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Total Body Irradiation (TBI)

This leaflet will help you understand what will happen when you come to Velindre hospital to have your radiotherapy treatment. It will explain how your treatment is given and the side effects you may have. There are also contact numbers for more information and support.

Before starting your radiotherapy

You will usually come to the Velindre out patients department on the Monday the week before your radiotherapy treatment is due to start. At this appointment you will meet your consultant or a member of their team. The doctor will explain your radiotherapy treatment and the possible side effects. We will ask you to sign a consent form. 

You will also meet members of the radiotherapy team and nursing staff. We will show you the treatment machine and the ward where you will stay. Please ask any questions you have about your treatment and stay at Velindre.

Starting your treatment

You will be brought to Velindre hospital from the University Hospital of Wales (UHW) on the Sunday before starting treatment on Monday. You will be taken to your room on the Chemotherapy Day Unit.

You will have eight treatments of radiotherapy. The first treatment will be on Monday morning. Then you will have two treatments a day for four days. Treatments will be given at least six hours apart, so one in the morning and one in the afternoon. Your last treatment will be given on Thursday afternoon then you will be taken back to the UHW. 

During you stay at Velindre hospital we will take all necessary care to reduce the risk of you coming into contact with any infections. Velindre hospital is situated away from many buildings so you will be able to open the windows of your room and drink the water from the taps, but bottled water is preferable.

During your treatment

A porter will take you to the treatment room. We will ask you to undress to your underwear. We would like ladies to wear a sports bra (a soft bra with no metal clasps). We will keep you covered as much as possible. You will lie on your back on a hard couch with a sponge under your head and a support under your knees. We will make sure you are as comfortable as possible because you need to keep still for the treatment.

The radiotherapy treatment is given to your whole body, so we need to take measurements of your head, neck, shoulders, waist, hips, knees and ankles. We will tape small measuring devices to different points of your body so we can make sure the radiation is given evenly through your body. 

The treatment machine will be on its side facing the couch. To get you in the right position the room lights are dimmed and the couch placed in the beam of light that comes from the treatment machine. This light shows where the radiation will go. 

A perspex screen with brass pieces is placed beside the couch. We adjust the brass pieces so they are beside your head and chest. This makes sure the dose to your head and lungs is correct for you. 

We will give the treatment to both sides of your body. When everything is set up correctly for treating the first side of your body, the radiographers will leave the room to switch on the machine. When the machine is on you will not feel anything, just hear a loud buzzing noise. The radiographers will watch you carefully on television cameras. If you need them, they can switch off the machine and can check you are ok. Treatment can restart when you are ready.

It will take about ten minutes to give the treatment to each side of your body. To help pass the time, please bring any CDs or cassettes you would like to listen to. 

Once the first side has been treated, the radiographers turn the couch around so we can treat the other side of your body. You won’t need to move.

When your treatment is finished we remove the small measuring devices from your skin and give them to our medical physics team. They work out the radiation dose your body has received. They then make any necessary adjustments to your next treatment, to ensure an even dose over your body is given. This will be done at every treatment so the number and situation of measuring devices you need may change.

Side effects

The side effects of TBI, as with chemotherapy, will affect your whole body. Short term side effects which soon settle down are:

  • Dry mouth and sore throat
  • Swelling of your salivary glands at each side of your face for the first few days or so
  • Redness and itchiness of your skin
  • Nausea (feeling sick)
  • Diarrhoea
  • Losing your hair – this occurs after about two weeks but the hair re-grows within a few months.

Long term side effects can be:

  • Interstitial pneumonitis (lung complications due to inflammation and scarring). This is why we carefully measure the dose to your lungs during your treatment.
  • Cataract – the lens of the eye is very sensitive to the radiation. This is easily treated by surgery.
  • Infertility – this can be a permanent side effect of chemotherapy and radiotherapy.
  • A new cancer due to the treatment you have had. This is very rare and affects only about 2% of patients having TBI treatment.

We will discuss these possible side effects with you.

This information is evidence based and reviewed annually

Further information

We hope this leaflet has been useful.  If you, or your family, have any other questions or worries then please contact:

Information, support and review radiographers - 029 2061 5888 ext 6421  

Chemotherapy Day Unit (CDU - Velindre hospital) - 029 2061 5888 ext 6380

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F.PI.2                    Issue 6            Aug 2016