Spine SBRT

Your doctor has decided to treat your bone metastasis in the spine with stereotactic body radiation therapy or SBRT.

What is SBRT?

SBRT is a type of radiation therapy treatment that gives a high dose of radiation in a small number of treatments, usually less than five sessions.

Your doctor will talk with you about your treatment, including possible side effects. You will be asked to sign a consent form for treatment, which the doctor will go over with you. You may also be given a prescription for medication that you must take one hour before each treatment.

Please talk to your treatment team about your medications at each appointment.

What happens next?

Once you have decided to go ahead with spine SBRT, the first step in the process is planning, also known as simulation. Your planning appointment may take up to two hours.

You need to wear the same shoes at planning and every treatment. Winter boots, flip-flops and sandals do not work with our positioning equipment so please bring an extra pair of shoes if you plan to wear these to your appointment.

Radiation planning is in the basement of the Odette Cancer Centre T Wing, across from the north elevators in room TB100 (green circle on the map).

What happens in planning?

During planning, a team of radiation therapists will give you a CT scan in the same position that you will be in for treatment. This CT scan is used to make your treatment plan.

You will be placed in a position lying on your back using equipment that will help keep you very still. The equipment used will depend on what part of your spine that we are treating, but it may put pressure on your chest, stomach or legs (see pictures below). It is important that you breathe normally during the CT and stay as still as possible.

The length of your treatment will be much longer than the CT scan. Please let us know if you are not comfortable so we can help find you a position that you can stay still in.

To make sure you are in the same position for every treatment, the radiation therapists will make tattoos on your skin that will last forever. These are small tattoos, the size of a mole or freckle, that are made with a needle.

Treatment appointments

You will get your treatment appointment times at the end of your planning appointment. Spine SBRT treatments are usually given once per day for two to five days. We may not be able to schedule your treatments at the time you request, as we have many patients who need to be booked in for treatment.

What happens during treatment?

On your first day of treatment please check in at the radiation reception on the ground floor of the Odette Cancer Centre (blue circle on the map). A team of radiation therapists will give you your SBRT treatment.

You will be asked to change into a gown so the radiation therapists can see the tattoos on your skin. Once you are in the right position, the treatment machine (see picture below) will move around you to take an image. The machine may come close to your body, but will never touch you. This image lets us know that you are in the right position for treatment.

How long do treatments take?

Your treatment will last about one hour. It is important that you stay still and breathe normally. You will not see or feel anything while the radiation is on. Your team of radiation therapists can see and hear you at all times.

Most patients can drive themselves to and from treatment. You will be at the cancer centre for about 90-120 minutes for each treatment. A member of your SBRT treatment team will see you at least once during your treatment to see how you feel and to arrange follow-up.

Possible side-effects

Side effects may differ from person to person based on their general health and the area of the body that is being treated. Many people have no side effects during or after treatment.

Possible side effects during treatment include:

Fatigue or tiredness (most common)
Pain flare, which is an increase in pain (your doctor may prescribe you medication to prevent this).
Nausea or upset stomach (our doctor may prescribe you medication to prevent this).
Diarrhea

It can take 4-6 weeks after your treatment is finished to recover from treatment-related side effects.

Resources

Patient and Family Support Program

Odette Cancer Centre, Room TG-230
416-480-6100 ext. 64623

Patient education

Information, videos, books, websites and other help can be found:

Online: Patient and Family Education
In-person: Patient Education and Research Learning Centre (PEARL) on the first floor of the Odette Cancer Centre.
You can contact PEARL at 416-480-4534 or patienteducation@sunnybrook.ca

Cancer Care Ontario: How to manage your symptoms guides

» Symptom guides for managing fatigue, nausea, vomiting and diarrhea

Contact information

Darby Erler MRT(T), MHSc
Clinical Specialist Radiation Therapist SBRT
416-480-6100 ext. 67844
darby.erler@sunnybrook.ca

CNS Nursing Line
416-480-6100 ext. 680967

GU Nursing Line
416-480-6100 ext. 680912

GI Nursing Line
416-480-6100 ext. 681061

Lung Nursing Line
416-480-6100 ext. 681067