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Radiation Therapy

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Radiation Therapy

Radiation Oncology is part of the Waikato Regional Cancer Centre and is located in the Lomas Building at Waikato Hospital. We serve a wide geographical area including patients from the Waikato, Lakes, and Tairāwhiti District Health Boards (DHB).

It is one of nine Radiation Oncology departments in New Zealand.

  • Our services are primarily used for treating cancer patients but radiation therapy can be an effective form of treatment for several other health conditions.
  • In 2019 1570 courses of radiation therapy were delivered to 1422 patients at The Waikato Regional Cancer Centre.
  • We operate Monday to Friday (including most Public Holidays) and offer a limited after hours on call service.
  • The centre has four external beam treatment units (Linear Accelerators), a CT scanner, a superficial treatment unit, a brachytherapy treatment unit, and a radio-isotope laboratory.

As a Radiation Oncology department we aim to provide excellent patient-focused care that results in a positive experience for our patients and creates an environment where our staff want to work. We utilise modern radiation therapy techniques including VMAT, SABR and SRT to deliver treatments in line with international best practice guidelines. Our image guided systems (kV, CBCT and MV Imaging) ensure accuracy with position verification. The department has a strong involvement in clinical trials and research, allowing us to keep up to date with best practice

What is Radiation Therapy?

Radiation Therapy is a treatment that uses x-rays to damage cancer cells. Radiation treatment only affects the part of the body where beams are aimed. You do not feel radiation as it is being delivered.

Why is Radiation Therapy used?

Radiation Therapy is often in addition to other cancer treatment (surgery, chemotherapy , and/or hormone therapy).

  • To shrink a tumour so that surgery is more effective.
  • To treat any cancer cells remaining after surgery.
  • To control cancers – slow cancer progression. 
  • To relieve cancer symptoms such as pain

How is Radiation Therapy delivered?

Radiation treatment can be given in two ways: from outside the body (external beam) or inside the body (internal).

External Beam Radiation Therapy

Linear Accelerator

This is the most common method. Radiation beams from a treatment unit (linear accelerator or superficial machine) are focused from outside the body into the area affected by cancer.

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Treatments are usually given Monday to Friday with a rest at the weekend to help normal cells recover. Almost everyone is treated as an outpatient.

Superficial Machine

The superficial machine is usually used to treat skin cancers. External beam radiation therapy is typically given over a number of days or weeks.

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Internal Radiation Rherapy (Brachytherapy)

Brachytherapy involves placing a radioactive source inside your body, on or near the cancer. This procedure may or may not require a general anaesthetic.

In some cases, a combination of both external and internal radiation therapy is used.

Radioactive iodine in a liquid or capsule form can also be given for different thyroid conditions.

First specialist appointment

This appointment is when you will meet your Radiation Oncologist or Radiation Registrar to discuss treatment options, the benefits, potential risks of radiation therapy, and to answer any questions you may have. This appointment will be on Level B1 of the Lomas building. Check in at reception. Patients who reside within the Tairāwhiti DHB will be seen in Gisborne.

If you decide to have radiation therapy, a simulation appointment will be scheduled. You will be contacted with a date and time. This appointment may be scheduled directly after your FSA appointment if appropriate.

For a list of relevant questions you may wish to ask at your specialist appointment please visit the Cancer Society website.

Simulation (CT planning scan)

Most patients require a CT planning scan prior to treatment.

The scan produces images of inside the body allowing the Radiation Oncologist to see exactly where to treat. This appointment will be on Level 1 of Lomas Building. Follow signs to Radiation – Simulation and Planning on Level 1 The scan is painless and takes approximately 30 minutes. During the scan we create a position that we can reproduce on treatment and take lots of measurements. We may even create a device to help you stay still. It is important that you are as comfortable as possible and breathe normally unless told otherwise. Photos will also be taken to document your position.

At your CT scan, a Radiation Therapist may need to make permanent marks (small freckle sized tattoos) on your skin. These marks ensure that you are quickly and correctly positioned for treatment. The mark is made using a tiny pin prick under the skin with a small needle.

Scan preparation

Some people require extra preparation before their simulation, for example, bladder filling or the making of personalised immobilisation equipment. If your scan requires extra preparation you will be informed by your Radiation Oncologist.

Head and/or neck treatment
Many people having treatment to this area require an immobilisation mask to help keep them still. 

Head and/or neck treatment immobilisation mask

After simulation

There is a gap between your simulation appointment and treatment start date.

This time (the planning phase) is used to produce a treatment plan specifically for you. The planning phase is usually between two and four weeks, depending on complexity and cancer type. For some, the gap may be much shorter and treatment may occur the same week as simulation.

Planning is the process of simulating how the radiation is going to be delivered, and the effect it is going to have inside your body. This involves using a highly sophisticated planning software system and review process, which means your treatment, will be safe and as effective as possible.

You are not required to attend for the planning phase. You will receive a phone call and appointment letter in the mail from our administration team with your first radiotherapy appointment during this time.

The number of radiation therapy treatments you receive and therefore the number of visits to the Oncology department will depend on the total dose of radiation prescribed for you.

The majority of people are treated weekdays as an outpatient. A small number of people may require hospital admission.

You may experience side effects during your treatment.

Your first Radiation Therapy treatment

This appointment will be on Level B1 of Lomas Building.

  • For your first treatment arrive 15-20minutes earlier than your appointment time so you can meet your Radiation Therapists and get ready. Some patients will need to do bladder and bowel preparation prior to their treatment and may need to be in the department 60-90 mins prior to their treatment time. When you arrive, check in with the receptionist who will direct you to your treatment unit. Note: Treatment units are colour coded for simplicity: Green, Pink, Blue, and Yellow
  • A Radiation Therapist will discuss your treatment and what to expect, prior to treatment being delivered. This is a perfect opportunity to ask any questions.
  • You will be given appointment times for the week ahead every Friday.
  • It is normal to feel anxious on your first day of treatment. The treatment team are here to support you should you have any concerns. We will let you know what to expect at every stage so you can feel as comfortable and relaxed as possible about your treatment.
  • It is likely you will be asked to change into a gown or trousers.

In the treatment room

  • For treatment you need to be in the same position as when you had your CT scan. Each day, two Radiation Therapists will take a few minutes positioning you on the treatment bed.
  • Your radiation treatment will be painless and non-invasive. Relax, keep still, and breathe normally unless told otherwise.
  • The total amount of time spent in the treatment room is approximately 10-20 minutes but your first treatment will take slightly longer as a series of day one checks are performed.
  • There may be a student present. The treatment team will check with you to ensure you are comfortable having them involved.

Treatment delivery

  • Once you are positioned correctly the Radiation Therapists will leave the room. Staff always watch you on closed circuit cameras and can communicate via an intercom system if necessary. We can hear you and see you at all times throughout your treatment. If you need assistance at any point through your treatment just wave your hand or call out and we will come straight in.
  • The treatment team take x-ray images to verify you are in the correct position. If we need to make any adjustments we can come back into the room to do this, or the treatment bed can be moved very slightly from the control area outside.
  • During treatment you will not feel or see anything. The treatment unit does not touch you but it does make a buzzing noise.
  • It is important that you remain relaxed and still during treatment. Please do not move until a Radiation Therapist tells you that your treatment is complete.

Additional care during treatment

  • During a course of treatment you will have additional appointments to see your Radiation Oncologist. We endeavour to co-ordinate these with your treatment times.
  • These appointments will be on Level B1 of Lomas building (the same level as the treatment units).
  • The department also has specialist nurses, dietitians, and other health professionals who can support you during your treatment.

Radiation Therapy can cause various side effects to the area of the body being treated. Some of these are short-term and may only occur during treatment and for a short time after treatment finishes. Others may be more long-term.

It is important to remember that because everyone is different their reaction to treatment differs too. Your Radiation Oncologist will discuss possible side effects with you before your treatment starts and see you regularly while you are on treatment to ensure you are managing your side effects appropriately.

The Radiation Therapists will be seeing you daily and checking to see how you are doing. Please feel free to bring up any concerns you might have as they will be able to asses and further refer you to the necessary people if required

There are many factors that determine which, if any, side effects you may experience. They include:

  • The amount of radiation given
  • The area of your body we are treating
  • Other treatments you may be having e.g. chemotherapy

The effects of radiation on your body increase gradually over the course of treatment. It is unlikely you will experience any side effects straight away. Side effects tend to develop after a week or so, reaching a peak approximately ten to fourteen days after your treatment finishes and then gradually subside.

The effects of radiation treatment accumulates which means your side effects may get worse for up to two weeks after your course of treatment is complete. After this point, they should gradually subside.

Staff will educate you about continued management of these side effects in your final few days of radiation treatment.

Follow-up appointment

  • Once you have completed radiation therapy treatment you will be given a follow-up appointment with your Radiation Oncologist/Registrar.
  • The appointment may be shortly after your last treatment but is often 4-6 weeks after finishing.
  • Before a follow-up appointment you may be required to have blood tests or scans.
  • At this appointment the Oncologist/Registrar will assess how the radiation treatment has gone and may ask to see you again in the future

Your radiation therapy team works closely with support services to care for all your needs. Some of these services are listed below along with how they can help and support you throughout your treatment. Please let us know if you feel any of the services below would benefit you.

Cancer Society

The Cancer Society support people with cancer, their family/ whānau and friends. A wide range of support services are available.
Visit www.cancernz.org.nz

Chaplains

Offer spiritual support regardless of religious or cultural backgrounds.

More information on Chaplains

Clinical Nurse Specialists

Support patients and their family/whanau throughout the whole cancer journey. They are available to offer advice, information, symptom management and act as you link person for any concerns you may have.

Interpreters

Interpreters can be booked if you are unable to communicate using the English language.

Oncology dietitian

Cancer, and the treatment of, can affect your ability to maintain weight. Dietitians are available to help manage your diet and appetite.

Palliative Care

Palliative care is an approach to caring for people with cancer and their family that focuses on improving their quality of life; it is not just about care at the end of life.

Physiotherapists and Occupational Therapists

Some people experience changes in their physical functioning and ability to carry out day-to-day activities. Physiotherapists and occupational therapists can help with expert advice and exercises to help you regain your mobility, or assist with specialised aids to help you better manage.

Smoking cessation

Staff at Waikato hospital support people wanting to quit smoking. Our smoking cessation programme includes free nicotine replacement therapy.

Social Workers/ Psycho-Social Support Services

Social workers and Psycho-social supports services are available to provide a variety of supportive services to you and your family. They provide counselling to help cope with the diagnosis of cancer and subsequent treatment. They can arrange financial support and can put you in contact with other community services. Social workers and clinical psychologists also help people navigate the health care system and find support to manage day-to-day challenges of living with cancer.

Speech Language Therapists

Some cancers and treatments can affect your ability to communicate and swallow. Speech language therapists are available to help patients facing these difficulties.

Te Puna Oranga (Māori Health Service)

Our Kaitiaki service offers cultural support for Māori and their whānau in hospital. They can also link patients and whānau to external support services.

More information on Kaitiaki service

Key personnel

Cris Hartopeanu
Radiation Oncologist/Clinical Director

Koki Mugabe
Chief Radiation Physicist

Michael Taylor
Radiation Therapy Team Leader

Location

Waiora Waikato Hospital Campus, Pembroke Street, Hamilton

  • Levels 1 & B1, Lomas Building

Contact

Phone: 07 839 8604

For information regarding the types of side effects you may experience, refer to the information booklets below related to your treatment site.

Frequently asked questions about Radiation Therapy. 

For more information regarding different types of treatment and support services visit www.cancernz.org.nz

External beam radiation therapy (the type most people receive) won't make you radioactive. For this treatment the radiation is generated electrically (not using a radioactive source). No radiation remains in your body so it is fine to be around other people while you are having treatment. Brachytherapy (internal radiation therapy) treatment, delivers radiation using an implanted radioactive source which, while in place, will be emitting radiation. If you are receiving this type of treatment any precautions required will be explained to you in detail. If you are receiving iodine treatment you will also be given specific instructions

Having radiation therapy slightly increases the risk of developing a secondary cancer.  However, it is important to remember that, for many people, radiation therapy can eliminate the current, existing cancer.  This benefit far outweighs the small risk that treatment could cause a new cancer later in life.

Radiation damages cancer cells and some surrounding healthy tissues.  For example, men with prostate cancer, who receive radiation therapy to the prostate, may experience bowel or bladder side effects because all these organs are located very close to each other.  Radiation is directed precisely and surrounding healthy organs are shielded as much as possible.

Talk with your Radiation Oncologist to learn what parts of your body could be affected by treatment and how to manage potential side effects.

Many people find that keeping active while having radiation treatment helps to reduce fatigue. Listen to your body; if you feel like a rest, try and make some time to do so. For most patients as long as you feel well and able, there is no reason why you can't go to work. If you have concerns about driving or operating machinery, talk to your radiation therapy team.

For more information visit: Being active when you have cancer

Radiation therapy is a localised treatment, meaning it only affects the area receiving treatment.  For example, if we are treating your pelvis then it won't affect the hair on your head.

Hair loss may be permanent or temporary; it depends on how much radiation you are given.

If we expect you to lose hair from your head, information will be given about wigs and head accessories.

Radiation to the pelvic area may affect fertility.  Your oncologist can discuss options to preserve fertility before starting any treatment.  They can also tell you how long you should wait before attempting to conceive a child.  Please discuss the need for contraception.

If you are a woman of childbearing age, it is important you do not become pregnant during your treatment.  Radiation treatment given during pregnancy could harm a developing baby.

If you think that you may be pregnant at any time during your treatment, please tell your radiation therapy team immediately.

Our department has four treatment machines each with its own team of Radiation Therapists.  Generally you will be scheduled on one machine but you can receive the identical treatment on another.

It is very important to speak with your Radiation Oncologist about any supplements, over the counter medicines, complementary or alternative medicines or therapies, you may be taking or considering starting, for any reason, not just cancer related.

Some have proven benefits whilst others (even natural remedies) can reduce the potential effect of radiation therapy treatment.

We are located at the Waikato Hospital Campus, Pembroke Street, Hamilton

  • Levels 1 & B1, Lomas Building
  • Level 1: Simulation (planning CT scan) and Planning
  • Level B1: Treatment units, Radiation Oncologist clinic rooms and nurses station

Click here to see the campus map for directions.

Parking

We recommend parking in the Hague Road car park building. Drive in through Hospital Gate 1 (off Pembroke Street) onto Hague Road.  The car park building (on your left) is well signposted. From the car park building it is only a short walk to the Radiation Therapy department.  Follow the signs directing you to the Lomas building.

There are weekly parking vouchers available to you, please see reception for these or ask your Radiation Therapist.

Drop off and pick up points

The transit lounge is the closest drop off point to the radiation therapy department. To get to the Transit Lounge, follow Hague Road until you reach the roundabout, turn left into Lomas Lane and follow signs to Transit Lounge (there is drop-off / pick up zone directly outside). There is seating and bathroom facilities in the transit lounge so it is a good place to wait if you are being dropped off before or picked up after your appointment or treatment.

Transport

Personal transport

If you are travelling a significant distance or making regular trips to the hospital you may be entitled to a reimbursement for your travel expenses.

See the National Travel Assistance Scheme page for more information.

Community health shuttles / Transport Services

Some towns outside Hamilton offer a daily health shuttle service to the hospital campus.

These include (but are not limited to) shuttles from Thames, Te Awamutu, Matamata, Morrinsville, Raglan, and Rotorua.

Cancer Society Volunteer Drivers

The Cancer Society provides a service to those who live locally and cannot arrange transport to and from medical appointments.

For further information or to apply visit the Cancer Society website.

Or contact:
Sue Worth
Ph: 0800 2277 44
sueworth@cancersociety.org.nz

Bus

For more information on local bus services:

Tairāwhiti District Health Board

Tairāwhiti District Health Board has a transport co-ordinator who organises travel arrangements for patients from that area having radiation therapy treatment at Waikato Hospital.

Cancer Society’s Lions Lodge

The Cancer Society Lodge is only a stone throw away from The Waikato Regional Cancer Centre, and offers relaxing and friendly accommodation to patients while they are undergoing cancer treatment. The lodge is a free facility, providing meals and support for people who have to travel for treatment each day.

For more information please visit the Cancer Society page.

Cancer Society Lodge

Te Whare Taurima

Short term, low cost accommodation for people who are supporting patients at the hospital. Priority is given to families living more than 100km from the hospital. Managed under a Maori Kaupapa philosophy but open to all ethnic groups.

For more information please visit the Waikato Hospital Accommodation page.

Nearby motels and hostels

Argent Motor Lodge: 0800 275 676
Abbey Motel: 0800 99 88 99
Astra Motor Lodge: 0800 427 872
YWCA Hamilton Hostel and backpacker accommodation: (07) 834 0094 (20min walk from hospital)

Radiation Therapy team

Team roles

Administrative staff
Responsible for arranging appointments, booking scans, typing medical records, filing, and the day-to-day running of the radiation therapy department. They are also a great source of information for general questions.

Medical Physicists
Performs important roles behind the scenes working in all aspects of radiation therapy. They are responsible for developing and directing quality control programs for equipment and procedures. They also take precise measurements of radiation beam characteristics and complete other safety tests on a regular basis.

Oncology Nurses
Specialises in the care of patients with cancer. They assist the radiation oncologists with their clinics and provide care and support for patients experiencing treatment side effects and managing health concerns.

Radiation Oncologists
Specialises in the use of radiation to treat cancer. Your Radiation Oncologist is in charge of your care. They are involved in the planning of your treatment and will see you before you begin, during, and once you complete your course of Radiation Therapy.

Radiation Oncology Registrars
Works with a Radiation Oncologist. These are qualified doctors who are undergoing more training to specialise in Radiation Oncology. A registrar may see you on behalf of your Radiation Oncologist.

Radiation Therapists
Specialises in the planning and operation of equipment to accurately deliver radiation treatment. They see you every day during your treatment and provide care and support, including side effect management.

Students
The Waikato Regional Cancer Centre participates in the training of radiation therapy students and physicists. These students may be involved in your care but are always under the supervision of a qualified staff member. Your permission will be asked for their involvement.

The Waikato Regional Cancer Centre is located at Waikato Hospital in the city of Hamilton, New Zealand. This centre serves a population of 600,000 from Waikato, Lakes and Tairāwhiti District Health Boards. The Oncology Department includes radiation therapy, chemotherapy, an inpatient ward, palliative care service, and a Haematology Department. The Waikato radiation therapy service is Varian integrated with Eclipse, Aria and four linear accelerators. We use the latest radiation therapy techniques including SABR, SBRT, SRT, IMRT, VMAT, DIBH and ultrasound guided brachytherapy. Our image guided systems are composed of kV, CBCT, 4DCT and MV imaging.

In addition to our linear accelerators our service consists of a superficial x-ray unit, HDR brachytherapy unit, radio-isotope laboratory and a fully equipped mould room including 3D printing. Our centre is equipped to deliver Total Body Irradiation (TBI) and is the only centre in New Zealand to deliver Total Body Electron (TBE/TSET) treatments.

Radiation therapists at Waikato are given ample opportunities to grow professionally. We offer a range of development roles such as planning and brachytherapy which allow staff to gain experience and develop their skills. Radiation therapists rotate through CT, planning and treatment every few months, with additional opportunities to rotate through the BIMS team (Brachytherapy, Iodine, Mould room, Superficial) our superficial unit and iodine clinic. Waikato Regional Cancer Centre also has a strong involvement in clinic trials and research. We are always seeking to advance our techniques using modern innovations to improve our practice.

If you would like the opportunity to work in a positive, innovative and caring environment, please email your expression of interest and CV to the team leader: Michael.Taylor@waikatodhb.health.nz