A Typical Radiotherapy Session - What it Looks like

Anatomy of an RT fraction visit

This is how it was/is for me at Oxford. Each department will do things slightly differently, but this should give you some idea of what to expect. I looked for this information on the forums but didn't find it. So I thought I would leave a record of it for future visitors.

Arrive in the department ~75 minutes before treatment time (they recommend "at least an hour" but I find I prefer not to rush my bowel voiding process).
Drink two cups (300ml) of water from the water cooler in the pre-treatment waiting room.

Void Your Bowels
Visit one of the toilets, have a wee and self-administer a micro-enema (Micralax, 5ml in a tube with a long nozzle. Lube is provided.)

Micralax micro enema photo ==> Micralax Micro Enema Photo

This takes a few minutes at first, but you get better at it as you go. Note the time.
Exit the bog and grab a seat in the waiting area.

Wait about 10-15 minutes or until strong bowel urges and then find a toilet and void the bowels. You will also empty the bladder at this point. It's not an optional extra.
I found this voiding can take several minutes until you are feeling confident you are finished. (And this seemed to increase as I got further into the treatment). YMMV (your mileage may vary).

The timing is such that I do the final check-in for my appointment precisely 45 minutes before due time.

Fill Your Bladder

I need to drink 6 more cups (900ml) of water before that. This takes me a couple of minutes. 900ml is a bit over a pint and a half. Downing a pint isn't too bad, but the extra half can be a bit harder.
(Your timing and quantity will be set at your planning scan appointment.)

Then dig out the "boarding pass" and go to the check-in machine and scan the barcode 45 minutes before appointment time. (In Oxford they use the Varian patient management system. You get a list of all your appointments with a barcode at the top. You scan this each day to check yourself in.)

And Then We Wait

I don't like waiting rooms or the nervous chatter that goes on in them. There is also a zero chance of being called early, so I usually sit for at least half an hour on the seats in the corridor where there is usually nobody else about. There's quite a lot of toing and froing, but that's better than listening to people talk (even with headphones on).

Everyone's different - that's how I make it work for me with minimal agitation. It's stressful enough having to make sure you arrive on time, shove something up your bum, then have an explosive poo and drink a pint and a half a lot quicker than you would choose to. So anything you can do to alleviate whatever your specific "personal issues" are is a bonus. 😀

So, with about 10 minutes left to go, I'll wander up to the "Departure Lounge" (final waiting room) and try to find a seat where I can see the status monitor showing if there are any delays.

Then wait to be called and hope things are running more or less on time. If it's a sub 15 minute delay, it won't show on the monitor. (There are six machines at Oxford and each one has a traffic light indicator showing delays and time).
15 minutes delay is OK, but you don't really want to hold for much longer than that with a fairly full bladder. The radiographers are sensitive to the issue though and won't delay you unduly.

Then you get called through into one of the Linear Accelerators. In Oxford they use Varian Halcyon machines for localised prostate treatment. They look like large CT scanners with a moving table on which you will lie down.

PHOTO of Varian Halcyon ==> Varian Halcyon Linear Accelerator

Lie Down and think of England

Identity check. You confirm your name and date of birth, then remove shoes and shorts/trousers and lie on the table. There are head, knee and foot supports to help you into the correct position.
A large paper towel goes over the pelvic area and pants about 3/4 down leaving penis tucked in to avoid movement.

This exposes the three dot tattoos they did at the planning scan. These are used for alignment on the bed. Usually there will be a couple of small adjustments where they will rock your hips and or pelvis a bit to get everything lined up perfectly. On one occasion no adjustment was required. Very often just one and usually two. Once or twice three tweaks.

Scan Organs, Align, then Zap

Then the radiography team (2 or 3 people usually) will depart and the machine will first scan you (CT scan) to see where all the pelvic internal organs are. After that the table usually makes a final alignment tweak (a few mm left-right, and/or up-down usually). And then the actual X-ray zapping occurs. It makes a different sound (sort of staccato sputtering noise) and lasts about 90s. It seems to me (from the position of the sound) that the beam makes two circular passes. The table does not seem to move during the treatment. I did not feel anything while I was being zapped.

Once done, the table slides back out from the ring section and you are done. One or more of the team will return, lower the table and then you can dismount, get dressed and go home. The whole process usually takes less than ten minutes.

Empty the Bladder

Your first stop will be the toilet. Let's get that bladder emptied. I then have a KitKat. It's nice to have something to look forward to when it's all over. Then you can escape, knowing that you are one fraction nearer to the end. 🙌 I found it encouraging to think of my 20 fractions as 5% per day.

It Should be Similar Elsewhere

The process should be the same or very similar, regardless of whether you are having primary, adjuvant or salvage radiotherapy. But there will be procedural differences between different departments. The above should give you an idea of what to expect.

A 5 minute delay is common. I think I only had delays longer than 10 minutes twice and none longer than 20. But on one occasion in week 1 a machine failure caused a postponement (but they phoned before I left home).

Edited by member 04 Oct 2026 at 10:48  | Reason: adding info