University College Hospital. Radiotherapy to the female pelvis: preparation for the treatment. Radiotherapy Department Patient information series

Transcription

1 University College Hospital Radiotherapy to the female pelvis: preparation for the treatment Radiotherapy Department Patient information series 28

2 2 If you need a large print, audio or translated copy of the document, please contact us on: (Direct line) ext 73711/bleep ext 73711/bleep 1458 We will try our best to meet your needs.

3 3 Contents Introduction 5 Why is bladder preparation important? 5 Why is following a low fibre diet important? 5 What will happen before my CT scan? 6 What will happen when I come for my radiotherapy CT planning scan? 6 What will happen when I come for radiotherapy treatment? 6 In addition to the fibre content of your food, you need to consider other factors 7 Breads, flours and cereals 8 Vegetables 9 Pasta and rice 9 Pulses 10 Fruit 10 Nuts and seeds 11 Protein foods 11 Cakes and biscuits 11 Miscellaneous 12 A suggested meal plan 13 Useful contact numbers 14 Space for notes and questions 15

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5 5 Introduction This booklet has been written for patients who are about to start a course of radiotherapy to the female pelvis. Before starting radiotherapy planning and treatment you will need to follow special instructions on preparing your bladder. You will also be asked to follow a low fibre diet. It is important that you understand and follow the instructions for preparation given to you. This booklet describes what needs to be done and what you need to do throughout your treatment. We understand that this is a daunting time for patients. You may feel that you have been given lots of information about what needs to be done in a short period of time. We hope this booklet answers some of your questions. If you still have any questions or concerns, please let your doctor, nurse or radiographer know. We are here for you. Why is bladder preparation important? When having radiotherapy to the female pelvis it is important that you have a comfortably full bladder, and maintain a similar bladder size for each treatment. The reasons for this are: A larger bladder will limit the amount of bladder and small bowel in the treatment area which will help to reduce any side effects you may experience. It will help maintain treatment accuracy on a daily basis. Why is following a low fibre diet important? Following a low fibre diet during your treatment is important because: It helps to reduce the build up of intestinal gas and avoids changes inside your body due to different bowel filling. It helps manage diarrhoea. It will reduce the risk of any long-term bowel side effects.

6 6 What will happen before my CT scan? You will be given special dietary advice on how to follow a low fibre diet. This advice is included in this booklet. You will have to follow the dietary advice from seven days before your CT scan, and then every day until the end of your treatment. What will happen when I come for my radiotherapy CT planning scan? At this appointment you will: Be asked to go to the toilet to empty your bladder. Be asked to drink approximately 500ml of water. This is three cups of water, which is available in the waiting area. Be asked to wait for 30 minutes, to allow for your bladder to fill (comfortably), before you have your radiotherapy planning scan. If you do not feel your bladder is full after 30 minutes please tell the radiographers. What will happen when I come for radiotherapy treatment? Please arrive 30 minutes before your radiotherapy treatment appointment. At each appointment you will: Be asked by the radiographers if you have been following the daily dietary advice. Be asked to go to the toilet to empty your bladder. Be asked to drink approximately 500ml of water. This is three cups of water, which is available in the waiting area. Be asked to wait for 30 minutes, to allow for your bladder to fill (comfortably), before you have your radiotherapy treatment. If you do not feel your bladder is full after 30 minutes please tell the radiographers.

7 7 For each radiotherapy appointment, you should allow up to one hour. You should aim to arrive at least half an hour before your given treatment appointment time, to allow for the above process. It is important that you understand and follow the instructions for treatment preparation given to you. If you have any difficulty following the instructions please discuss this with the radiographers treating you. There may be various reasons for this problem, including side effects to your bladder and bowels. You should only modify the routine for your bladder/bowel preparation as a result of discussion and agreement with your radiotherapy doctor. If you still have any questions or concerns, please let your doctor, radiographer or nurse know. We are here for you. In addition to the fibre content of your food, you need to consider other factors Eat small and frequent meals spaced regularly throughout the day and avoid skipping meals. Smaller meals may be better tolerated as larger meals may cause you problems. It is essential to drink enough water through the day. Between eight and ten glasses or cups a day is recommended. Preferably drink after, rather than with a meal. Eat slowly and chew your food well. Chewing your food thoroughly will help break it down and make it more easily digestible by your gut. On the following pages are lists of foods that are suitable for a low fibre diet, as well as those high fibre foods that should be limited. If you have any difficulty following the dietary instructions please discuss this with the radiographers treating you. They can refer you to the dietitians for further expert advice. The following dietary recommendations are used with the kind permission of the UCLH Department of Nutrition and Dietetics.

8 8 Breads, flours and cereals White flour and products such as breads, scones, crackers, rolls, crumpets, bagels, muffins, pancakes, dumplings, Yorkshire puddings and pizza bases Ground oatmeal porridge Cornflakes Rice cereals Cornflour Chapatti/naan flour Nº1 Foods to limit: Breads such as granary, seeded, wholegrain and wholemeal Rye breads Crispbreads Malted fruit bread Wholewheat breakfast cereals such as Shredded Wheat, Weetabix and Muesli Crunchy cereal bars Tortilla chips Twiglets

9 9 Vegetables Peeled and deseeded vegetables Remove tough stems, skins, husk, etc Cook until soft and easily mashed, or pureed Foods to limit: Corn Pips Tough skins of vegetables such as: skins of baked potatoes, cucumber, bell peppers and tomato Green vegetables such as: broccoli, sprouts, leeks, spring greens, curly kale, okra, pak choi Onions Pasta and rice Well cooked, soft white pasta and noodles Well cooked, soft white rice and Basmati rice Foods to limit: Wholemeal pasta Wholegrain and wild rice

10 10 Pulses Hummus Refried beans and other pureed beans Smooth dhal Foods to limit: Whole beans Lentils and peas, especially baked beans Red kidney beans, soya beans and green beans Fruit Peeled and soft fruit without pips or pith Cooked or tinned fruit Soaked or cooked and softened dried fruit Avocado (smooth guacamole) Fresh fruit smoothies (without pips) Fruit jellies, compotes and jams without pips Smooth fruit juice Foods to limit: Fruits with seeds, pips, pith, hard skins or fibres, such as berries, kiwifruit, citrus fruits, grapes, rhubarb and plantain Unpeeled fruit such as apples, pears, peaches and nectarines Raw or dried fruit such as prunes, figs, dates and apricots Mixed dried fruit Jams or fruit spreads containing seeds, pips or tough skins

11 11 Nuts and seeds Smooth nut and seed butters and spreads such as peanut, pumpkin, sunflower seed, almond, cashew nut, hazelnut and pistachio Finely ground nuts and seeds. For example, almond flour Tahini Foods to limit: All whole nuts and seeds Crunchy peanut butter Nut roast Protein foods Tender meats (baked or poached), with the fat trimmed Poultry with skin removed Fish Eggs Cakes and biscuits Plain flour sponges Biscuits such as chocolate, ginger, wafers and shortbreads Cakes such as Madeira, carrot, Swiss roll and teacakes Danish pastries without dried fruit Foods to limit: Fruit cake or biscuits containing hard pieces of dried fruit or fruit peel, nuts and seeds

12 12 Miscellaneous Barley sugars Caramels Jellies Boiled sweets Honey Lemon curd Seedless spreads Marmite Prawn crackers Foods to limit: Bombay mix Chocolate with nuts or dried fruit Yoghurt with seeds, nuts or dried fruit Wholegrain mustard Hot and spicy foods Fizzy drinks and beer Coffee try to drink less than four cups per day

13 13 A suggested meal plan Breakfast ideas: Cereal and milk. For example, oatmeal porridge, corn flakes, rice breakfast cereals. Fresh peeled or stewed peeled fruit. Tinned fruit or fruit juice, or a fruit smoothie without pips. White bread or toast, butter or margarine, seedless jam or marmite. Lunch ideas: White sandwiches or rolls filled with lean meat, tinned fish, meat paste, cheese or boiled egg. Scrambled, boiled or poached egg on toast. Yoghurt without seeds or nuts. Fruit as for breakfast. Dinner ideas: Tender, lean meat or fish, cheese or egg dishes. White pasta, rice or peeled potatoes, well cooked. Vegetables, well cooked. Remove all tough parts and skins. Choose larger portions from the lower fibre varieties. Milk puddings. For example, custard, yoghurt and rice pudding. Sponge puddings and sauce, jelly and ice cream.

14 14 Useful contact numbers Senior Specialist Oncology Dietitian Direct telpehone: Main switchboard: ext 79289/bleep 1022 Alternative switchboard: ext 79289/bleep 1022 Macmillan Information and Support Radiographer Mark Williams Direct telephone: Main switchboard: ext 73711/bleep 1458 Alternative switchboard: ext 73711/bleep Dr McCormack s Secretary Direct telephone: Dr Mitra s Secretary Direct telephone:

15 Space for notes and questions 15

16 First published: May 2009 Last review date: June 2013 Next review date: June 2015 Leaflet code: UCLH/S&C/CD/RT/FPBP/2 University College London Hospitals NHS Foundation Trust Created by Medical Illustration RNTNEH Unique Code: 28901