Here are our guidelines to help you prepare for your simulation appointment and what to expect.
Before the day of your simulation
Contact your nurse coordinator or advanced practice provider beforehand if you:
- Experience pain while lying flat on your back, and you think you may require pain medication for the scan.
- Are allergic to any type of contrast materials or dyes such as gadolinium.
- Have diabetes, in case you may need to refrain from taking certain medications before or after the simulation.
- Are claustrophobic.
- Have any implanted devices, such as a port, cardiac pacemaker, or brain/spinal stimulator, so that you can bring documentation showing the device’s make and brand.
- Have shrapnel or metal shards in your body.
Imaging scans to plan treatment
You will need to have scans done during your simulation to help plan your radiation treatments. Your radiation oncologist may order one or more of the following scans:
- Computed tomography (CT): Uses X-ray technology to produce cross-sectional images
- Magnetic resonance imaging (MRI): Uses radio waves and a powerful magnetic field to produce highly detailed images
- Positron emission tomography (PET): Uses a safe, radioactive tracer to detect cancerous cells in your body
On the day of your simulation
- Drink lots of water to stay hydrated
- Wear comfortable clothing that you don’t mind getting ink on
- Please follow your fasting instructions, if your care team has provided any
Go to the Stanford center where you have scheduled your simulation. Check in at the reception desk when you first arrive.
- Verify your name and date of birth at the reception desk.
- Remain in the waiting room until a care team member takes you to the dressing room and procedure area.
Here’s what to expect during your simulation appointment:
- Positioning and immobilization:
- You’ll meet with our radiation therapists, who will position you in a mold, cradle, or cushion customized to your body shape to help hold you still during treatment. The pillow will ensure that you are in the same position for every treatment.
- You will most likely need to lie on your back with one or both arms raised above your head. Sometimes, you may need to lie on your stomach.
- Once you are in a comfortable position, a radiation therapist will mark your exact position. When you are immobilized for your series of treatments, you will be in this same comfortable position.
- IV start: If your doctor orders an IV contrast, we will place an IV catheter near you before the scan.
- Marks on skin: We will make some marks on your chest to outline the target treatment area. Sometimes, we put a tiny tattoo dot on your skin so that you will be positioned correctly at every treatment.
- Scan: We will do a focused CT scan of your chest. The CT scan gives us a 3-D image of the area we want to treat and areas such as the lungs and heart that we want to avoid. If the tumor was in your chest, we use a special technique called deep inspiration breath hold (DIVH) to protect your heart during treatment:
- During your CT scan, you will take a deep breath and hold it for about 10 seconds. When your lungs expand, your heart moves down and away from the area we want to treat, avoiding the radiation.
- During your series of treatments, we will ask you to repeat this breath-holding process. Our radiation therapy system uses the timing and location information from the previous CT scan. The radiation beam turns on only when you hold your breath, keeping your heart safely out of the way.
Schedule your first treatment:
- Your radiation oncologist may need to review the scan first. If not, you can schedule your first treatment appointment for about 1 to 2 weeks later.
- Please tell your care team your preferred daily treatment time. We do our best to accommodate your request.
Published June 2019
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