Once you begin radiation therapy, your daily appointments will start to follow a familiar process.

Your radiation therapists will bring you into the treatment room, help position you for treatment, verify that your setup is correct, and then deliver the radiation treatment prescribed by your radiation oncologist.

Although the actual delivery of radiation may be relatively quick, there are several important steps that happen before your treatment begins. Understanding what your radiation therapists are doing during this time can help make the daily treatment process feel a little less unfamiliar.

Who Delivers Your Daily Radiation Treatments?

Radiation therapists are the members of your treatment team who deliver your radiation treatments each day.

They will escort you into the treatment room, position you for treatment, make sure you are in the correct position, and operate the radiation treatment machine.

Your radiation oncologist is responsible for designing your treatment plan and directing your treatment, but they are not typically present for your daily radiation treatment. There are some specialized treatments where your physician may be involved more directly, but for most patients, your radiation therapists are the team members guiding you through the daily treatment process.

How Do Radiation Therapists Know Where to Deliver the Radiation?

The details of your radiation treatment have already been carefully established in your treatment plan.

The radiation dose, the shape of the radiation field, and the angles of the treatment machine have been determined ahead of time and programmed into your treatment chart.

Your radiation therapists use the information from your treatment plan and CT simulation to make sure your daily setup aligns with the customized plan created for you.

How Are You Positioned for Radiation Treatment?

Once you are in the treatment room, your radiation therapists will help you into the same position that was established during your CT simulation.

You may recognize the same positioning devices or immobilization equipment used during that appointment. You do not need to remember exactly how you were positioned. Your treatment team documented those details during your CT simulation so they can reproduce your setup each day.

Your therapists will fine tune your position until they are satisfied with the reproducibility of your setup. Radiation therapists work in millimeters, so what may seem like a very small adjustment can be an important part of preparing you for treatment.

Why Is Imaging Taken Before Radiation Treatment?

Depending on your individual treatment, your radiation therapists may take positional images before delivering the radiation.

These images are used to further fine tune your position for that day's treatment. They are not diagnostic images and are not being taken to determine whether your cancer is responding to treatment.

Some patients have positional imaging before every treatment, while others may not. The imaging protocol depends on your treatment type and the area of the body being treated.

If you are unsure what type of imaging your team is using or how often you should expect it, you can ask your radiation therapists to explain the imaging process specific to your treatment.

What Happens When the Radiation Is Delivered?

Once your position has been verified and any necessary adjustments have been made, your radiation treatment can begin.

The machine used to deliver external beam radiation therapy is called a linear accelerator. It is designed with an open space and can rotate around you while you remain on the treatment table.

During treatment, the machine may move to different positions around your body depending on the angles established in your treatment plan. You will not feel the radiation beam as it is delivered.

The actual delivery of radiation may be one of the quickest parts of your appointment. Much of the time you spend in the treatment room is devoted to getting you into the appropriate position and making sure your setup is accurate before treatment begins.

What Should You Expect During Daily Radiation Treatment?

As you continue with radiation therapy, many of these steps may begin to feel familiar: getting into position, allowing your therapists to fine tune your setup, having positional imaging when needed, and then receiving your treatment.

There is a lot happening during a radiation treatment appointment that may not be obvious while you are lying on the treatment table.

Understanding what is happening and why can give you more context for the steps you experience each day.

If you would like a more detailed explanation of the radiation treatment room, positional imaging, treatment delivery, and what your radiation therapists are doing throughout your appointment, I explore these topics in much greater depth in Let’s Talk Radiation Therapy.