By Valerie Powell
It’s not surprising that a lot goes on behind the scenes of radiation therapy, and it’s definitely not surprising that there are many people who have a hand in your care. With all the people you see during your visits, there are just as many behind the scenes who have a role in what will happen from consult to continued follow-ups.
Dosimetrists are some of the first people to look at your case after your pathologist and doctor. These are the people who are eyeballs-deep in graphs, formulas, and scans making sure that your treatment is planned correctly so it targets the most effective areas. Dosimetrists carefully calculate the dose of radiation you will receive and the daily machine settings/parameters.
Once they finish their work on your case, they pass the plan back to your radiation oncologist for approval. Your plan is then ready to be put into action.
It may sound strange for a physicist to be part of your radiation oncology team, but they serve a very important role in the precision and accuracy of your treatment. Physicists keep radiation treatment machines properly calibrated every day by taking precise measurements of the equipment output. They also ensure that the machines are delivering the precise dose of radiation during every treatment, which is important for patients who undergo daily treatment.
Certified Medical Assistants (CMAs)
CMAs are not a part of every care team but larger facilities often have someone in this role to help with patient flow. CMAs are the people on your care team who may perform duties similar to a nurse. They might take your vitals, ask you questions regarding your current and recent status, and get you ready to see the doctor.
Your radiation therapy nurse is a registered nurse whose main job is to implement the plan of care your radiation oncologist has prescribed. Your nurse will be the one to administer medications and monitor side effects or adverse reactions that you may experience during or after radiation treatment.
You will see your radiation therapist every day of your treatment. Your therapist will walk you to your treatment machine, get you set up in place, and make sure you are comfortable before leaving the room. But where are they going?
While you are on the treatment table, radiation therapists are stationed nearby so they can monitor you and operate the machines. In many cases, they are taking quick images of your placement to make sure you are in the correct position so that the radiation will hit the correct spot. They are also controlling the radiation. If anything were to happen mid-treatment, they can/will stop the machine and get to you as quickly as they can to make sure everything is OK. Once your treatment is complete, they will help you off the table and escort you back to the dressing/waiting areas.
Radiation Oncologists (and Residents)
Radiation oncologists are the medical minds who oversee your care. They review your pathology, pinpoint the location(s) of the tumor or lesions on various scans, plan your dose of radiation and how many treatments you will have, manage your symptoms throughout your treatment, and do their best to ensure you get the best treatment and care you can, whether it’s curative or palliative.
Your radiation oncologist should be skilled and knowledgeable about typical side effects, prognosis, standards of care, and research opportunities. They are the ones who you should direct your questions to at your visit, but it is important to understand that there are some that your doctor isn’t able to answer.
At many facilities, residents are a part of the radiation oncology team. Residents may visit your room first and ask you questions during an exam or they may enter the exam room with your regular physician. Residents are oftentimes observing and absorbing as much information about each patient and the appropriate care as they can as they move closer to graduation. You also might notice that depending how much time passes between your visits, there may be a different resident present for your visit. Residents rotate doctors so they have a wide variety of experience by the time they finish their residency.
THE REST OF THE TEAM
Research Study Coordinators
Depending on whether your doctor recommends that you participate in a clinical trial, you may or may not interact with a study coordinator. These folks are the experts in the department on the clinical studies open in that practice, and will make sure each aspect of the study elements outside of standard of care treatment is taken care of. These will also be the people most likely to explain the study to you and check on you for follow-ups. These follow-ups may be in person at your regular visits or they may be a telephone call to see how you’re doing.
Lastly, social workers are there specifically for you. Their purpose is to make sure you are taken care of and provide you with the tools to deal with emotional burdens you may experience and/or help with decision-making strategies for your care. Social workers also typically have the ability to assist with more concrete needs including housing, transportation, finances, hospice or home care, and other supportive resources.
Valerie Powell is a graduate of Auburn University with a bachelor’s degree in English and Technical and Professional Communications. She works at the University of Alabama at Birmingham Department of Radiation Oncology as a marketing and communications professional. She is a previous head and neck cancer patient and survivor treated with 60gy over 30 fractions of radiation therapy in 2017. She is in her second year of coaching the dance team at Samford University, a small private university in Birmingham. She is married to her husband of 5 years, K.T. Powell, and they have two dogs, Fox and Stella.