Radiation Therapy Simulation & Planning
Get prepared before radiation therapy for cancer
Comprehensive Radiation Treatment Planning
If you and your oncologist (physician who specializes in cancer) agree that radiation therapy is the best treatment option for you, the next step is a treatment planning session. This session allows you to meet key members of the radiation team from the Department of Radiology Oncology at Beth Israel Deaconess Medical Center (BIDMC) and learn what to expect during treatment. The session also allows your team to make important preparations to ensure they can customize your radiation therapy to your needs.
During the visit, you’ll meet your primary nurse who will provide you with written material and a video that describes the radiation therapy process. Your primary nurse is available to you throughout your course of treatment.
Understanding the Simulation Process
When you and your radiation oncologist decide to pursue radiation therapy, your radiation oncologist must plan the specific technique for your treatment. The first step in establishing a treatment plan is to identify the area they’ll be treating.
Your radiation oncologist uses simulators (or CT/simulators) to complete this mapping for radiation therapy. This specialized equipment “simulates” or mimics the treatment machine by taking X-ray or CT scans to identify the exact treatment approach. You do not receive radiation at this session.
Radiation therapists work with members of your radiation oncology team to complete your simulation. At your planning session, you may receive contrast material — barium or intravenous pyelogram (IVP) dye — to help your care team pinpoint the area they will be treating. If you need contrast material, the radiation oncologist will discuss it with you before the simulation procedure begins.
Transportation to Appointments
Most patients can get to their daily treatment on their own. If you don’t feel well, you may want to ask a family member, friend or neighbor to take you to and from treatment.
Some communities provide transportation for eligible residents. Some chapters of the American Cancer Society have volunteers who transport patients to and from treatments. Let your primary nurse know as soon as possible if you have problems with transportation.
What To Expect When Planning Radiation Therapy
Your planning session will be on the 5th floor at The Carl J. Shapiro Clinical Center at Beth Israel Deaconess Medical Center – East Campus. There is ample, convenient parking in the clinical center's underground garage. It’s located just around the corner from the main hospital, through the entrance on Binney Street (off Longwood Avenue).
You will change into a hospital gown. A member of your care team will escort you into the simulation room, which may be chilly. You will lie down on an X-ray table. A member of your care team will expose the area of your body that will be receiving treatment.
It is important to remain very still during the procedure. If you need pain medication, take it 30 minutes before your appointment so that you will be comfortable. If your care team needs to use a contrast material, they will give it to you at this time. If you are aware of any allergies to contrast materials, please inform the therapists or your doctor.
A technician will take X-rays from the simulator at various angles. During your treatment sessions, the technician will use these X-rays to double-check your positioning on the treatment table. They look at your bones in reference to the images that were taken during your initial simulation.
The planning is very technical and may feel impersonal. However, your team will closely monitor you throughout the process. They will explain each step as it happens.
Your care team will make temporary marks on your skin. Then, once they identify the exact area for treatment, they’ll mark you with a few tiny permanent tattoos the size of freckles. These will help the radiation therapist direct the radiation beam precisely to the treatment area during each of your visits. A member of your care team will take photographs to document your treatment position.
Following the procedure, a member of the team will escort you back to the dressing room. You shouldn’t feel any side effects from the treatment planning.
The treatment planning session will take about one hour, depending upon the nature and complexity of the treatment. After you finish the simulation, the Radiation Oncology Treatment Planning Center staff completes calculations to determine the specific dose of radiation that you’ll receive. Depending on the area of your treatment, your team may need to make lead blocks to place in the treatment machine to shield normal tissue.
Next Steps
Before you leave the Radiation Oncology Treatment Planning Center, your care team will confirm your appointment to start treatment. You’ll get details on your treatment location. If you’re having CyberKnife Stereotactic Radiosurgery, review planning and preparation instructions for this specific type of radiation therapy.
On the day you start treatment, you’ll meet with your radiation oncology nurse and the radiation therapist on your treatment team to discuss details.
We encourage you to call your radiation oncologist or radiation oncology nurse with any questions you may have in the meantime. You’ll need to complete a signed consent for treatment before treatment begins.
Advancing Care, Research & Education
Department of Radiation Oncology
The Department of Radiation Oncology offers the latest therapies and treatments for the management of cancer and other health conditions.
Cancer Research Institute
The Cancer Research Institute is an interdisciplinary center focused on understanding cancer with the goal of curing it.
Radiation Oncology Education & Training
Our radiation oncology team offers education and training programs to students and physicians.
