We recently had a request from the Radiotherapy Team, specifically for the mould room for some heavy-duty plastic boxes. Intrigued to understand more about why the team needed so many boxes we popped along to see Dosimetrists Marissa & Rica to find out more.

So in simple terms, the boxes are to be used to keep safe the various moulds and shields patients need while having their treatment. They are often bespoke pieces of wax and lead that are made for patients receiving close to the surface of the skin. The paranet wax (Bolus) help the electron beams reach the correct depth and the lead pieces (applicators) stop healthy tissue from being affected by the treatment. The boxes will keep the moulds together safely in a clean and protected environment.

Marissa gave us a more detailed overview of how the boxes will be used, together with an insight to Electron Treatment:

“Radiation damages cells which are fast dividing and therefore spread quickly. Targeting those specific cells will reduce the radiation healthy cells receive. Electron treatment is a form of radiotherapy for skin surface lesions. The electron beams can only treat to a depth of 0-3cm compared to the high-energy x-rays which are used for deeper tissue treatments, such as radiotherapy to the lung. 

The applicator is attached to the machine which will then rest on the patient’s skin. It is a lead cadmium alloy which has a melting point of around 100°C. Lead is used as a shielding material in order to make sure healthy cells receive minimal doses of radiation. At the Sussex Cancer Centre, we have a variety of sizes which our applicators can come in, 6x6cm, 10x10cm, 14x14cm and 20x20cm. Inside the applicator is a cut-out which we call an insert. These can be standard sizes varying from 3cm to 20cm circles or rectangles/squares of different widths. Due to the metal’s low melting point, we are also able to pour applicators with custom inserts. The shape is decided at the mark-up appointment by the radiographers and doctor. 

Bolus is also produced which is a skin-equivalent material, used for the following reasons: it increases the dose to the surface of the skin to really target the lesion, it degrades the energy from the beam which reduces the penetration, and it can also be used to fill in irregularities on the surface of the skin. 

Bolus at the Sussex Cancer Centre is made of the following: strips of pink wax layered on top of each other to create the required thickness on Head & Neck masks or paraffin wax layered to the required thickness, both of which only need creating once and can be used for the duration of the patient’s treatment. There is also bolus made from wet gauze which is a single-use bolus for every treatment.  

In some instances, patients will also require a lead eye shield to protect from the radiation if the treatment area is close to the eye, or sometimes a lead and aluminium nose plug, both of which are small components of the treatment. The boxes provided by the Sussex Cancer Fund have made it possible for us to keep each patient’s individual applicator, bolus and any other element of the set-up secure and within infection control standards. This will go a long way to assisting us when transporting individual items securely to our satellite sites. We are very thankful to the Fund for providing us with the means to deliver a more individualised service to our patients having electron treatment. “

A huge thank you to Marissa & Rica for taking the time to explain to us how this simple solution will aid such a key treatment process. We would also like to thank our supporters that have helped us provide this equipment.