Jefferson University Hospitals

Preparing for Your Visit

If you decide to receive your radiation therapy at the Bodine Center for Radiation Therapy/Sidney Kimmel Cancer Center at Jefferson, you'll need to know about registration and the CT simulation process.

After your consultation appointment, talk with your physician to schedule your CT simulation treatment planning procedure. If you need to reach your physician, call 215-955-6702.

You should plan to be at the Bodine Center for your CT simulation appointment for approximately 1 to 3 hours.

A CT simulation is a specialized CT scan that helps your physician know where your tumor is located. Contrast or dye may or may not be given before your CT simulation.

The CT scan you will receive during your simulation is different than a diagnostic CT scan, because it is used specifically by your radiation therapy team to create a treatment plan that is customized just for you.

About the Registration Process

  • When you arrive for your CT simulation appointment, you will come to the front desk in the Bodine Center for Radiation Therapy.
  • The front desk staff will direct you to the registrar, who will record your insurance information, collect referrals (if required) and co-payments at this time.
  • After the registrar receives all the information we need, you will be directed to take the elevator to the 'B' level for your CT simulation appointment.
  • When you arrive on the 'B' level, you will go to the reception area.
  • The receptionist on the 'B' level will verify your name and date of birth.
  • A barcode will printed for you, which you will need to bring to ALL of your radiation therapy appointments. This barcode is used for identification purposes.
  • After the receptionist hands you your barcode, you will be given your changing instructions, shown the changing area and then directed to the nurses' station.

About CT Simulation

  • After you've arrived at the nurses' station, a nurse will ask for your name and date of birth.
  • At this time, the nurse will check if your consent for radiation treatments is signed. If not, the nurse will call your physician to explain the consent and ask for your signature.
  • If you have questions about your radiation treatment, you may be able to speak with your physician before your CT simulation appointment.
  • After your signature on the consent form is verified, the radiation therapists will greet you, ask your name and date of birth and escort you to the CT treatment planning room.
  • A digital picture will be taken of your face for identification purposes.
  • Sometimes, your physician will give the therapist an order to make a positioning or custom mold for you. This will be used during your daily treatments. If a device is needed, the therapist will make it at this time and explain how it is made and why it is being used.
  • Sometimes additional therapy team members may be called in to check the positioning device. The therapist will introduce these team members to you.
  • The therapist will help position you on the CT table.
  • If your physician requires you to have a CT scan with contrast, you will be given a questionnaire to see if you can have the dye. Contrast is dye that is used to show the physician where the tumor is located.
  • The therapist will tell you when the CT scan is ready to start and then you will be asked to leave the room.
  • The CT scan will begin. It is quick and painless.
  • Afterwards, photos will be taken of the treatment area and small marks will be made on your body to identify the area of treatment. These photos and marks ensure the therapist will position you correctly for your daily treatments.
  • Next, the therapist will help you off of the CT table.
  • If you have any questions, the therapist or your physician will be able to answer them for you.
  • The therapist will then work with you to schedule your next appointment, which will be a trial run of your treatment plan. This trial run is also called port filming.
  • The trial run appointment is made for certain times on specific days, depending on your physician's schedule.
  • Between your CT simulation and trial run appointment, your radiation therapy team members work together to create a personalized treatment plan for you.
  • In most cases, after your trial run is complete and approved by your physician, you will schedule your regular treatment appointment time with your therapists.
  • If anything at all is unclear to you, please ask our staff and they will do their best to answer your questions.

Thank you for choosing Jefferson. Before you arrive for your first appointment with Radiation Oncology, please print and fill out the Health Assessment form (PDF) as well as the JUP Communication of Protected Health Information form (PDF).

Preparing for your appointment is the best way to assure that you have a visit that is as successful and productive as possible. You will need to set aside a certain amount of time for the visit and allow for a number of steps.

Download the Sidney Kimmel Cancer Center at Jefferson Patient Packet (PDF).

The following may help make your appointment at the Sidney Kimmel Cancer Center at Jefferson go smoothly:

  • Arrive 30 minutes early so that you have time to complete any needed paperwork.
  • Have knowledge about your medical and family history and/or bring the completed health questionnaire which may have been sent to you. This information will help us care for you.
  • Bring a list of your current medications and allergies.
  • Have your insurance information, including your insurance card with ID number and group number and prescription plan information.
  • Bring referrals from your primary care provider if your insurance requires.
  • Be prepared to pay any in-office co-payments necessary.
  • Bring any relevant radiologic images (x-rays, ultrasounds, PET, CT, MRI, bone scans and others- in either film or CD-ROM format) and pathology slides and their written reports.
  • Bring a pen and paper to take notes and written questions you would like to ask.
  • If you have one, bring a copy of your advance directive. Download a living will document (PDF).
  • Download the forms you will need to fill out and bring with you (PDF).

Consultation, Simulation & Treatment

Consultation

Talk with your radiation oncologist about your cancer and listen to the recommendation about how you should be treated.

Tracking seed placement (prostate only)

Most patients with prostate cancer will have three metallic markers placed around the prostate, which will help track the tumor's location during each treatment.

Simulation

After you decide to be treated with radiation therapy, CT images are taken of your treatment area in order for a customized radiation treatment plan to be created for your body and your tumor. This can take 1 to 2 hours.

Devices may be made to immobilize you during your daily treatment. They will also be made during your simulation. These devices can include a customized plastic mask of your face or a mold of your back.

You may receive several tattoos on your body, which will be no bigger than the size of the head of a pin. This helps your radiation therapy team to target the tumor on your body. After your simulation, it can take about one to two weeks to create a treatment plan that will maximize radiation to the tumor and minimize side effects. The machines will also be calibrated for your treatment regimen during this time.

Treatment

This can take two to seven weeks of weekday treatments. Treatments often take 15 to 30 minutes each. The same devices and/or tattoos made during the simulation to hold you still will be used. You will feel nothing during radiation delivery.

You will have daily and/or weekly imaging taken of your body in the treatment room to confirm you are correctly held in place. This can include a CT scan or X-rays and is called image-guided radiation therapy (IGRT). These images are used only to make sure you are correctly positioned; they usually cannot tell if the tumor is shrinking.

Depending on your cancer, you may need multiple CT scans during your treatment course – due to weight loss, tumor shrinkage or to make sure you are always positioned correctly for your treatment. You will see your radiation oncologist at least once a week during treatment to make sure you are not having unexpected side effects.

About the Process

Although every situation is unique, the typical process for stereotactic radiosurgery and radiotherapy patients at Jefferson Hospital for Neuroscience is:

Step 1

Your first step is an initial consultation with a Jefferson neurosurgeon or radiation oncologist, depending on your referral. At your appointment, please bring any scans you have, and be prepared to discuss your symptoms.

Step 2

The neurosurgeon will bring your case before the Tumor/Radiosurgery Board, which includes representatives from neurosurgery, radiation oncology and medical oncology. The panel will discuss your case and recommend a treatment.

Step 3

You'll receive a phone call from the Clinical Coordinator, who will explain the Board's recommendations, answer your questions and schedule your next appointment.

Step 4

If the Board has determined that you're a candidate for stereotactic radiosurgery or radiotherapy, you'll need to meet with a radiation oncologist or neurosurgeon (depending on who you did not see in your initial appointment) before treatment. (Please note: This appointment is required even for benign tumors.)

If your treatment is single-dose radiosurgery using the Gamma Knife or LINAC, you have one step remaining:

Step 5

Your MRI and CAT scan, development of treatment plan, and actual treatment will occur over the course of a single day. You'll need to block an entire day and bring a relative or friend with you to the hospital.

If your treatment is multiple-dose (fractionated) radiosurgery using the LINAC, you have the following steps remaining:

Step 5

Come to Jefferson for your MRI, CAT scan and fitting for the masking or mouthpiece system. This process will take approximately 4 hours to complete.

Step 6

The Jefferson team will thoroughly review your scans and develop your treatment plan. As soon as that has been completed, you'll receive a phone call to set up your appointments.

Step 7

Your treatment will vary depending upon your diagnosis. For most patients, stereotactic radiotherapy requires treatments five days per week for five to six weeks. Once a week you will have a treatment visit with your radiation oncologist to monitor your progress. Although actual treatment time may be less, block one hour for each of those treatments.

If your treatment begins on the same day as your trial run...

  • You will be asked to remain on the table in treatment position after the images are taken and approved by your physician. To make sure your treatment delivery is accurate, more photos will be taken of the treatment area.
  • The therapist will come to check on you and will let you know when treatment will begin.
  • The therapist will leave the room. Remember the therapist is still able to see and hear you at all times.
  • When treatment starts, the machine will make noise and may or may not begin to move.
  • Radiation treatments are painless and feel no different than getting a chest X-ray. You will not feel or see anything. During the treatment, you may or may not notice an unusual smell or see flashes of light, even when your eyes are closed. This is normal. Just remain as quiet and still as possible.
  • Treatment can take any amount of time between 10 to 30 minutes, depending on your personalized treatment plan.
  • After treatment is over, the therapist will help you get off of the table.
  • You will then discuss your daily appointment time with the therapist.
  • Any questions you have will be answered at this time.
  • After your questions are answered, you will be able to change your clothes and return home.
  • Please remember you are not radioactive during or after radiation therapy. The radiation is active only while the machine is on.

If your treatment does NOT begin on the same day as your trial run...

  • You will discuss your daily appointment time with the therapist.
  • Any questions you have will be answered at this time.
  • After your questions are answered, you will be able to change and return home.
  • If your physician needs to change the way your tumor will be treated, you may be asked to come in for another trial run. Some of the changes the physician makes can be done by the next day, while other changes might take a few days.
  • If it is necessary, the therapist will work with you to make an appointment for another trial run.

Your regularly scheduled treatment appointments

  • Don't forget to bring your barcode, which we use to identify you during all of your visits to the Bodine Center.
  • After you arrive in the Bodine Center, you will need to take the elevator to the 'B' level and check in at the reception desk.
  • You will scan your barcode and the receptionist will direct you to the changing area.
  • You should change just like you changed for your CT simulation appointment.
  • After you are changed, you will go the sub-waiting area room.
  • When it is time for your treatment, you will hear your name on the intercom.
  • At this time, you will walk down the hall to your treatment machine. If you need assistance, someone will be available to help you.
  • Your therapists will greet you at your treatment machine and confirm your name, date of birth and treatment site.
  • You will be asked to scan your barcode at the machine. This allows your customized treatment plan to be recognized by the machine. Your picture will also appear on the computer screen for identification purposes.
  • You will then be taken into the treatment room.
  • The therapist will assist you onto the treatment table and will help you get into the correct treatment position.
  • The therapist will leave the room. Remember the therapist is able to still see and hear you at all times.
  • When treatment starts, the machine will make noise and begin to move.
  • Treatment can take any amount of time between 10 to 30 minutes, depending on your personalized treatment plan.
  • After treatment is over, the therapist will help you off of the table.
  • Any questions you have will be answered at this time.
  • After your questions are answered, you will be able to change and return home.

Weekly On-Treatment Visits (OTVs)

Once every five days while you are receiving radiation therapy, you will see your physician for an on-treatment visit (OTV).

  • Please allow yourself additional time to see your physician on this day.
  • Flyers are posted in the elevators to help remind you when your on-treatment visit with your physician will be. Sometimes your physician may change the day for your on-treatment visit.
  • On the day your physician is scheduled to see you, the therapist will direct you to the nurses' station after your treatment.
  • A nurse will take you to a consultation room.
  • The nurse will complete an assessment. Then you will see your physician.
  • After you see your physician, you will be able to change and return home.