Prostate Scenario
Updated: 6/17/2020
Prostate Scenario
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  • First Day of Treatment
  • First I will take a KV image to check if the patient is straight. If the patient is crooked I will go back into the room and make any adjustments needed. If any adjustments are made, I must go back in the room, triangulate and reimage. Next, I will take a CBCT. This will allow me to see soft tissue as well as the capacity of the bladder. It is important the bladder is within the contour that the doctor created for the patient and the bladder is at least 50% full. Also, the rectum must fall within the contour and is empty. Another thing to look for is gas bubbles to avoid any bolus or scatter effect and for any pelvic tilts. The beacons should be within their contours as well with minimal shifting. Next, I will call the doctor for approval of the images
  • OBIKV imaging
  • First Day of Treatment
  • The images look great. You’re good to treat.
  • CBCT
  • Now I will deliver the first IMRT fraction. IMRT treatment techniques can be used to customize the dose to the prostate bed and avoid structures such as the bladder and the rectum
  • First Day of Treatment
  • Besides trying to hold still, it went well
  • The morning works well
  • You will come back for approximately 37 fractions, can you tell me which time of day works best for you?
  • Not so bad right?
  • At the console
  • First Day of Treatment
  • Treatment RoomTrilogy
  • At the console
  • Fraction 37/37
  • Yes, but why?
  • Hello Mr.John Doe! Today is fraction 37, but as you know the doctor decided to treat 5 more fractions known as a boost
  • The patient is treated and taken down from the table
  • Boost 5/5
  • This has been quite a journey but i appreciate all the support you have given me!
  • Today is your last day!
  • The therapist creates the patient's schedule and completes the treatment verification note
  • Thank you!
  • Ok, I’m going to walk you over to the nurses while I create your schedule. Once you finish with the nurses you will come back to change and I will give you your schedule. You will also be seeing the doctor every week for a status check
  • The patient expresses concerns about side effects he is experiencing
  • I am experiencing impotence and urinary incontinence
  • Those side effects are both normal. Impotence should go away 1-2 months after treatment. For urinary incontinence, I will have you go to the nurses for any medications that can help
  • Having a boost will help destroy any residual disease and target the tumor more precisely. Are you having any difficulties with side effects?
  • The patient finishes his final boost treatment
  • Please be sure to keep your follow up appointments with your radiation oncologist. They will evaluate your response to treatment. You may have blood tests, x-rays, and scans during these visits. I wish you the best of luck!
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