use your images for accuracy purposes only. We need to make sure that you are in the perfect position for treatment, so that we can deliver your radiotherapy safely and accurately. We are not able to tell you if your treatment is working through these images and scans.

Is the treatment safe?

Each treatment is planned with careful consideration to avoid as much healthy tissue as possible. Every patient is considered individually and a unique treatment plan is produced. Each department has careful checking procedures in place to minimise risk.

Is there any risk to my friends and family while I am having radiotherapy?

No. There is no risk to your friends and family while you are receiving or after radiotherapy treatment. Once the machine is switched off the radiation is switched off. The radiation does not stay in the body so you cannot harm anyone else.

If you are receiving internal radiotherapy as an in-patient you will be given further information about this.

Who will be looking after me?

Your radiotherapy will be planned and delivered by a mixed team of specialist staff, including therapeutic radiographers, doctors, medical physicists and technical services.

The radiotherapy department is supported by an extensive team including reception and administration staff, radiotherapy assistants, specialist radiographers and nurses, dieticians, therapists and porters, who will help to look after you and make sure your experience is as good as it can be.

Do I have to stay in hospital while having radiotherapy?

Most patients are treated as outpatients and travel to the radiotherapy department for each treatment. However, if the doctor anticipates any problems due to your health or the type of treatment you might be having you could be offered treatment as an inpatient.

Pregnancy

Where relevant, patients between 12 and 55 years will be asked to confirm their pregnancy status at their first appointment in the department. If you are, or think you might be pregnant please make sure that you inform your consultant clinical oncologist or a radiographer as soon as possible.

It is important that you take precautions during your treatment so as not to become pregnant.

Pacemakers

It is important that you inform your consultant clinical oncologist or a member of their team if you have a pacemaker during your initial consultation. This is required as it is known that radiation can affect pacemakers. Your department will arrange a pacing check for you and make sure that any necessary precautions are taken. Sometimes on your first day of treatment it is necessary for a doctor or a member of the clinical measurements team to be present and for your heart rate to be monitored. You may also be required to go for a pacing check once your whole treatment has been completed.

I have only just had a CT scan; do I need another one?

Yes. The radiotherapy CT scan is different to ones you may have had before as you will be scanned in the position that is required to treat you. Radiotherapy CT scanners are linked to a computer planning system so that the scanning information can be used to plan your treatment.

Are there any side effects?

The treatment does have some side effects but these are not immediate and vary from patient to patient. Your treatment team will explain these to you and offer advice for reducing them.

Should I moisturise my skin?

We suggest you moisturise the area of your body which will receive radiotherapy with your usual moisturiser – this will keep your skin in good condition. If you buy something new – you do not need to buy anything expensive. Choose a moisturiser without sodium lauryl sulphate (SLS) which can irritate the skin. Many supermarkets have ‘own brand’ moisturisers which are SLS free and are inexpensive. Your radiographers will speak with you about any other skin care you need.

Will I lose my hair?

Most patients will not lose their hair. However, if you are having radiotherapy to your head or neck you may suffer some hair loss. Your consultant clinical oncologist should have discussed this with you and an appointment to discuss having a wig can be arranged for you by a radiographer or nurse.

Treatment to other parts of your body that have hair can also be affected by hair loss.

Patients who suffer hair loss caused by radiotherapy may find that it takes longer to grow back and is often patchy.

Can I have an interpreter?

If you require an interpreter, this should have already been arranged for you. If you think an interpreter is required and has not been arranged, we can arrange for one to be present at your first appointment and any review appointments and consultations you may have. Ideally friends and family members should not be used as interpreters. Please contact the Radiotherapy Bookings Team on 0300 422 4471 if you have any queries regarding an interpreter.

Can I keep my clothes on?

In order to maintain your dignity during treatment we only ask that clothing which covers the area to be treated are removed. Specialist gowns may be provided where required.

Why is my treatment and number of appointments different to other peoples?

Everybody's treatment is individually planned so the number of appointments can vary depending on the treatment site and what the consultant has decided is the best treatment for you.

Do not worry if your appointments differ to somebody else's.

We treat many different areas within the body, each requiring a different number of treatments, but please speak to the radiographers if you have any questions.

Can friends or family come with me?

Friends or family are more than welcome to attend with you. They will not be able to come in to the treatment room with you but they can be there for consultations and review appointments. This may change depending on national guidance.

Am I alone during my treatment?

You are alone during treatment. However, the radiographers can see you at all times on CCTV and can talk to you via an intercom if you wish.

Can I eat before/after treatment?

Unless it is stated in your personal treatment preparation that you must not eat or drink prior to treatment, you are able to eat and drink as normal before and after treatment. Please speak to a radiographer if you have any questions.

Will I still be able to drive?

Most patients can continue to drive throughout treatment. However if you feel unwell or tired it is advised that you ask someone else to drive you or find an alternative way to travel in for treatment.

Some patients are not allowed not to continue driving and your doctor will advise you of this. You may need to inform the DVLA of your condition.

How will radiotherapy affect my day to day life?

Depending on the area being treated, radiotherapy can cause specific side effects. Your consultant will give you some written information about these side effects and the radiographers will discuss these with you when you come for your first radiotherapy appointment.

Generally, treatment to all areas of the body may cause tiredness and this can mean that you need to take more time to complete everyday tasks and take regular breaks. However, many people find that they can carry on working and continuing a normal routine.

If you have any questions at any time during treatment, please ask the team.

Can I go swimming?

You may go swimming if your skin is not blistered, broken down or peeling. It is best to shower immediately afterwards to wash off chlorine and apply moisturiser. Please stop swimming if it irritates your skin.

Can I use deodorant?

Please continue to use the deodorant that you normally use, unless it irritates your skin; stop if your skin blisters or peels where you are applying deodorant.

Will my radiotherapy treatment hurt?

You will not see or feel anything during your treatment. You will just hear the machine making a buzzing noise which is normal.

Do I see a doctor during my treatment?

You will not normally see a doctor during your course of radiotherapy. Everybody's treatment and well-being is closely monitored throughout and you may be seen in a Treatment Review Clinic. These clinics are run by specially trained review radiographers to support you during your treatment. The treatment radiographers can also make sure that you have the correct medication and use their expertise to answer any questions.

If you have any problems and you do not have a review appointment booked, please speak to one of the radiographers and they can give you advice.

Can I miss any treatments?

Your consultant will decide the number of treatment sessions necessary for your radiotherapy to be effective and it is important you attend these appointments.

Some patients may need to attend on bank holidays or Saturdays. If you have other appointments that you need to attend during this time, please discuss this with the radiographers and they will try to arrange your radiotherapy appointment to accommodate them.

If you do miss a treatment, then another appointment will be added for you so you can complete your full course of treatment.

Does radiotherapy have an effect on my immunity?

No, radiotherapy treatment is localised to the treatment site and does not affect your immune system. Some concurrent treatments such as chemotherapy and immunotherapy can affect your immunity. Please speak to a radiographer if you have any questions or concerns.

Can I have the flu vaccination while I am having radiotherapy?

You may be offered the flu vaccination. If you are just having radiotherapy it is fine for you to have the flu vaccine. If you are having chemotherapy as well, please ask for further advice.

What happens after I have finished my radiotherapy?

Some side effects of your treatment may continue after you have completed your radiotherapy but the radiographers will advise you on how to manage these. They will also make sure you have all the necessary telephone numbers and information before you leave the department. You will receive a follow-up appointment to an outpatient clinic where you will meet your consultant to discuss the outcomes of your treatment and your progress. You will usually continue to attend outpatient clinics for several years after your treatment.

How do I know if my treatment has worked?

Radiotherapy treatment can keep working for several weeks after treatment has finished. You may not find out for a few months about the results of your treatment, but you will have a follow up appointment to discuss this further. The period in between your treatment finishing and your follow up appointment allows time for your radiotherapy side effects to settle.

What support is available once I finish radiotherapy treatment?

When you finish your treatment, you will be given a letter with general information that you may find useful. There is a large variety of materials that are available once you finish your radiotherapy treatment. Please speak to a radiographer if you have any questions or concerns.