Time flies, indeed when you love what you’re doing. My radiation theraphy (radiotheraphy) clinical has already come to an end and there are still lots of stuff to learn and master. Three weeks in the department is not enough. I’m sure going to miss the patients, the staffs and the linac (linear accelerator) machine. However, it would also be nice to go back to school again and prepare for the last exam this semester. The exam is going to be an oral exam via Zoom. Nerve recking but it saves a lot of time rather than a home exam for eight freaking hours!

Before the radiotheraphy clinical, I thought that this is the same as PET (Positron Emission Tomography) but no it is not. While PET is also used in the Oncology Department, its purpose is different from radiotheraphy. Radiotheraphy is used to treat sickness by killing cancer cells/tumors and relieve pain by ionizing radiation. PET on the other hand is used for visualizing the metabolic and physiological process of the cells in the body. In short, PET is used for imaging and examination only.

The first week in the department was both exciting and challenging for me and my classmate because we never had any lectures yet since this course about radiotheraphy and oncology is a third year course. However, the department’s adviser has given us some of her time and gave us an introduction and short lecture about the department and what radiotherapists do. We were also introduced to our respective supervisors and showed the treatment rooms that we were assigned to. My classmate was assigned at the treatment room for patients with prostate cancer and I was assigned at the treatment room with almost all kinds of cancer patients. Then my supervisor showed me around the department and of course showed me the linac machines. Linacs are used for external beam radiation treatments. External beam radiation treatment means that cancer cells are targeted and shot from the outside of the body. Then before the first week ended I got the chance to “drive” the linac and give my very first radiation treatment to a cancer patient. It was a great feeling and at the same time I was also tensed because it was my first time to operate a linac. 🙂

The treatment room I was assigned to has an old linac from 2007. I feel fortunate to be able to operate it because the department is going to replace it soon with a newer one. Unlike the newer models, this linac has two pedals (not in the pictures). Then, the newer ones are of course more automated and quicker. Thus, saving a lot of time and can treat more patients.

During the second week of the clinical, I was again allowed to operate the linac and my supervisor gave me some “matching” tasks offline on the computer. When we say matching, it means that we match the CT images taken before the radiation dosage planning to the images that we’ve taken during the radiation treatment. Because radiation treatment is not just only done once but multiple times. To avoid unnecessary exposure and damage to other parts of the body or organs, the point of entry should exactly be the same every time.

Then my classmate and I was given short lectures about dosage planning, the software that they use, side effects of radiation theraphy, brachytherapy and hyperthermia treatment. Brachytherapy is an internal radiation treatment using a radioactive material enclosed in a capsule and hyperthermia treatment is a cancer treatment where the cancer cells are heated up at around 40 degrees Celsius to damage and kill the cancer cells. This old hyperthermia chamber (the picture below) is the only one in Norway. We were told that when this machine stops working, the patients who would need hyperthermia treatment should go to Germany because Norway has no plans of replacing it. Financial reasons, I guess?

Since the hyperthermia chamber doesn’t use/emit ionizing radiation, we were allowed to give it a try. Well, at least feel the pressure as the bag is being filled with water.

Anyway, I can say that my clinical in the oncology department is a unique experience and very educational. I’ve learned a lot of new stuff and met wonderful people. The days varied as there were no days are the same even though most of the patients that I met are the same. There were the happy shifts and there were some sad as well because some of the patients displayed worsening symptoms and some had to stop the treatment because of the unresponsiveness of the cancer to the radiation.