Childhood Cancer

Print

Childhood Brain and Spinal Cord Tumors

What is a radiation treatment like?

Radiation treatments can be very stressful for both children and parents, but knowledge and preparation can make the entire process much easier. This section describes radiation simulation and the various types of radiation therapy.

Radiation simulation

Prior to receiving any external radiation therapy, measurements and technical x-rays are taken to map the precise area to be treated. This preparation for therapy is called the “simulation.” The simulation will take longer than any other appointment—from 30 minutes to 2 hours. Because simulation does not involve any high-energy radiation, parents may be allowed to remain in the treatment room to help and comfort their child. Some children require sedation for the simulation.

During simulation, the radiation oncologist and technologist use a specialized x-ray machine or a CT scanner to outline the treatment area. They will adjust the table that the child lies on, the angle of the machine, and the width of the x-ray beam needed to give the exact dosage in the proper place. Ink marks or permanent tattoos are placed on the skin or the immobilization device to ensure accuracy of treatment. After the simulation is completed, the child can leave while the radiation oncologist carefully evaluates the developed x-ray film and measurements to design the treatment field.

External radiation treatment

To receive external radiation, children are given appointments to visit the radiation clinic for a specific number of days, usually the same time each day. Standard radiation treatment for many brain and spinal cord tumors is given 5 days a week for 5 to 7 weeks (weekends off). At some institutions and for some protocols, children go more than once a day to receive hyperfractionated dosing.

When the parent and child arrive, they must check in at the front desk. The technologist or nurse comes out to take the child into the treatment room. Often, parents accompany young children into the room. If the child requires anesthesia, it is usually given in the treatment room.

I desperately wanted my 3 year old to be able to receive the radiation without anesthesia. I asked the center staff what I could do to make her comfortable. They said, “Anything, as long as you leave the room during the treatment.” So I explained to my daughter that we had to find ways for her to hold very still for a short time. I said, “It’s such a short time, that if I played your Snow White tape, the treatment would be over before Snow White met the dwarves.” Katy agreed that was a short time, and asked that I bring the tape for her to listen to. She also wanted a sticker (a different one every day) stuck on the machine for her to look at. I brought her pink blanket to wrap her in because the table was hard and the room cold. Each day, she chose a different comfort animal or doll to hold during treatment. So we’d arrive every day with tapes, blanket, stickers, and animals. She felt safe, and all treatments went extremely well.

The technologist will secure children or teens in place with an immobilization device. Measurements are taken to verify that the child’s body is perfectly positioned. Frequently, the technologist will shine a light on the area to be irradiated to ensure that the machine is properly aligned. The technologist and parents leave the room, closing the door behind them.

At some institutions, parents are allowed to stay and watch the TV monitor and talk to their child via the speaker system. If this is the case, the parent should be careful not to distract the technologist as he administers the radiation. At other institutions, parents are asked to wait in the waiting room. It’s important that parents understand the department’s policies; they should ask the radiation therapist if anything is unclear.

The treatment takes only a few minutes and can be stopped at any time if the child experiences any difficulty. When the treatment is finished, the technologist turns off the machine, removes the immobilization device, and parents and child can go home. There is no pain at all when receiving x-ray treatment.

Internal radiation treatment

There was something about the radiation or the anesthesia that frightened Shawn terribly. He would scream in the car all the way to the hospital. It was a scream as if he was in pain. He had nightmares while he was undergoing radiation and every night after it was over. We decided a month after radiation ended to bring a box of candy to the staff who had been so nice. Shawn asked, “Do I have to go in that room?” When I explained that it was over and he didn’t need to go in the room anymore, he asked if he could go in to look at it once more. He stood for a long time and just looked and looked at the equipment. Somehow he made his peace with it, because he never had any more nightmares.

Children are admitted to the hospital to receive internal radiation. Certain hospital rooms are specially designed for children undergoing this type of treatment. The walls may contain lead, and often items such as sheets and eating utensils are disposable. This is because the child and everything he touches will become radioactive during therapy. Internal radiation may be given in the child’s hospital room after catheters have been placed in the radiology department or in the operating room. The child is then transported to the special room, where he will remain until he is no longer radioactive. The interstitial implants will generally remain in place for several days. Once they are removed, your child may resume normal activities and will no longer require isolation.

Children and pregnant women cannot visit while a child is receiving internal radiation. Parents and nursing staff can spend a limited amount of time in the child’s room. This may be distressing for very small children who are unable to understand why people must maintain a safe distance. It may be possible to keep the door to your child’s hospital room open. In these instances, you can sit in the hall and talk to your child to help alleviate any fears or feelings of boredom. Parents should talk with the nursing staff and the child life specialist and ask if they have suggestions about how to make the child as comfortable as possible.

Our son was 5 years old when he was admitted for his internal radiation. The biggest issue we had to deal with was boredom. It was hard for him to understand that I wasn’t allowed to spend all my time at his bedside. The door to his room was open at all times, so I moved a reclining chair into the hall, and that was where I stayed for 4 days. I would read him stories, stopping from time to time to hold up the book so he could see the pictures. He had a Nintendo® machine and a VCR in his room, and that helped to keep him entertained. The nurses even thought of clever games to play. They would inflate rubber gloves and bat them into his room as they passed by his door. After a while they became more and more creative, taking time to draw faces and hair onto the rubber gloves.

SedationPossible short-term side effects

Table of Contents

All Guides