CyberKnife planning and treatment for prostate cancer



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CyberKnife planning and treatment for prostate cancer Please bring this handout with you to all of your radiation appointments. Appointments If you take pain or anti-anxiety medication, please bring it to all planning and treatment appointments. Take the medication as appropriate before each procedure. Feel free to bring music with you, such as an ipod. Seed Implant Appointment Date Time CyberKnife Room Treatment Planning First Treatment (you will be called at home with this date and time) Notes

2 CyberKnife planning and treatment for prostate cancer What happens if I cannot make an appointment or will be late? Call 905-387-9495, ext. 63808 and let the clerk know. Please give 48 hours notice if you need to change your appointment. Where do I go for my appointments? Once at the JCC, take the main elevators to Level 0. At the Level 0 reception desk, swipe the barcode on your radiation schedule or check in with the receptionist and go to the waiting area closest to your treatment unit. What if I have more questions? If you have questions or concerns before or after the treatment planning appointment: Call 905-387-9495 and ask for your radiation oncologist s primary nurse. Radiation Therapy Department regular clinic hours: 9 am to 5 pm, Monday to Friday. We are closed on holidays. If you have difficulty lying flat, please tell your care team as soon as possible. If you cannot maintain a stable flat position for one hour, other treatment options may have to be explored with your radiation oncologist.

CyberKnife planning and treatment for prostate cancer 3 Preparation for your appointments Low Residue Diet - for planning and treatment For 24 hours before your CT planning and treatment appointments do not eat foods that cause gas. This is called a low residue diet. The least amount of gas in your rectum improves the quality of the scan. To decrease the amount of gas: Do not eat raw fruit and vegetables. Do not eat whole grain bread and cereal. Do not eat foods that contain bran. Do not eat high fiber foods. Avoid food containing seeds, nuts or raisins. Avoid highly seasoned and fried food. Laxative - for planning appointment only For 2 days before the CT planning appointment you will need to take Dulcolax at around 4 pm. Dulcolax is a laxative. This will help to clean out your rectum. Bladder - for planning and treatment appointments When you arrive for your CT planning and treatment appointments you will be asked to empty your bladder. Right after you empty your bladder, you will need to drink 1 bottle of water (500ml). Your CT scan will take place about 20 to 30 minutes later. The goal of drinking the bottle of water is to make sure your bladder is full, but not uncomfortable.

4 CyberKnife planning and treatment for prostate cancer What happens at the treatment planning appointment? A radiation therapist reviews what happens and answers your questions. An I.D. photo is taken. You may need to change into a hospital gown. Planning is done in the Simulator Room. Radiation therapists, medical and planning staff are with you in the Simulator Room. The therapists guide you into a stable position. You will need to be in this position for each of your radiation treatments. A photo may be taken to help reproduce the set-up. X-rays or a CT scan of the area to be treated are taken. When will my radiation treatments start? After the treatment planning appointment, time is needed to make your treatment plan. You will be called at home with the start date and time of your treatment. The JCC aims to give you at least 2 days notice before your treatment starts. This is not always possible.

CyberKnife planning and treatment for prostate cancer 5 Treatment appointment(s) Please arrive for treatment at least 30 minutes before your appointment. Your appointment lasts about 1 to 2 hours. Some of that time is used for answering questions, as well as setting up and taking images to check your position. Check in at the Level 0 reception desk before each appointment. The receptionist will direct you to a waiting area. Right after arriving please use the washroom and empty your bladder and bowels as needed. Drink 500 ml (about 1 bottle) of water to fill your bladder as you did before your CT scan. By having a bowel movement and filling your bladder with 500 ml of water your bladder, rectum and prostate should return to the position they were in during your planning CT scan. This will reduce the amount of time you spend in the treatment room. Once you check in with reception, a radiation therapist will come and find you in the main waiting area and show you to the treatment area. During treatment In the treatment area you will be set-up on the treatment couch just as you were in the simulator room. Images are taken with the treatment machine to make sure that you are in the correct position. You may feel the treatment couch moving. You can be seen and heard by a radiation therapist at all times on a TV screen and intercom. We understand that you may feel anxious about radiation. You will not feel the radiation, but you will need to lie still and breathe as normal as possible. The therapist will guide you into a stable position and you will need to be in this position for each of your treatments.

6 CyberKnife planning and treatment for prostate cancer Your appointments We will give you a schedule for your treatment appointments You will be scheduled to see your radiation oncologist at least once over the course of your treatment. Side effects The side effects you have will depend on: any other treatments you may have had your general health the location of your tumour or lesion the current treatment plan Possible treatment related changes During your radiation therapy you may notice these changes: skin irritation in the treatment area changes in bowel movements have to urinate more often burning when urinating fatigue, tiredness Your team of radiation therapists, nurses and radiation oncologist will regularly check for these changes during your treatment. Please tell them if you have any of these changes or other concerns.

CyberKnife planning and treatment for prostate cancer 7 Take care of yourself Please follow these instructions during your radiation treatments and for about 2 weeks following treatment. During your bath or shower, gently wash the skin in the treatment area with warm water and a mild non-deodorant soap, such as Dove or baby soap. Pat the area dry with a soft towel and avoid scratching or rubbing. Protect the skin from all sources of heat or cold such as hot water bottles, heating pads or ice packs or saunas. Do not use any creams of lotions in the treatment area unless directed by your doctor or nurse. Wear loose fitting, cotton underwear. Do not wear clothes that are tight fitting. Talk with your primary care team before exercising or going swimming. If you have any questions about your radiation therapy, please speak with a health a care team member

Notes PD 7518-07/2012 dpc/pted/prostatecancercyberknifetreatjcc-th.doc dt/july 13, 2012