How can patients and families prepare for radiotherapy?

Author:  Dr. med. habil. Gesche Tallen, Editor:  Maria Yiallouros, Reviewer:  Prof. Dr. med. Dr. h.c. Günter Henze, English Translation:  Hannah McRae, Last modification: 2020/06/18

The following text provides recommendations on how children and adolescents and their families can prepare for radiation. It also discusses the possibility of “test radiation.”

Information and recommendations

Prior to radiotherapy, most of the cancer programs offer a service that provides the opportunity for the child and his or her family to meet with the radiotherapists and their assistants. The purpose of such a family meeting is to ask questions and get information about radiotherapy. It also serves to give everyone the chance to learn to know each other, inspect the devices, and learn how they work.

For preparation and during the phase of radiation therapy, the following activities and habits have proven useful for older children, young adults, and parents to better cope with the treatment:

obtaining age-appropriate information (for example, information sheets, books, and videos provided by the treatment team in addition to the information provided here)
avoiding discouraging statements in the presence of the child (for example, criticising the child when wiggling)
avoiding undue pressure, for example, by not being pushy or threatening punishment if the child has trouble laying still during the radiation. There are ways to manage this, for example, by giving sedatives prior to treatment. It is also important to know in this context that it won't cause a major problem to the course of the disease, if radiation is delayed or postponed owing to a circumstance like this
discuss the "how" rather than the “why” (for example like: “Should we take a stuffy? - “Which book do you want to read in the waiting room?” - “What would you like to do afterwards as a reward?”)
contact other young people who have already experienced radiation or families whose child has already received radiation therapy (for example online)
recourse to professional, such as psychological, intervention, if emotional disturbances, for example anxiety, occur

For very young patients, the following coping strategies may be helpful:

  • role play (turn on dim lights, lie still and quietly, stopwatch, paint, let the child pretend to give radiation to you or a member of the treatment team, play “radiation” with action figures)
  • child-friendly discussions with qualified staff
  • repetitive practice of saying "good-bye" in the radiation room when every-one except the patient must leave to prevent separation anxiety
  • a bag for the “trip” to radiation (for example, with a drink, small meal, games, and a book for the waiting room)
  • reading child-friendly, professional literature on radiation (various books and brochures can be obtained online from the "Deutsche Kinderkrebsstiftung").

"Test" radiation

In many treatment centers, a “test" radiation is offered by the caregiver team both on the oncology ward and at the radiotherapy clinic to help the patient become slowly and age-appropriately familiar with the upcoming treatment phase.

Test radiation may include getting to know the radiotherapy team, watching the screen, using some of the computers, radiating a stuffy, even trying out the technical capabilities of the chair by pressing buttons, sitting and lying on the chair, trying on the exposure mask, being left alone in the radiation room, taking photos to show to friends later, and getting a reward for each new step that is learned. By test radiation, potential problems that may occur later may be recognised early and thereby prevented.