Radiotherapy and positioning

i start radiotherapy next week, looking at my times i have a treatment and then something called positioning, the radiographer sort of glosssd over it, does anyone have an idea what it could be? As far as i can tell i am not having lymph nodes done as they were clear. I am to have 15 fractions plus four boosts. Also have a review with nurse and HNA, what does HNA stand for? Again it was glossed over. Thank you 

Hi anmarj

That’s when the team do some very precise measuring (often using a school ruler!) and you get your tattooes. This means that, each time you lie on the treatment bed, they can ensure you are quickly positioned for the precise target. The positioning session is the longest because they have to get it spot on, to the millimetre. If it’s your left breast, they have extra precautions to shield the outer edge of your heart and, for both breasts, they need to minimise contact with lung tissue. Sounds scary but really it’s not.

After that, it’s only a couple of minutes each day, more time spent undressing and dressing! You will feel nothing during treatment. Some women get through very easily (I found it a doddle after chemo) but others do have side effects which you will be talked through. Some women feel tired after treatment so maybe don’t drive yourself until you know how you react. Make sure you use a non-greasy moisturiser for your scar before and after (I still use Aqueous BP which the hospital provided, others recommend Aveeno or E45, so long as they aren’t oil-based) and don’t wear talc or deodorant/antiperspirant.

I think the HNA is a lifestyle questionnaire to identify if you have any special needs relating to your life and cancer (needs assessment?). This is where you assert yourself and make sure you get what you feel you need. I got an invaluable referral to the oncology rehabilitation physio which helped me tremendously - she’s a precious resource and not easily accessed! Which reminds me, make sure you have been doing your exercises faithfully - you need to get your hand/lower arm behind your head comfortably and it can be a stretch on your scar if you aren’t prepared. 

Well, that was cheerful! Honestly, radiotherapy should be very straightforward and, after the positioning session, you’ll know exactly what to do. I hope it all goes smoothly for you xx

Hi. This is about half way through the treatment. I didn’t have the tattoo, partly because of my fear of needles, but partly of haemophilia so have three big blue crosses on me! I already have a neck/shoulder issue and the exercises is similar to what i have been already doing and unfortunately doesn’t work for me. I will have to drive as hubby works shifts. I did pick up some

aveeno cream and decanted into a little had gel container to put in my bag. I wonder if they intend doing the lymph nodes even though its not been mentioned (lots of things being done without prior knowledge), wouldn’t have thought they would have been done if clear. Oncology didn’t mention it nor did the breast surgeon. I will have to try and remember to ask, cause i have a phobia about hospitals, i often forget to ask even if i have it written down. I did sail through chemo with very little side effects, some have said i maybe sail through this too.

Panic over, extra positioning appointment is if they need to change where they are aiming for once they have started so it may or may not happen.