Consultation
Your first appointment with your radiation oncologist is an opportunity to learn about your SBRT treatment and how to prepare. You are encouraged to ask any questions or discuss any concerns you may have.
During your consultation, your radiation oncologist may discuss:
- Your treatment plan and what to expect throughout the SBRT process.
- Possible side effects.
- How to prepare for treatment.
- Helpful resources and support available to you.
Medications
Your doctor may also prescribe medication to help:
- Prepare you for treatment.
- Reduce anxiety related to treatment.
- Manage treatment-related symptoms.
If you have any questions about your medications, please speak with your healthcare team.
Simulation
Your simulation appointment is a planning session that will help your radiation treatment team customize your treatment. This lets them create a treatment plan specific to your cancer while protecting your vital organs.
You will not be receiving any radiation during this appointment.
During your simulation appointment, your radiation therapy team will:
- Position your body carefully for imaging
- Take detailed imaging of your body (usually a CT, MRI or PET scan)
- Plan how to deliver radiation safely and accurately
These steps are important for making your treatment as effective and safe as possible. Most simulation appointments can be finished in less than two hours depending on the treatment location, or if additional preparation is needed.
How to prepare for your simulation appointment
Your treatment team will give you specific instructions to follow to prepare for your lung SBRT simulation appointment.
Some general tips to prepare for your simulation appointment include:
- Avoid eating food or drinking for a certain period before your appointment.
- Arriving with an empty stomach or fasting for a specified time before the appointment.
Please talk to your treatment team if you have any questions or concerns about how to prepare for your simulation appointment.
What to wear or bring to your appointment:
- Wear comfortable, loose-fitting clothing that is easy to remove.
- Avoid wearing things with metal (e.g., jewelry, metal buttons, belts, bras with underwire).
- Bring a list of your current medications and any questions you may have.
What happens during your simulation appointment
When you arrive at the hospital, you may be asked to change into a gown before your simulation appointment. This can vary depending on which hospital you are treated at.
A staff member will guide you to the medical imaging room where your simulation appointment will take place.
A radiation therapist will help you lay down onto a custom support called an immobilization device to help you stay still during the scan. You will be positioned inside this device during the scan. You will usually be laying down on your back, with your arms raised up over your head or down by your sides.
This is where illustrations of possible immobilization devices would be included. Examples will include a wing board device, VakLok, and ABC device.
You will be alone in the imaging room during the scan, but you will be closely monitored by your radiation therapist and treatment team. You will still be able to communicate with them at any time during the appointment. If you feel any discomfort during the scan, please let a radiation treatment staff know so they can pause the scan.
During the scan, your radiation therapist may also ask you to follow some simple breathing exercises (like holding your breath for short periods of time).
While this is happening, you may hear the machine or table moving, but the process is not painful.
Once the scans are done, the final step will be for the radiation therapist to make some small permanent tattoo markings on your skin using a needle. These are meant to help make sure you’re put into the same position during your SBRT delivery appointments afterwards. Certain treatment centers might not require these tattoos, or may offer temporary options. Please speak to your treatment team if you have any questions or concerns about this process.
After your simulation appointment
After your scans are finished, you are free to continue your normal routine unless your treatment team instructs otherwise.
The care team will review your scan images and use them to build the treatment plan. You will usually go home the same day and wait for the next appointment in the process.
- Ask when you should expect the next call or visit.
- Let the team know if you have new symptoms after the appointment.
- You may receive reminders about the treatment schedule or prep instructions.
Planning
After taking your scans, your treatment team will come together to create your treatment plan. Your plan will be carefully checked multiple times before your first treatment to make sure it is safe and accurate.
This will usually take one to two weeks. You will be contacted by your care team when your treatment appointments are ready.
Creating your treatment plan
Each SBRT treatment plan is different. Your treatment team will work together to create a plan that is fully customized for your condition.
The team of people working on your treatment plan includes your radiation oncologist, radiation therapists, medical physicists and dosimetrists.
While your treatment is being planned:
- The radiation oncologist contours the tumour and nearby healthy tissues that need protection.
- Medical physicists and dosimetrists verify the plan for accuracy and safety.
- Your overall care team will confirm that the plan is safe and effective to implement.
Your treatment plan will specify the specific dose of radiation you will be treated with and create the radiation delivery approach to target your tumour.
Please let your treatment team know if you have any questions about the planning stage.
Treatment
Your SBRT treatment sessions are when you will receive radiation to treat your cancer. You will usually have up to five of these appointments.
During this visit, your radiation therapy team will:
- Position your body on the treatment table (in the same position used for simulation)
- Take a scan of your body to make sure everything is aligned correctly
- Make any small positioning adjustments
- Deliver the radiation treatment
Each treatment session usually takes about 30-60 minutes, but may be different depending on which type of SBRT machine is used.
How to prepare
Preparing for your SBRT treatment session will look similar to your simulation appointment.
Before treatment, follow any instructions about clothing, medication, and eating. You may be asked to:
- Wear comfortable, loose-fitting clothing that is easy to remove.
- Avoid wearing things with metal (e.g., jewelry, metal buttons, belts, bras with underwire).
- Bring a list of your current medications and any questions you may have.
What happens during
When you arrive for your treatment session, a radiation therapist will guide you to the treatment room and help you get positioned on the treatment table. You will be positioned in the same way as your simulation appointment, and may be placed in the same immobilization device to help you stay still during treatment.
The staff positions you carefully, takes images to confirm alignment, and then delivers the radiation. The treatment itself is painless and usually only takes a short time.
- You need to stay very still while the machine is on.
- The team may step out of the room, but they can see and hear you the whole time.
- You may hear the machine move around you between imaging and treatment steps.
The amount of time it takes to deliver your radiation treatment will take about 15-30 minutes, but this could vary depending on your treatment plan.
After the appointment
Most people can go home right after treatment unless your healthcare team tells you otherwise.
- You can usually drive yourself home.
- You can return to your normal eating and daily activities unless you are told otherwise.
- You may feel tired later in the day, so plan a lighter schedule if possible.
- Some side effects may begin shortly after treatment or over the next several days.
Keep track of your symptoms
- Make note of any side effects or new symptoms.
- Write down any questions or concerns to discuss at your next appointment.
- Contact your healthcare team if you develop worsening symptoms, such as difficulty breathing or a fever.
Your last day of SBRT
On your final treatment day, your healthcare team will:
- Review any side effects or concerns you may have.
- Provide instructions for your care after treatment.
- Explain how to contact your healthcare team if you have questions or develop new symptoms.
- Review the plan for your follow-up appointments.
Caring for your emotional well-being
It is common to feel relieved when treatment ends, but you may also experience stress, uncertainty, or emotional exhaustion.
Talking with family, friends, a counsellor, a support group, or your healthcare team can help. If these feelings become difficult to manage, let your care team know so they can connect you with additional support.
Continue seeing your family doctor
Continue regular check-ups with your family doctor for your general health and any concerns unrelated to your radiation treatment. Your healthcare providers will work together to support your ongoing care and recovery.
After SBRT: Follow-Up Care
Even though your radiation treatment is complete, your care will continue. Follow-up appointments help your healthcare team monitor your recovery and the results of treatment.
Your follow-up visits may include:
- Discussion of your recovery and any side effects.
- Physical examinations.
- Imaging tests to assess how the tumour is responding.
- Ongoing symptom management, if needed.
The timing of your follow-up appointments will depend on your treatment and overall health.
Managing your recovery side effects
It is normal to experience some side effects after treatment. Side effects after SBRT to the lung is generally milder compared to conventional radiotherapy.
- Most side effects improve gradually over time without intervention.
- Side effects can vary depending on which part of the lung is being treated.
- Some side effects may require medical attention, so it's important to report any new or worsening symptoms to your healthcare team.
Your radiation oncology team will monitor your progress and provide support as needed.
Potential side effects after lung SBRT may include:
Fatigue is one of the most common side effects of radiation therapy. You may feel more tired than usual during treatment or in the weeks afterward. This often improves gradually over time.
Managing fatigue
- Try to maintain a regular sleep schedule
- Rest when needed, but avoid staying inactive for long periods
- Light physical activity, such as short walks, may help improve energy levels
- Eat balanced meals and stay hydrated
- Prioritize important activities and pace yourself throughout the day
Speak with your care team if fatigue becomes severe or interferes with daily activities.
Some patients may experience nausea or vomiting after treatment. Symptoms may occur within a few hours after treatment and usually improve within 1–2 days.
Please let your radiation therapy team know if nausea or vomiting becomes severe or difficult to manage.
If you have anti-nausea medication, take it as directed by your care team.
Some patients may develop a dry cough, mild shortness of breath, chest tightness, or irritation after lung SBRT. These symptoms may occur gradually during or after treatment, and are usually temporary.
Rarely, radiation can cause inflammation in the lungs called radiation pneumonitis. This may occur several weeks to months after treatment.
Managing Cough or Breathing Symptoms
- Pace yourself with activities and rest as needed
- Drink fluids regularly to help keep secretions thin
- Avoid smoking and second-hand smoke
- Use prescribed inhalers or medications as directed by your healthcare team
- Sleep with your head elevated if this helps your breathing
Contact your radiation therapy team if you experience:
- Increasing shortness of breath
- Persistent or worsening cough
- Fever or chills
- Chest pain
- Coughing up blood
Some patients may experience mild soreness, tenderness, or discomfort in the chest wall or ribs near the treatment area. This is usually temporary and mild.
Managing Chest Discomfort
- Wear loose, comfortable clothing
- Avoid activities that worsen discomfort
- Use pain medication if recommended by your healthcare team
Tell your care team if pain becomes severe or persistent.