How to Prepare For Your First Stereotactic Radiotherapy Session

What will the treatment involve? What should you do beforehand? And how do you prepare for something that is often described as highly precise but unfamiliar?

The process is usually more structured than people expect. Preparation happens in stages, and much of it takes place before the first treatment session itself. Knowing what to expect can make the experience feel more manageable.

What happens before the first session

Before any treatment is delivered, there is a detailed planning phase.

This typically involves a planning CT scan, sometimes combined with other imaging such as PET or MRI. The purpose is to map the exact position of the tumour and understand how it moves, particularly in areas like the lung where breathing affects position.

Positioning is also important at this stage. You may be asked to lie in a specific position using customised supports. These are designed to help you stay as still and consistent as possible during treatment.

In some cases, small skin markings or temporary tattoos are used to guide alignment.

This part can feel more involved than the treatment itself. But it is where most of the precision comes from.

Understanding the treatment plan

Once the imaging is complete, a treatment plan is created.

This involves carefully shaping the radiation dose around the tumour while limiting exposure to surrounding tissue. It is not a generic approach. The plan is tailored to your specific anatomy and the characteristics of the tumour.

For patients, this stage is less visible, but it is one of the most important parts of the process.

Much of what makes stereotactic radiotherapy effective comes from this level of detailed planning, where both the tumour and the surrounding structures are carefully considered.

Having input from a private oncologist at this stage can help ensure that the plan is reviewed in detail and tailored as precisely as possible from the outset.

What to do in the days leading up to treatment

Preparation before your first session is usually straightforward.

You may be given specific instructions depending on the area being treated. For lung treatments, this can include guidance on breathing or positioning.

In general, it helps to:

• follow any instructions provided by your care team
• continue taking regular medications unless advised otherwise
• stay well hydrated
• maintain a normal routine where possible

I mean, there is rarely a need for major lifestyle changes at this stage. The focus is on keeping things stable and predictable.

If you have questions, this is the time to ask them. Understanding the process often reduces anxiety more than anything else.

What to expect on the day of your first session

The first treatment session is usually straightforward.

You will be positioned in the same way as during the planning scan. The team will take time to ensure everything is aligned accurately before treatment begins.

This may involve imaging immediately before the session to confirm positioning.

The treatment itself is painless. You will not feel the radiation. The machine may move around you, but you will need to remain still during delivery.

Sessions typically last between 20 and 45 minutes, although much of that time is spent on setup rather than the radiation itself.

Managing anxiety before treatment

It is quite common to feel some level of anxiety before the first session. This is not necessarily about the treatment itself, but about the unfamiliarity of the process.

Knowing what will happen can help. So can speaking with your care team beforehand.

Some patients find it helpful to bring music or use simple breathing techniques to stay relaxed during the session.

To be honest, once the first treatment is completed, most people find that the process feels more manageable than expected.

Practical tips to consider

There are a few practical points that can make the experience easier:

• Wear comfortable clothing
• Allow extra time for travel, particularly for the first appointment
• Bring any relevant documents or information you have been given
• Consider arranging transport if you feel unsure about travelling afterwards

Most patients are able to return home shortly after each session.

What happens after the first session?

Stereotactic radiotherapy does not produce immediate results.

The treatment works gradually over time, even after the sessions have finished. Follow-up scans are usually arranged weeks or months later to assess how the tumour has responded.

In many cases, stereotactic radiotherapy is highly effective at controlling small, well-defined tumours, particularly when they are in a location that can be targeted precisely. Results vary depending on the tumour type, size, and overall health, but the aim is often long-term local control with minimal impact on surrounding tissue.

You may notice some early effects, such as fatigue or mild discomfort, depending on the treatment area. These are usually temporary.

The key point is that the first session is just the beginning of a process that continues beyond the treatment itself.

About Dr James Wilson

Dr James Wilson is a consultant clinical oncologist specialising in lung cancer and advanced radiotherapy. Working in private practice in Central London, he focuses on guiding patients through these stages with a clear and carefully structured approach to treatment.