University College Hospital. A visit to the radiotherapy mould room. Radiotherapy Department Patient information series

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1 University College Hospital A visit to the radiotherapy mould room Radiotherapy Department Patient information series 33

2 2 If you need a large print, audio or translated copy of the document, please contact us on: (Direct line) ext 73711/bleep ext 73711/bleep 1458 We will try our best to meet your needs.

3 3 Contents Introduction 5 Positioning 6 Making a thermoplastic mesh Posicast mould 6 Making a clear plastic (PETG) mould 7 Preparing for your visit to the mould room 8 Useful contact numbers 9 Space for notes and questions 10

4 4

5 5 Introduction You have been asked to attend for some radiotherapy treatment. Radiotherapy is a very precise treatment. To ensure accuracy in your particular treatment you will have a mould made of the area being treated. This mould will be worn each day during your treatment. You will need to attend the mould room in the radiotherapy department. The mould has three purposes: To help you keep still during your treatment. To ensure you are in exactly the same position each day for treatment. To prevent having to draw treatment marks on you, as they are drawn on the mould instead. There are two basic types of mould: A thermoplastic mesh (called Posicast ) which is used in the majority of moulds. A clear solid plastic (called PETG) which is used in the remaining moulds. Occasionally it may be necessary to use a combination of both types. Both these types of mould need to be made directly onto your skin so it may be necessary to remove some clothing around the area that is to be treated.

6 6 Positioning The purpose of the mould is to ensure you are in the same position for each treatment. It is important that we get you into the best position to receive your treatment before we make the mould. If you are lying on your back (supine) for your treatment, we have a range of different shaped cushions or supports to go under your head and shoulders. We may need to try several different positions before finding the best one for you. Sometimes we may need to take an X-ray of you to help us choose the right position. If you are lying on your front (prone) for your treatment, we will need to make a two-piece mould. The first mould will be to support your face. The second mould will be over the back of your head and shoulders to ensure you are in the exact position every day. This will usually involve two to three visits to the mould room. If it is your leg or arm that needs moulding, we may need to make a personalised leg or arm rest, in addition to the mould. Making a thermoplastic mesh Posicast mould Posicast is a lightweight green plastic mesh. A sheet of the Posicast material is placed in a tank of warm water. As the plastic warms it becomes very soft and elastic. We take the plastic out of the water, dry it and then place it over the area to be treated. The plastic will feel warm on your skin. The plastic needs to stay in place for approximately six minutes whilst it cools and sets. During this time you will feel us gently moulding the plastic to your shape with our hands. As the plastic is a mesh it has lots of small holes in it. However, if we are moulding it over your face we will put a much larger hole in for the area over your nose, mouth and/or eyes for your comfort. The making of the mould is normally completed on a single visit, usually on the same day as your treatment planning session.

7 7 Making a clear plastic (PETG) mould Making a clear plastic mould requires at least two visits to the mould room. On the first visit we will take an impression of the area to be treated with wet plaster of Paris bandage or a combination of plaster bandage and a dental impression material called alginate. This impression takes about 10 to 15 minutes. First we will cover your hair with a swimming cap and put a moisturising cream onto your skin (just to make it easier to remove the plaster bandage). Strips of warm, wet plaster bandage are placed around the edges of the area to be moulded and gently smoothed into your shape with our hands. The dental alginate powder is then mixed with cold water into a smooth paste and spread directly onto the skin, leaving holes around the nose and mouth if the mould is of your face. Some more plaster bandage is then put on top of the dental alginate and the whole thing is left for two to three minutes to set. At the end of this time we simply lift everything off in one piece, and after washing off any excess cream or plaster you will be free to go home. If you are having a mould made of a limb, strips of warm, wet plaster bandage will need to be used only. Before going home you will be able to wash and also be given an appointment for a second visit when the completed mould can be fitted. After you have gone home it will take us at least a couple of days to turn the plaster/alginate mould into a clear plastic PETG mould ready for you to wear whilst having your treatment. On your next visit, usually the same day as your treatment planning session, we will ensure that the clear plastic PETG mould fits snugly.

8 8 Preparing for your visit to the mould room Moulds normally need to be made directly onto your skin so please try to wear clothing that can be easily removed around the area to be treated. We will also ask you to remove any jewellery from around the area to be treated. Ladies The impression will remove any make-up. You may prefer not to wear any or bring some along to freshen up after the procedure. Gentlemen If you have a lot of facial hair this can cause problems with the impression. Please contact us so that we may discuss any appropriate action. If you are having radiotherapy to the head and have long or thick hair, you may be advised to cut your hair short before the impression is taken. This will ensure that the mould will fit exactly for treatment and prevent the need for having a repeat mould made due to potential hair loss. If you have any worries or questions about this, please do not hesitate to contact us. If you need any dental work carried out please ensure this is done prior to the impression. This prevents altering the shape of your mouth and affecting the fit of the mask.

9 9 Useful contact numbers If you have any queries or worries about the mould room procedure please contact: The Radiotherapy Mould Room Direct telephone: or :00 to 17:00 Main switchboard: bleep 2229 Alternative switchboard: bleep 2229 The Radiotherapy Planning Department Direct telephone: :00 to 17:30 Macmillan Information and Support Radiographer Mark Williams Direct telephone: Main switchboard: ext bleep 1458 Alternative switchboard: ext bleep

10 10 Space for notes and questions

11 11

12 First published: January 2005 Last review date: June 2013 Next review date: June 2015 Leaflet code: UCLH/S&C/CD/RT/MOULDRM/2 University College London Hospitals NHS Foundation Trust Created by Medical Illustration RNTNEH Unique Code: 28907

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