Close-up of the process of 'making' cancer radiation therapy masks

After 15 minutes of simulation, the mask used in cancer radiotherapy is completed. The mask's fit helps the patient feel comfortable and breathe normally during radiotherapy.

For most radiotherapy techniques in the brain, head and neck area, patients need to wear a mask during each radiotherapy session. The parameters of the radiotherapy mask need to be made almost absolutely precisely, fitting the face. The mask helps to fix the posture, making the radiotherapy as effective as possible.

After being persuaded many times by doctors and his mother, Hoang Duc (6 years old) obediently lay down on the fixed table to make a mask. Ms. Luu Thi Hoan (38 years old, Dak Lak), the patient's mother, had to coax and encourage her. "You go in first, when you're done, I'll go in and make one. We'll wear the mask when we go out ," Ms. Hoan whispered, kissing her son's cheek.

Listening to his mother, Duc lay on a fixed table, behind him was a foam pad shaped to the shape of each person's back. The boy clenched his fists and closed his eyes. The technician used a contrast-soaked thread to stick the surgical scar on the patient's skin, in order to determine the correct treatment volume after a CT simulation. The 6-year-old boy was diagnosed with a rare left parotid sarcoma, a high-risk disease at stage 4. After surgery and 9 chemotherapy treatments, the boy was assigned to a mask simulation for 20-30 radiation beams.

From the hard plastic piece, the technician puts it in the steamer for about 5-7 minutes at a temperature of 70-75 degrees, takes it out, waits for a few dozen seconds, sprays water to cool it, and then places it on the child's face. The technician fixes the mask with pins on the table, using his hands to adjust it to the contours of the patient's face, like a ceramic artist.

Next, the doctor will determine the simulation center at the patient's chin, the technician will measure to fill in the information form. This operation is to determine the location of the center, compared to the anatomical landmarks on the patient's body. This process helps reduce the error rate during radiation therapy. In case the tape marking the center is peeled off during radiation therapy, the information form must be used to measure and re-determine the radiation center. Thus, in just 15 minutes, the radiation mask was completed.

After the measurements are completed, the technician will go to the control room to take a simulated CT scan for the patient. This helps the doctor determine the treatment volume, calculate the radiation dose, where to go from the treatment frame, how many slices, and what the radiation intensity is. During this time, the patient will lie down and wait for the mask to harden for about 10 minutes. For children who are scared and fussy, family members will be given a lead apron to stand with during the CT scan. But during radiation therapy, the child will be alone in the empty room with the machine.

According to specialist II Lam Duc Hoang, Head of the Department of Head and Neck Radiation Therapy, Ho Chi Minh City Oncology Hospital, the children have to stay alone in the simulation room, only able to breathe through the tiny holes on the mask. Therefore, the technician has to work while reassuring the children, encouraging them to try to breathe deeply and evenly. The doctor lets the children watch others do it first, or gives them cute teddy bears and toys. With the finished masks, the nurse will draw many different shapes to create excitement and reduce anxiety for the children. A simple mask, the nurse can draw within 30 minutes. More complex shapes can take several hours.

Thai Hoa (12 years old) holds a pink cat-shaped radiation mask specially made for her. When she first got sick in 2023, she had no symptoms of pain, and only a small lump the size of a chopstick appeared in the corner of her face near her ear. When the doctor diagnosed her with a parotid gland tumor, Thai Hoa's long days of treatment officially began. After surgery at Children's Hospital 1, Hoa continued to be prescribed 25 radiation beams at the Ho Chi Minh City Oncology Hospital.

Because the tumor was located in the center of many nerves, the doctor was worried because there was a risk of mouth distortion and facial drooping. Fortunately, after the surgery, the baby's condition was stable. Receiving the radiation mask from the nurse, with a drawing of his favorite character, Thai Hoa looked at it the whole time. He said that he was no longer worried, and that he was not afraid anymore because radiation therapy was painless, and he would just lie down and sleep for a bit and it would be over.

Like Duc and Hoa, hundreds of other pediatric patients undergoing radiation therapy at the Ho Chi Minh City Oncology Hospital receive special attention from doctors, nurses and technicians compared to adult patients. The way medical staff here care for pediatric patients seems to want to share some of the physical and mental pain with the children.

Once the simulation mask is complete, adults will have a small mole-like tattoo on their chest. This tattoo is used as a reference point for each patient to be treated. This tattoo will stay with them for the rest of their lives. However, doctors will not tattoo children because they cannot bear the pain. The more important reason is that they have a long life ahead of them, and if they recover, doctors do not want them to remember the painful days when looking at the tattoo.

Behind the colorful cancer radiation masks at the Ho Chi Minh City Oncology Hospital are hundreds of different stories of unfortunate children suffering from incurable diseases, as well as the love and care that adults try to soothe their painful childhoods.