SBRT for tumours in the pelvic region is a non-invasive cancer treatment method when
surgical options are limited. Pelvic SBRT can be used to treat tumours in the pelvis region
such as cancers
of the prostate, ovaries, uterus, and rectum.
Select a stage in the treatment timeline to see what happens at that point in the process.
Treatment Timeline
In this section
Consultation
Your initial meeting with your radiation oncologist will help you get familiar with
what the
treatment will look like, and how you can prepare for each step. You can also bring
up any
questions or concerns you may have about your SBRT treatment during this
appointment.
Some of the topics your radiation oncologist may discuss include:
The overall treatment process
Potential side effects
Instructions on how to prepare for treatment (such as bladder and bowel
preparation)
Useful resources to begin your SBRT journey.
Your radiation oncologist or doctor may also prescribe you certain medication to:
Help you prepare for treatment
Help manage treatment anxiety
Help manage treatment-related side effects, such as improving bladder or bowel
comfort.
If you have any questions about your medication, please let your treatment team know.
Your consultation appointment is an opportunity to ask questions and learn about your treatment process.
In this section
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
Most
simulation appointments can be finished in less than two hours depending on the
treatment
location.
How to prepare for your simulation appointment
Your treatment team will give you specific instructions to follow to prepare for your
pelvic
SBRT
simulation appointment.
General tips to prepare for your simulation appointment include:
Drinking water before your appointment in order to arrive with a comfortably full
bladder
Arriving with an empty stomach or fasting for a specified time before the
appointment.
Following special bowel preparation instructions if needed.
These instructions help keep your bladder and bowel in a consistent position for
treatment
planning. 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.
In this section
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.
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:
Confirm your bladder and bowel status
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 30-90 minutes, but may be different depending
on which
type of
SBRT machine is used. It will
usually be longer than your simulation appointment.
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. Your
treatment
staff may ask you to:
Follow bladder filling instructions before treatment
Empty your bowels before treatment
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 you are told otherwise by your
healthcare
team.
You can usually drive yourself home after treatment unless you are told otherwise.
Normal eating and daily activities are usually allowed right away
Note of any side effects or symptoms you experience.
Keep track of any questions or concerns to discuss with the treatment team at your
next
SBRT
treatment appointment
You might feel tired later in the day, so plan for
a quieter schedule if possible.
You may begin to feel some side effects shortly after your appointment is finished, while
some
could develop over the next
couple
days.
Potential side effects may include:
Urinary discomfort or symptoms
Diarrhea or changes in bowel movement
Fatigue
Changes related to sexual health and intimacy
Side effects could be different depending on which area of the pelvis is being treated.
Please
advise your treatment team about any side effects you experience.
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.
In this section
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
pelvis
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 pelvis 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 pelvic SBRT may include:
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.
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.
Because pelvic radiation may affect the bladder or urinary tract, some patients
may
experience:
More frequent urination
Burning or discomfort during urination
Increased urinary urgency
Waking more often at night to urinate
These symptoms are usually temporary.
Managing urinary symptoms
Drink fluids regularly unless advised otherwise
Avoid bladder irritants such as caffeine, alcohol, and spicy foods
Empty your bladder regularly
Take medications prescribed by your care team as directed
Please contact your treatment team if you:
Are unable to urinate
Notice blood in your urine
Develop severe pain, fever, or worsening urinary symptoms
If radiation affects part of the bowel or rectum, you may notice loose stools,
more
frequent bowel movements, cramping, bloating, gas, or rectal irritation. These
symptoms
can begin during treatment or shortly afterward.
Managing bowel symptoms
Drink plenty of fluids to stay hydrated
Eat smaller meals more often throughout the day
Limit foods that may irritate your stomach or digestion
Choose gentle foods that are plain or easier to digest
Contact your radiation therapy team if symptoms become severe, last longer than
24 hours,
or interfere with eating and drinking.
Depending on which area of the pelvis is being treated, some patients may notice
temporary or longer-term changes related to sexual health or intimacy after
pelvic SBRT.
Possible changes can include:
Changes in sexual desire or comfort
Erectile dysfunction or difficulty maintaining erections
Vaginal dryness, irritation, or discomfort
Changes in ejaculation or fertility
Fatigue or emotional stress affecting intimacy
Not everyone experiences these side effects, and symptoms can vary depending on
the
treatment area, radiation dose, other cancer treatments, and your overall
health.
Managing sexual health concerns
Talk openly with your treatment team about any symptoms or concerns
Ask about medications, lubricants, pelvic health therapy, or other
supportive
treatments that may help
Take time to resume intimacy gradually as you recover
Seek emotional support if treatment is affecting relationships or wellbeing
Your healthcare team can help connect you with additional support services or
specialists
if needed.
