What to Expect

Please follow the below patient instructions on the day of your consultation visit:

a. Arrive 30 minutes prior to your appointment time

b. Bring your active insurance card(s)

c. Bring your active (unexpired), government-issued photo ID. The two most common options include:

• Driver's license
• Passport

d. Bring an insurance referral from your Primary Care Physician (PCP) (if required by your insurance carrier)

e. Companion policy (NYP-Columbia Policy)

• Only one person may accompany adult patients to their visits with Columbia providers

• Pediatric patients may be accompanied by two adult caregivers

f. Mask policy (NYP-Columbia Policy)

• Masks continue to be required in cancer care areas

g. Complete your eCheck-In in on the Connect Patient Portal 2-3 days prior to your appointment date

h. Check in with our front desk staff upon arrival to our department

If you are considering radiation therapy, the first step is scheduling a consultation visit with a radiation oncologist to see if radiation therapy is right for you. During your initial visit, the doctor will evaluate your need for radiation therapy and its likely results. This includes reviewing your current medical problems, past medical history, past surgical history, family history, medications, allergies and lifestyle. The doctor will also perform a physical examination to assess the extent of your disease and judge your general physical condition. Depending on where your radiation oncologist practices, you may also be seen by a medical student, a resident (radiation oncologist in training), a nurse practitioner, a physician assistant or a nurse.

After reviewing your medical tests, including CT scans, MR scans and positron emission tomography scans (PET scans), and completing a thorough examination, your radiation oncologist will fully discuss with you the potential benefits and risks of radiation therapy and answer your questions.

To be most effective, radiation therapy must be aimed precisely at the same target or targets each and every time treatment is given. The process of measuring your anatomy and marking your skin to help your team direct the beams of radiation safely and exactly to their intended locations is called simulation.

During simulation, your radiation oncologist and radiation therapist place you on the simulation machine in the exact position you will be in during the actual treatment. Your radiation therapist, under your doctor's supervision, then marks the area to be treated directly on your skin or on immobilization devices.

Immobilization devices are molds, casts, headrests or other devices that are constructed and placed on a certain part of your body to help you remain in the same position during the entire treatment. The radiation therapist marks your skin and/or the immobilization devices either with a bright, temporary paint or a set of small permanent tattoos.

Your radiation oncologist may request that special blocks or shields be made for you. These blocks or shields are put in the external beam therapy machine before each of your treatments and are used to shape the radiation to your tumor and keep the rays from hitting normal tissue. Some treatment machines have built-in blocks or shutters called multileaf collimators, which also help shape the radiation.

Often, a special treatment planning CT scan is done to help with the simulation and treatment planning. This CT scan is in addition to your diagnostic CT scan.

Although simulation is typically only one session, your physician may schedule additional sessions depending on the type of cancer you have and the type of radiation therapy that is being used.

If your insurance company/plan requires a prior authorization, the authorization process officially begins on the date of your simulation. Please be assured that our dedicated department will handle this process on your behalf. Our primary goal is to ensure a swift approval, which is required prior to your treatment start date. However, it is important to be aware that some insurance companies may require additional information or documents, which can potentially result in a delay.

In the event that the authorization process faces unforeseen delays, there might be a need to adjust the start date of your treatment to a slightly later date. Please know that we will only consider and contact you for rescheduling if it becomes absolutely necessary and in your best financial interest in order to avoid the generation of patient-responsible, self-pay bills for your radiation therapy.

We understand that your time and health are of the utmost importance, and we will do everything in our power to expedite the authorization from your insurance company. Our team is committed to minimizing any potential delays and ensuring you receive care as soon as possible.

Your well-being is our top priority, and we're here to support you throughout this process. If you have any questions or concerns regarding the authorization or any other aspect of your treatment, please do not hesitate to reach out to us at 212-305-7077. We're here to provide the guidance and assistance you may require.

Thank you for entrusting us with your care, and we look forward to working with you to make this treatment process as smooth and efficient as possible.

After simulation, your radiation oncologist and other members of the treatment team review the information they obtained during simulation along with your previous medical tests to develop a treatment plan especially for you. Frequently, sophisticated treatment-planning computer software is used to help design the best possible treatment plan. After reviewing all of this information, your doctor writes a prescription that outlines the exact course of your radiation therapy treatment.

Radiation treatments are scheduled Monday through Friday and usually last 1-10 weeks. The amount of time needed for treatment is determined by your individual medical needs. Treatment is delivered by a team of professional radiation therapists, licensed by New York State. Our staff will work with you to plan your treatment schedule. You can expect to receive a weekly schedule and that any necessary revisions will be made as treatment continues. Please note that the chief radiation therapist and/or simulation technologist is responsible for daily scheduling or other issues regarding your treatment. Please check in with our front desk staff, who will provide you with a wristband with your name and date of birth and alert the radiation therpist that you have arrived for your scheduled treatment.

Once a week, you will see your radiation oncologist, a resident, and a nurse for a status check to follow your progress, evaluate whether you are having any side effects, recommend treatments for those side effects (such as medication or diet changes). As treatment progresses, your doctor may make changes in the schedule or treatment plan depending on your response or reaction to the therapy. They will also address any concerns you may have.

After you complete your radiation treatment, you will be scheduled for a follow up appointment with your radiation oncologist. Your radiation oncologist may also order additional diagnostic tests. Reports on your treatment can be sent to your other doctors.

Subsequent follow up appointments will be scheduled so that your radiation oncologist can make sure your recovery is proceeding normally and can continue to monitor your health status. As time goes on, the frequency of your visits may decrease. However, you should know that your radiation oncology team will always be available should you need to speak to someone about your treatment.