Simulator

Purpose:
This was part of the planning process of a course of Chemotherapy for a patient with prostate cancer. Its function was to establish alignment marks i.e. tattoos, which are necessary for positioning the Chemotherapy beams. The simulator replicates the Linear Accelerator (Linac) treatment machine, except the power of the x-ray beam is very much lower being more in keeping with that of a diagnostic x-ray machine.

Experience:
Having been shown to the waiting area, I was collected by a radiographer, asked to undress and lie on the simulator couch. Three radiographers manned the facility, varying their time between the patient and the control room. A radiographer put a thin rod a little way into my rectum, and I was asked to lie on my back. The couch was moved into a pre-determined position and height in accordance with the computerised plan. The head of the Linac rotated to the required position, initially pointing vertically downwards. The direction of the x-ray beam is indicated by a laser beam and the couch is moved until this is positioned over the tumour target and at a pre-determined angle. The radiographer then makes a small permanent tattoo mark on the skin, which then becomes an alignment mark used during treatment. This is checked by operating the Linac at low power, the x-rays creating an image on the film positioned under the couch.

The process was then repeated by rotating the Linac head so its beam was approximately horizontal pointing to the left. There were some additional visible laser beams crossing the room which served as reference lines for the positioning of the couch. The radiographer made another tattoo mark on my side, and the whole process was repeated with the Linac head rotated to point in the other direction.

Once this was done the radiographers checked when my appointment was to commence treatment and let me get dressed and leave.

Duration:
The whole process in the simulator room took about 30 minutes, and the time spent in the department was almost an hour.

Side effects:
Apart from the tiny pin prick associated with the tattoo, there was no discomfort. As this was my first sight of a Linac and knowing I was getting near to receiving treatment, the experience was rather more nerve racking that other procedures. However, the radiographers were very caring and went to a lot of trouble to try to put you at ease and to explain what they were doing.

Purpose:
To establish the alignment mark and Linac settings for a patient with prostate cancer and who was about to undergo a short course of palliative Chemotherapy on a metastasis tumour in one spot in the spine.

Experience:
The details are very similar to case 1 above except the treatment was to involve an x-ray beam in just one direction. As a result I was asked strip to the waist and to lie face downwards on the simulator couch. The radiographer positioned the couch under the beam and made a tattoo mark on my back. She then checked its position by taking an x-ray film with me in that position.

This done I was able to get dressed and leave.

Duration:
I spent only about 5 minutes in the simulator room and only 15 minutes in total in the department.

Side effects:
None