How do you manage significant gas in patients undergoing pelvic radiotherapy?

This is tough, especially once the simulation is completed, the patient comes in for treatments and now you see very different anatomy.

The one thing that I have changed in practice - and I'm aware this is not always possible at higher volume centers - is to have the simulation at about the same tim...

I think the need to worry about this issue depends on what you're treating. If you are treating just the prostate +/- the proximal seminal vesicles, you are aligning the fields to the prostate and this is generally a non-issue. If you are including the prostate, SVs, and pelvic nodes, it can create ...

If the patient is gassy at CT sim, unless it's in the rectum for a prostate patient, don't 'fix' it. All you're doing is setting yourself up for issues down the line. This mentality is also why I dislike enemas prior to CT sim because unless you're going to ask them to do it prior to each treatment,...

Red rubber catheter. Our therapists are adept at recognizing the need and at inserting a rectal tube to relieve the gas. Then, they repeat the cone beam. The difference is readily apparent!