Radiotherapy is one of the three pillars of modern cancer treatment, alongside surgery and systemic therapy. It uses precisely targeted radiation to damage the DNA of cancer cells so they can no longer divide. When it is planned well, the damage to surrounding healthy tissue is minimal and recoverable.
Before you arrive
Please bring everything related to your diagnosis: biopsy report, all imaging (CT, MRI, PET-CT) on disc and on film, your surgical or chemotherapy summary if you have had treatment elsewhere, and a list of any medications you take daily. If you can, bring one family member who can listen alongside you — the first consultation contains a lot of information.
The first visit, step by step
Your first visit is a consultation, not a treatment. We will discuss the goals of radiation (cure, control, or symptom relief), the expected schedule, side effects, and answer questions. If we decide to proceed, the next visit is simulation.
Simulation & the planning CT
Simulation is the rehearsal. You will lie on a flat couch in a CT scanner in the exact position you will hold during every treatment. The radiation technologists will make small permanent ink dots on your skin (smaller than a pen tip) — these act as alignment marks. For head and neck cancers, a soft thermoplastic mask is moulded over your face; it feels snug but is not painful.
The single most useful thing you can do is stay still and breathe normally. Everything else is our job.
Planning week
Between simulation and your first treatment, you usually wait 5–10 working days. In that quiet week we are doing the loudest work — drawing the tumour and the organs around it on every slice of your CT, calculating dose, and running the plan through quality checks. The radiation physicist, the dosimetrist, and I will each sign off before a single beam is delivered.
Treatment days
Most courses run Monday to Friday for between two and seven weeks. Each daily session takes about fifteen minutes — most of that is positioning. The actual beam-on time is usually under two minutes. You feel nothing during treatment. The machine is large and will rotate around you; it will not touch you.
Common side effects, and what helps
- Fatigue. The most common effect. It builds slowly and lifts a few weeks after treatment ends. Short walks help more than full bed rest.
- Skin changes. The treated area may look sun-tanned, then peel. Use only the moisturiser we prescribe, and wear loose cotton over the area.
- Site-specific effects. Mouth dryness, swallowing pain, or loose stool depending on what is treated. We see you weekly to catch these early.
Questions to ask me
I would rather you ask a question twice than not at all. Some patients bring a small notebook — write things down between visits. Some of the most useful questions to ask at your first visit:
- What is the goal of my treatment — to cure, to control, or to relieve symptoms?
- How many sessions will I have, and over how many weeks?
- What side effects are likely for me, given where my treatment is aimed?
- What should bring me back to the hospital between sessions?
- What can I keep doing — work, exercise, prayer, travel?
A final word
Radiotherapy can feel like a long tunnel. From the inside it is, but it is also one of the most effective tools we have to give people more time, and better time. You will see the same faces every day — the technologists, the nursing team, the registrars. Lean on them. We are walking it with you.
