You will be given a time to arrive at the Radiation Therapy Department. This is usually in the morning. It is important that you are on time, as the entire schedule depends on you being here. You should dress comfortably; there is no need for special clothing. You should have nothing to eat or drink for three hours before you come. The Novalis Coordinator will tell you the specific time. You may still have medicines with sips of water. You may order breakfast as soon as the CT scan is done.

Once you arrive, the Novalis Coordinator will start an IV, or access your Port or Central Line, if you have one. This is used to give medications needed for the procedure. She will then review the information that the physicians have covered with you regarding possible risks associated with the procedures. You will then be asked to sign a consent form for your Radiation treatment and headframe placement.

Once the headframe is in place most patients say that while it is awkward to have the headframe on, they do not find it uncomfortable. If you feel pain, please let your coordinator know.

Once the headframe is in place, you will be escorted over to the hospital for a CT scan. Your family may wait in the reception area during the actual procedure. The CT is used to precisely define the size and position of your tumor or lesion in relation to other structures in your brain. During the CT, an open plastic box, called a localization box, will be placed on the headframe. Once the CT is finished, the localization box will be removed.

Once the CT is done, you will return to the Radiation Therapy department. Your period of waiting will begin. The medical physicist, physician and Dosimetrist (those people responsible for planning your customized treatment) go to work while you wait.

Your images are transferred to the Novalis Planning Computer, and they are fused with your treatment planning MRI. These images are used to confirm the precision and accuracy of the shaped beams of radiation. Once the treatment plan is completed and approved by your Radiation Oncologist and Neurosurgeon, we perform a series of carefully controlled quality assurance tests that the shaped radiation beams we have planned will indeed precisely and accurately deliver the dose to the tumor or lesion.

This process is quite involve and may require a considerable period of time, possibly several hours.

While waiting, you may join your family in the reception area for the day of the procedure. There is room for you and two or three guests to wait comfortably in the room. Other family will need to wait in the main waiting room. Just remember the day of treatment for Stereotactic radiosurgery can be a long day of waiting. Do to the wait time involved and that we may have people being treated with vulnerable immune systems; we ask that you make arrangements for someone to watch small children for the day. It is normal and natural for small children to need a place to run and play, and we don't have an area conducive to their needs at this time.

If you wear glasses it will be difficult to do so with the headframe on. If you need glasses to be able to see, you may wish to bring an old pair with the ear pieces removed. Sometimes those will fit under the headframe and can be taped in place to allow you to see. These will need to be removed for the CT and for the actual treatment.

You may wish to bring games, books or videos/DVDs to help pass the time. Having family or friends with you helps the time go faster.

We provide meals for you. Food service will deliver one guest tray for a small charge. We also can provide friends and family with directions to our cafeteria, to our hospital restaurant called Lacey's or to local restaurants. They can bring their food over to eat with you. You may also go to Lacey's or the hospital cafeteria with your family or friends. In case of financial need, please let your coordinator know and we will try to assist. Meal trays are available to you anytime between the completion of the CT scan and the removal of the headframe.

What Should I expect During and After Treatment?
The procedure itself is not painful. You will be taken to the treatment room and positioned carefully on a firm table. Your headframe will be secured to the table so your head will not move during the procedure. Once treatment is started, the Novalis machine will move around your head, delivering the prescribed dose of radiation. Radiation is painless, and invisible, and you will be able to communicate with your treatment team throughout the procedure. Depending on your specific treatment plan, there may be intervals where the treatment team needs to adjust the table before restarting the radiation beam.

Treatment time can be expected to take between 30 minutes to one hour, depending on how many areas are being treated.

After treatment you will be able to return home. You will need to arrange for someone else to drive you home. After treatment, you may experience a headache, fatigue or dizziness. Rest if the best remedy. Your doctor will talk to you about specific side effects and the way to treat them. Most people are able to resume their normal activities the same day or the next day following treatment.