Patient Instructions (Radiation Therapy Start-of-Treatment)

Patient Instructions: Starting Radiation Therapy

Date Issued: [Date]

Patient Name: [Patient Full Name]

Date of Birth: [Date of Birth]

Clinic/Location: [Clinic or Location]

Prepared by: [Preparer Name and Role, e.g., Radiation Oncology RN]

Interpreter: [Interpreter Name or ID] — [phone / video / in-person] (Include only if an interpreter was used)

Caregiver present for teaching: [Caregiver Name], [Relationship] (Include only if a caregiver was present)

Key Points to Remember

• You are starting radiation treatment. Common side effects can be managed.
• Do not wait to report new or worsening symptoms. Call us.
• How to reach us: see the "How to Reach Your Care Team" section below.
• [You are not radioactive after you leave the treatment room. It is safe to be around family, friends, children, and pregnant people. / You may have temporary radiation safety steps after treatment. Follow the instructions from the Radiation Safety Officer.] (Select based on treatment type: external beam vs. internal/systemic radiation)

Your Radiation Treatment Plan

• Treatment area: [Plain-language body site, e.g., right breast, lower belly/pelvis, chest]
• Type of radiation: [external beam / IMRT / VMAT / SBRT / SRS / brachytherapy / radiopharmaceutical therapy] — [One-sentence plain-language explanation of the technique]
• Start date: [Start Date]
• Expected end date or total treatments: [End Date or Total Number of Treatments]
• Schedule: [Frequency, e.g., Monday–Friday], [Typical visit length], arrive [X] minutes early.
• If you miss an appointment: Call [Scheduling Phone Number] to reschedule as soon as possible. Missing visits may extend your treatment course.
• Other therapies: [Concurrent systemic therapy details and which team to contact for which concerns] (Include only if receiving concurrent chemotherapy, immunotherapy, or targeted therapy)
• Daily preparation: (Include only applicable items)
  • [Bladder prep instructions]
  • [Bowel prep instructions]
  • [NPO/fasting instructions]
  • [Mask or immobilization device instructions]
  • [Medication timing changes]

(If treatment plan details are not yet finalized, state: "Your team will provide additional details once your treatment plan is complete.")

What to Expect During Treatment Visits

(Use this section for external beam treatments; adapt for other techniques as appropriate.)

• Check in at the front desk.
• Staff will help position you on the treatment table. You will need to lie still.
• We may take images to confirm your position.
• The machine makes noise. The treatment itself is painless.
• We can see and hear you at all times. Use the call button if you need us.
• You will have weekly visits with your care team to check symptoms and answer questions.
• Protect skin markings or tiny tattoos. Do not scrub. Let them fade naturally after treatment ends.
• [Practical notes on what to wear or bring] (Include if helpful)

Side Effects and Self-Care

(Include only sections that match this patient's treatment site and technique.)

General

• Fatigue: Feeling tired is common and varies by person. Balance rest with light activity, like short walks. Eat well. Drink fluids. Ask for help when you need it.
• Skin changes in the treated area: You may notice redness, dryness, or itching. See the Skin Care section for detailed steps.

Head, Neck, Mouth, or Throat

(Include only if treating head, neck, mouth, throat, or esophagus)

• Mouth sores, dry mouth, thick saliva, taste changes, or pain with swallowing can occur.
• Start the oral care routine now. See the Mouth and Throat Care section.
• Call early if you have trouble eating or drinking.

Breast or Chest Wall

(Include only if applicable)

• Skin irritation can happen, especially in skin folds.
• The breast or chest wall may feel tender or swollen.
• Reduce friction from clothing or bras. Choose soft, non-underwire options as tolerated.

Chest or Lung

(Include only if applicable)

• You may notice cough, mild shortness of breath, or chest discomfort.
• Call 911 for sudden severe shortness of breath or chest pain.

Abdomen

(Include only if applicable)

• Nausea, cramping, or diarrhea can occur.
• Drink fluids often. See Nutrition and Hydration for tips.

Pelvis

(Include only if treating prostate, bladder, gynecologic, or rectal area)

• Urinary frequency, urgency, or burning can occur.
• Diarrhea or rectal discomfort may occur.
• Skin in the area can become irritated.
• Tell us about sexual health or fertility questions. We can help.

Brain or Scalp

(Include only if applicable)

• Scalp irritation and hair loss in the treatment area can occur.
• Fatigue is common.
• Urgent symptoms requiring immediate care: new weakness, new confusion, or severe headache.

Technique-Specific Notes

(Include only applicable items)

• SBRT or SRS: Short treatment course. Symptoms can flare sooner or feel stronger. Report severe pain, new neurologic changes, or sudden weakness right away.
• Brachytherapy or Internal Radiation: You will receive radiation safety steps. See the Radiation Safety section.

(If treatment site is not yet documented, state: "Site-specific guidance will be added once your treatment site is documented.")

Radiation Safety

External beam radiation: You are not radioactive after your treatment. It is safe to be around family, friends, children, and pregnant people.

Internal radiation, brachytherapy, or radiopharmaceutical therapy: (Include only for patients receiving internal or systemic radiation. Use only RSO-approved instructions—do not generate or infer safety details.)

• Duration of precautions: [RSO-approved duration]
• Distance from children and pregnant individuals: [RSO-approved distance guidance]
• Sleeping arrangements: [RSO-approved instructions]
• Bathroom and laundry guidance: [RSO-approved instructions]
• Breastfeeding interruption: [RSO-approved instructions] (Include only if applicable)

Skin Care for the Treated Area

Follow these steps during treatment and for at least 2 weeks after.

Do:

• Wash gently with lukewarm water and mild, fragrance-free soap. Pat dry.
• Use only moisturizers or products approved by your care team.
• Wear loose, soft clothing over the treated area.
• Protect treated skin from sun exposure.
• Use an electric razor if hair removal is needed.

Do Not:

• Scrub or use washcloths on the treated area.
• Apply lotions, creams, or deodorants within [time window, e.g., 2–4 hours] before treatment.
• Use heating pads, ice packs, or hot tubs on the treated area.
• Apply adhesive tape directly to treated skin.
• Shave with a blade razor.

Call us if you notice: blistering, open sores, drainage, rapidly spreading redness, fever, or pain that is severe or getting worse.

Mouth and Throat Care

(Include only if treating head, neck, mouth, throat, or esophagus)

• Rinse your mouth every 4–6 hours and after meals with a salt and baking soda solution (1 teaspoon salt + 1 teaspoon baking soda in 1 quart of water). Swish gently and spit out.
• Use a soft toothbrush. If prescribed fluoride gel, use as directed.
• Avoid alcohol-containing mouthwashes, tobacco, and alcohol.
• If eating is painful, try soft, moist foods at mild temperatures. Avoid spicy or acidic foods.
• Keep lips moisturized. Ask about timing limits before treatment.
• Tell us right away if you have pain that prevents eating or drinking, signs of dehydration, or unintentional weight loss. We can prescribe medications and refer you to a dietitian or swallowing therapist.

Nutrition and Hydration

(Include for higher-risk sites such as head/neck, abdomen, or pelvis, or when clinically indicated)

• Drink enough fluids so your urine is pale yellow.
• Eat small, frequent meals with protein and calories.
• For diarrhea: choose low-fiber, low-fat foods. Replace fluids and electrolytes. Track bowel movements.
• For sore mouth or throat: choose soft, moist foods; avoid irritants.
• Weigh yourself regularly and report unintentional weight loss.
• If you have other medical conditions affecting diet (such as diabetes or kidney disease), ask to see an oncology dietitian.

When to Call or Seek Emergency Care

Call 911 or go to the emergency department immediately for:

• Chest pain or severe shortness of breath
• New confusion, sudden weakness on one side, or trouble speaking
• Uncontrolled bleeding, fainting, or seizure

Call the radiation oncology team the same day for:

• Fever of [fever threshold, e.g., 100.4°F / 38°C] or higher
• Inability to keep liquids down or repeated vomiting
• Diarrhea with blood, black or tarry stools, severe belly pain, or signs of dehydration
• Severe skin reaction: blistering, open sores, drainage, or rapidly spreading redness
• Inability to urinate, blood in urine, or severe pelvic pain
• Mouth or throat pain that prevents eating or drinking

Mention at your next visit or call during business hours for:

• Mild to moderate fatigue
• Mild skin dryness or itching
• Mild nausea controlled with medication
• Mild urinary frequency without fever or blood

How to Reach Your Care Team

(Complete all fields before finalizing this document. Do not leave contact information blank.)

• Daytime clinic phone: [Phone Number], available [Hours]
• After hours, weekends, and holidays: [After-Hours Contact Method]. Ask for the radiation oncologist or APP on call.
• Non-urgent questions: Send a message through the patient portal. Expect a response within [Timeframe].
• If told to go to the hospital: [Hospital Name and Address]

Medications and Supplements

• Keep taking your regular medications unless your doctor tells you to stop.
• Before starting any new vitamins, herbal products, or over-the-counter medications, check with your oncology team.
• Supportive medications prescribed: (Include if applicable)
  • [Medication Name] — [Purpose] — [How to take: dose, timing, with/without food] — [When to call if not working or if side effects occur]

Support Services

(List only services relevant to this patient)

• [Oncology dietitian: contact or referral status]
• [Oncology social work: contact or referral status]
• [Patient navigator: contact or referral status]
• [Financial counseling: contact or referral status]
• [Rehabilitation/physical therapy: contact or referral status]
• [Lymphedema therapy: contact or referral status] (For breast/axillary treatment)
• [Speech and swallowing therapy: contact or referral status] (For head/neck treatment)
• [Smoking cessation program: contact or referral status]

Write down your questions before visits. Bring an updated medication list. Track your symptoms each day.

Understanding Confirmation

We reviewed these instructions with you today. Please bring this handout to your treatment visits and contact us with any questions.

• Teach-back: [completed / patient declined / unable to assess] — [Topics demonstrated, e.g., when to call, skin care routine, oral care routine] (If unable to assess, state reason)
• Written materials provided in patient's preferred language: [Yes / No] — Language: [Language]
• Notes on understanding or barriers: [Notes on comprehension, barriers, or need for follow-up education]