Palliative Whole Brain Radiation Therapy

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This information explains what to expect during your simulation for palliative whole brain radiation therapy. It also explains what to expect during your treatments and side effects you may have.

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Simulation

Figure 1. An example of a mold used for whole brain radiation therapy

Figure 1. An example of a mold used for whole brain radiation therapy

Simulation (also called a mapping or planning session) is a procedure to plan your radiation treatments. It’s done to map your treatment site, make sure you get the right dose (amount) of radiation, and limit the amount of radiation that gets to your nearby tissues.

During your simulation, we may make a plastic mesh mold of your face and head (see Figure 1). You’ll use the mold during your simulation and all your treatments to help you stay still and make sure your head is in the same position every time. You’ll be able to see and hear with it on. Making the mold will take about 15 minutes.

Remove devices from your skin

The manufacturer recommends taking these devices off your skin before your simulation or treatment:

  • Continuous glucose monitor (CGM)
  • Insulin pump

If you use one of these, ask your radiation oncologist if you need to take it off. If you do, make sure to bring an extra device to put on after your simulation or treatment.

While your device is off, you may not be sure how to manage your glucose (blood sugar). Ask the healthcare provider who manages your diabetes care. Make sure to do this before your simulation or treatment appointment.

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During Your Treatment(s)

A staff member will bring you to the radiation treatment room. There, the radiation therapist will greet you and help you onto the treatment table (see Figure 2). You’ll be positioned exactly how you were during your simulation. Then, you’ll get your treatment. During your treatment, the machine will move in a circle around you.

Figure 2. An example of a radiation therapy machine

Figure 2. An example of a radiation therapy machine

You’ll be in the treatment room for 15 to 90 minutes, depending on your treatment plan. Most of this time will be spent making sure you’re in the right position. The radiation therapist will walk in and out of the room, but they’ll be able to see and hear you the whole time.

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Side Effects

You’ll probably have some side effects during and after your treatments. Common side effects are listed below.

If you have any side effects, be sure to tell a member of your radiation therapy team. We’ll help you manage them.

  • Hair loss: You’ll probably lose some of the hair on your head and eyebrows about 2 to 3 weeks into your treatment. Your hair should grow back 3 to 6 months after your treatment ends.
  • Skin reactions: Your skin may become pink or tanned about 2 to 3 weeks into your treatment. As you continue treatment, it may become bright red or very dark. It might also feel dry and itchy and look flaky. You can use lotions meant for dry skin (such as Eucerin®) to help keep it moisturized. Protecting it from the sun by wearing sunscreen will also help. These skin reactions will start to gradually get better about 3 or 4 weeks after your treatment ends.
  • Fatigue: Fatigue is a feeling of being tired or weak, not wanting to do things, not being able to concentrate, or feeling slowed down. Fatigue can range from mild to severe. You may develop fatigue about 2 to 3 weeks into your treatment, and it may last for 6 weeks to 1 year after your treatment ends.
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