Radiography

The therapeutic radiographer works closely with doctors, nurses, physicists and other members of the oncology team to treat patients with cancer. The radiographer treats these patients using ionising radiation - usually high energy X-rays. The aim of the treatment is to deliver an accurate dose of radiation to the tumour / cancer whilst minimising the dose received by the surrounding tissues.

As a therapeutic radiographer you may be involved in patient care from the initial referral clinic, where pre-treatment information is given, and may specialise in either the planning or delivery stages of the treatment.

In addition, you may participate in regular treatment review and post-operative (follow-up) clinics.

Therapy radiographers remain a valuable contact point for patients and their carers throughout the course of the treatment; they are educated and trained to provide most of the care, information and support required during that time.

The planning process is crucial in therapeutic radiography. It normally takes place in two stages. The first stage is called 'localisation' and normally happens during the patient's first visit, when s/he will be positioned precisely as s/he would be for treatment and X-rays are taken of the affected area. Depending on the type of cancer, a CT or MRI scan may also be performed to help identify the location and size of the tumour.

Before treatment begins, the radiographer carefully explains the process to the patient, discussing possible side effects and advising on care throughout treatment. On a daily basis, the therapeutic radiographer assesses each patient and monitors side effects of the previous sessions before administering the next dose of radiation.

On average, the patient will spend approximately 15-20 minutes in the treatment room at each visit. Most of the time is spent accurately positioning the patient and the equipment for treatment, and reassuring and advising the patient. Each treatment dose is usually delivered in less than one minute per entry beam.

Mary is a therapeutic radiographer at a large cancer unit:

"As well as planning and delivering a highly accurate dose of radiation using equipment which is technically very complex, it is essential that the radiographer at the same time attends to the psychological and emotional needs of each patient.

"As a therapeutic radiographer you need a wide range of skills (both technical and interpersonal) and must be able to communicate well with the other professionals in the team to ensure the most appropriate treatment is given to each patient.

"The atmosphere in the radiotherapy department is usually friendly and hopeful (up to 60% of those who come for radiotherapy can be cured). Some patients attend for periods of up to six weeks and get to know the staff quite well. Most patients who come to a radiotherapy department attend as outpatients and normally look fit. We do, of course, get some patients who are very ill and there are also times when, sadly, the aim of treatment is not to cure but simply to help improve their quality of life, for example, by relieving pain.

"Overall, there is terrific job satisfaction, and this is a very challenging career. You need to be able to give a lot of yourself but at the same time not take home the individual patient's problems. Not everyone can do that. In fact, you need to be a very special person, both intelligent and humane and with good manual dexterity.

"It's marvellous when people come back years later and are hardly recognisable because they look so well. Most of our patients come to the department whenever they visit the hospital just to say 'Hi, I thought I would let you know how I'm getting on'. At Christmas we are always inundated with cards.

"I wouldn't choose to do any other job."

Career Prospects

During the course of education, training and clinical practice, radiographers develop such a wide range of transferable skills - including pyscho-social, organisational, managerial, technical and scientific skills, - that individuals are prepared for work in any situation that best suits their individual skills and interests. This can extend to general management at all levels within and outside the NHS, including industry and higher education.

After their degree therapeutic radiographers may choose to specialise in:

Ref:  HSC11, Diagnostic and Therapeutic Radiographers, Department of Health (March 1999)