The Simulation (what to expect)

"Simulation" is the process before external radiation therapy where you are scanned and aligned about a week prior to treatment.  The scan taken will be looked at with any other internal imaging you've had done to get a complete picture of where everything is inside you.

Notes:

For certain female cancers in the pelvis, you might be asked to not have a completely empty bladder.  A fuller bladder may move your intestines slightly so less radiation touches them.  Less radiation equals less symptoms.  Don't hold it in if you really have to go, though.  Just do what you can for the simulation and subsequent days of treatment.

Wearing loose-fitting clothing will be to your benefit with certain cancers.  I, for instance, had to have my shirt up over my stomach and my pants/underwear down to mid-thigh.

Unless they adjust you, stay as still as you can on the table once fairly comfortable.
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1.  You will go into an exam room (or other private space) and talk to the radiology nurse.  He/they/she will tell you what to expect, ask if you have questions, etc.  You might get your picture taken holding a board with your information on it for records/identity reasons.

2.  You will go into a room with a table and type of scanner similar to a CT machine.

3.  You will need to get on the table and lie down.  The clothing you wear might be adjusted before you get on, or after.  (Since I'm disabled and there's a mechanical lift involved, mine was done after.)

4.  They'll adjust you, putting pillows under your knees, head, etc.  They will try to get you straight.  They might give you a rubber ring to hold with both hands lying on your chest so your arms aren't in awkward places (I had one).  Depending on what part of you is bare, they may give you a sheet for warmth or modesty.

5.  They run the table through the machine.  There is a whirring sound, like a washing machine and you might have to close your eyes because of the red laser guide.  Unlike a CT scan, you do NOT have to hold your breath and there is NO injection!  No moving, though.

6.  You might have to be adjusted again, depending on what they see.

7.  They make marks on your skin with a marker and might put tape over them once your alignment is perfect.  After they're certain they got the marks right, they MIGHT wipe off the marks and tattoo you.  The tattoos are just TINY DOTS.  It feels like a needle poke, then done.  As an example, I got one on each hip and one on my pubic mound.

8.  They will take photographs of your position on the table to assist them with other times you're there.  Your nudity (if any) will probably not be in the pictures.  They just want to know where they have you lying.

9.  When it's over (if you're lucky) they will give you a treatment schedule before you even leave the building.  Your treatments will start about a week from the simulation.  They will, if possible, be at the same time each day.

10.  Go home and relax!