A lot of planning goes into your radiation therapy even before you get your first treatment. Planning includes the steps below:

1. You will have a treatment planning session where your radiation oncologist finds the area to be treated by using a CT simulator. This is called a simulation because the patient position and beam aiming “simulates” the positioning used for daily treatment. You will not get radiation during simulation.
   • Sometimes an MRI simulation will also be performed. This gives your care team the information they need to plan your treatment. It is done on a piece of equipment called a linear accelerator or “linac”. The CT and MRI simulators produce diagnostic-quality images to verify the position of the area to be treated. Your doctor or nurse may give you special instructions for simulation.
2.  Your skin will be marked with small dots, or tattoos, to identify the area of radiation and to make sure the therapists can treat you accurately each day. If needed, custom devices will be made for you during the simulation step to help you stay in the precise position every day of treatment.
3. Your team of doctors will make a treatment plan using information gathered during the simulation phase. This process could take up to 1–2 weeks.
4. You will return to Fox Chase for a set-up or “trial run” using the treatment machine. You will be placed on the machine in your simulation position, and special X-rays (called electronic portal images) will be taken to show the path of the X-ray beams.
5. On most days, images will be taken to make sure you are in the proper position so that your radiation treatment will be given as accurately as possible. There are multiple ways to guide radiation, including electronic portal images, CT images and information from implanted markers. These daily images will be compared with the plans made by your treatment planning team.
6. Once the planning process is complete, your treatment will begin.

Radiation Treatment

When you get to the Radiation Oncology Department, you must check in at the front desk. The first time you check in, we will give you an ID card. We will ask you for this card at every visit, so please keep it with you at all times. We will place a white bracelet around your wrist and direct you to a waiting room. At this point, you are officially checked in.

While having treatment, you will see your radiation doctor for an exam once per week on the same day each week. This is called your “on-treatment” day. Please allow at least one hour for your on-treatment day. After you have your daily radiation on your on-treatment day, you will check in at the nurses’ desk (next to the waiting room) with your ID card to see your radiation doctor.

On-treatment clinic times most often run from 7am to 5pm. Please check the radiation oncology schedule for the day you will be seen by your radiation doctor. We will let you know about any schedule changes. Once you are given a time slot, you will stay in that slot for your daily treatment. Please note that our daily schedule is tightly booked. If you have a conflict, we will do our best to meet your change requests.

Because radiation treatment is complex, it sometimes takes longer than we expect to complete a treatment. Please plan on being here for one hour, although we will most often complete your treatment sooner. If we are running behind schedule, we will tell you while you are in the waiting room. If you are waiting longer than 15 minutes and have not yet been taken for treatment or received an update, please let us know at the nurses’ desk.

We suggest that you do not miss any scheduled treatment days. If you miss a treatment due to a holiday or an emergency, we will add that day(s) to the end of your schedule. You must complete the entire number of treatments prescribed by your radiation doctor for maximum benefit.

Patients Getting Chemotherapy and Radiation

We understand how hard it can be to schedule different treatments, tests or visits in a single day. Some chemotherapy treatments take many hours and sometimes the doctor will want your chemotherapy
to be before your radiation treatment as part of your treatment plan. If you are getting radiation and chemotherapy at the same time, scheduling your chemotherapy in the morning is best so that there is enough time for you to get each treatment. This may cause you to arrive early or late for your radiation appointment, but that is okay. You may come down to the radiation department after your chemotherapy, and we will start your treatment as soon as we can.

Bringing Guests to Your Appointments

You may bring family members or friends with you to your radiation treatments and/or clinical exams. Waiting-room space fills quickly, so please limit your number of guests. Please tell the nurse if someone will be joining you in the exam room on your on-treatment day.

Treatment Schedule

Radiation therapy is given Monday through Friday. Treatments are not given on Saturdays or Sundays except in urgent situations. We are closed on these holidays:

• New Year’s Day
• Memorial Day
• Fourth of July
• Labor Day

• Thanksgiving Day
• Christmas Day

Vacations/Maintenance Scheduling

Fox Chase is committed to making sure your treatment plan runs as smoothly as possible. Please schedule any vacations at least one week after you have finished your entire course of treatment. While Fox Chase engineers perform regular preventative maintenance on our machines, we sometimes have mechanical issues. This may cause your treatment to be canceled for a day, causing the day missed to be added to the end of your treatment schedule. We will let you know in advance if this happens. Please give us a number where you can be reached in case of a mechanical delay.