Step 1. The first day is called the simulation. The patient needs to lie on a (hard) table for about an hour (or longer) while the radiation fields are lined up (aimed accurately to hit the tumor.) Some times it is necessary to use contrast (swallow that nice tasting barium or have an Xray marker placed in the rectum, etc.) Some times it is necessary to make a body cast or mold or face mask on this day (if you're claustrophobic tell us!) After the fields are lined up properly, the light marks (laser markers actually) are marked on the skin with ink (later permanent tattoos) so that the fields can be set up quickly and accurately the rest of the days. Many people complain about how long (and uncomfortable) the first day is, so if you are in pain be sure and take some pain pills before coming, and if you are uncomfortable on the table, be sure and speak up. Sometimes a CT scan will be obtained on this day.

Step 2. The actual first treatment is normally not started until the next day (or even a few days later) to allow for analysis of the CT scan images or to allow special blocks to be cut. This day also takes a little longer than most since pictures are usually taken on this day (to be sure the beam is lining up properly.)

Step 3. From then on most days should go quickly (10 - 15 minutes.) The patient undresses, and lies down on the table, the blocks are put into the machine, the laser lights are lined up on the skin marks and the machine turned on. The machine is actually turned on for only a few minutes. There is no sensation (or burning) just the sound of the machine coming on.