Preparing for your first radiation therapy session: what to expect

The short answer

Before the actual first session, almost everyone goes through a planning scan (simulation), where the team works out exactly where and how the treatment will be given. The treatment sessions themselves are short — usually 15-30 minutes — and most of that time is spent on positioning, not radiation. A simple checklist made in advance takes away a lot of the stress of the first day.

The planning scan is a separate session, usually with a specific type of imaging (often a CT scan), where the radiation therapy team sets the exact position you will lie in at every session and the target area of the treatment. Small marks on your skin or a custom-made mask may also be made at this point, if the area being treated calls for it.

No treatment is given at the planning scan — it is the planning stage, not the first session.

• your list of current medicines and any referral or document you received from your oncologist;
• an ID card and your health insurance card, if the center asks for them at every visit;
• something to read or listen to while you wait — the schedule can run a little late;
• water and a light snack, if the journey to the clinic is long.

Many centers recommend comfortable clothes that are easy to partly take off, because the area being treated needs to be uncovered at every session.

1. arrival and, at some centers, a short check before you go into the treatment room;
2. positioning on the treatment table, exactly as at the planning scan — the team helps you get into the right position;
3. the team leaves the room while the treatment itself is being given, but stays in contact with you through a camera and an intercom;
4. the treatment itself usually lasts a few minutes; the rest of the time is positioning and checks;
5. leaving — there is usually no need for recovery time or observation after a routine session of external beam radiation therapy.

The session does not hurt while the treatment is being given. There may be some mild discomfort from holding still in one position, especially if the treatment takes longer or the area is sensitive.

• confirm the exact address in advance, along with where to park or how to get in, so the first day does not bring the added stress of finding the place;
• ask how long a typical session takes, on average, at that center — your daily schedule is easier to plan with a realistic estimate;
• if someone is coming with you, check whether they can wait at the clinic, or whether it makes more sense for them to come only to certain sessions;
• put the first treatment date in your calendar as soon as you know it, so the rest of your appointments in that period can be arranged around it.

• What exactly happens at the planning scan, and how long does it take?
• Will I need a mask or skin marks for my treatment area?
• How long does a treatment session take, on average, at this center?
• Can I eat and drink normally before a session?

Once the first date is set, add it to your appointments calendar and note there any questions you still have for the team — it helps to have everything in one place before the 5-6 week series of sessions begins.