A head-and-neck patient at fraction 15 says the thermoplastic mask feels tighter than it did at simulation, has been scrubbing the drawn skin marks in the shower, and applies moisturizer over them each evening. Which guidance should you reinforce before today's set-up?
Select an answer to reveal the explanation.
Short Explanation
Before today’s setup, you can reinforce mark care: don’t scrub the marks or put cream over them. Have the patient report the tighter mask before setup so the team can check its fit.
Full Explanation
The guidance to reinforce before today’s setup is to preserve the skin marks, keep moisturizer off them, and report the tighter-feeling mask for a fit check before positioning. Scrubbing can remove marks needed for setup, while cream can obscure them; a change in mask fit may reflect a change in the patient’s condition or positioning, so it should be assessed rather than assumed harmless. Applying moisturizer over preserved marks still risks obscuring them, so preserving the marks and reporting the fit change does not make that practice appropriate. Asking staff to redraw marks scrubbed away is not a substitute for avoiding scrubbing; if marks are missing, staff can advise what to do under local practice. Keeping cream off and preserving marks is not enough if the tighter fit is reported only after treatment, because assessment is needed before today’s setup. Exam caveat: skin-mark practices vary by department and may use tattoos, removable marks, or image guidance, so follow local instructions rather than assuming every mark is permanent. Practical check: before positioning, confirm that the marks are visible and ask whether the mask feels different; alert the radiation therapist for assessment if it does.