If your child is prescribed radiotherapy at the Harley Street Clinic, you will be given several patient leaflets and have ample time to discuss what is entailed. This page will also be provided at that time and explains the specific issues relating to children

INTRODUCTION

Radiotherapy is mainly used for treating cancer and consists of using a beam of radiation. Cancer cells are more sensitive to radiation than normal cells but it is still important to only expose the cancer to the radiation beam and to carefully measure the dose or amount. Radiotherapy may be given on its own or together with surgery or chemotherapy.

In practical terms, the radiotherapy is given by a large machine that looks similar to an X ray scanner. The patient has to lie very still for a few minutes so only the cancer cells are irradiated. The radiation is repeated, normally each day for five days a week, for several weeks. Nobody else can stay in the treatment room.

Although most adults remain awake for radiotherapy, this may be impractical in young children, so we normally administer radiotherapy under general anaesthesia. Older children and adults may be suitable for sedation, but sedation is not practical for smaller chidren, and offers no additional safety.

WHAT IS INVOLVED?

I will normally see you before we start treatment to take a history, examine your child and answer your questions. We first need to make a mould or shell which is a light plastic mask that the head fits into. The shell fixes the head and spine (the most common cancer areas we irradiate) in relation to the beam.

Next a plan is developed, which determines the amount of radiation, the area of the body exposed, and the number of sessions or ‘doses'. Planning is now normally done in one session and entails setting up the shell and taking CT scans.

There will normally be a break of a few days whilst the plan is calculated, checked and rechecked for accuracy before being signed off by your oncologist. After that your child will have radiotherapy each day from Monday to Friday.

THE PRACTICAL ARRANGEMENTS

All children are admitted to the paediatric floor of the Harley Street Clinic which has specialist nurses as well as play specialists. One parent can come down to radiotherapy with the patient. I will anaesthetise your child in the planning room or the radiotherapy room, and you will then be asked to go to the waiting room. I monitor the anaesthetic using cameras and monitors from the control area. The treatment takes only a few minutes (planning sessions may take longer), and then we will transfer your child to the recovery room adjacent to the operating theatres where specialist recovery nurses will care of him or her until awake. You can then take your child back to the paediatric floor accompanied by a floor nurse.

Most children remain in hospital initially, although you may be able to take your child out during the day. Some children come in daily, but this depends upon how close you live, your child's condition and other issues that we will address on an individual basis. If you do come in daily, please arrive two hours before treatment to allow your child to relax and to give the nurses time to prepare him or her. The radiotherapy machines are very busy, and if you miss your scheduled time it may be impossible to arrange another time that day.

There is a very important issue we need you to help us with: nutrition. Good nutrition is vital during radiotherapy. Children need to increase the amount of food they eat during radiotherapy and we must try to avoid weight loss. However, it is important that the stomach is empty for a general anaesthetic (please click here for the paediatric section that explains this in detail). Your child must have no food or milk or fruit juice for six hours before the radiotherapy each day, and must have no fluids for two hours before. We need your help to ensure this is strictly adhered to – if your child has eaten we will cancel treatment that day. However, it is equally important that you encourage your child to eat and drink up to those times, and to eat and drink as soon as possible after recovery.

OTHER ISSUES

The anaesthetic is normally given into a vein as this is kindest and minimises the recovery time. In view of the number of anaesthetics required, we normally insert a Groshong line (please click here for information about lines) early in the treatment under the same anaesthetic we are using for radiotherapy that day. Your child may already have a line and if so we can normally use it.

Many children find it difficult to eat enough as the radiotherapy progresses. This may be because they are not feeling well, due to nausea (although we will give drug for this) or soreness in the mouth if the radiation includes this area. If necessary, we will recommend a PEG which is a small tube inserted through the wall of the abdomen directly into the stomach. Again we try to do this under the same anaesthetic as that day's treatment.

I look forward to meeting you.