Tattooing

Question 1

Why do we tattoo patients undergoing RT?

Answer 1

• Reproducibility
  
  • Straightening
  • Future treatments/retreatment: if the tattoos are within 10cm
  • Increased efficiency
  • External reference mark in terms of internal anatomy

Question 2

Location of tattoo

Answer 2

determined at CT, marked with marker
Place tattoos at mid sep for lateral. Avoid skin folds as they are moveable and different attenuation (build up)
Visibility: no double, clearly visible

Question 3

Documentation

Answer 3

location of tattoos need to be accurately documented. Measurements are made from common anatomical landmarks

Question 4

Important safety precautions

Answer 4

• Supervised as a student
  
  • Follow Universal Safety Precautions: gloves, having a sterile environment, wash hands
  • Needles cannot be recapped
  • Follow departmental needle stick injury procedures if a needle stick occurs

Question 5

Equipment

Answer 5

• Needles, gloves, marker pen, ink, alcohol wipe, sharps bin

Question 6

Consent

Answer 6

• What is involved
  
  • How many tattoos will be done
  • Location of tattoos
  • What the tattoos look like

Question 7

Why may patients refuse tattoos

Answer 7

• Religious reasons
  
  • Cosmetic effect
  • Seen as a reminder of their cancer journey
  • Fear of needles

Question 8

Alternatives to tattoos

Answer 8

SGRT

Question 9

Steps of tattooing

Answer 9

Line up patient using lasers
Check proposed location is suitable
Mark area of tattoo with a pen
All equipment should be ready
Clean area where tattoo is to be placed
Inform patient
Put on gloves
Place a drop of ink on the RP
Using free hand, hold area around tattoo
Use sterile needle to pierce the top layers of skin
Dispose of needles in sharp bin
Use alcohol wipe, wipe off residual ink and check that the tattoo is visible
Tidy up the work area, remove gloves and wash hands

Question 10

How to explain the process of tattooing

Answer 10

1. We will first make sure you are nice and straight on the bed using some of our lasers
2. We will place 3 markers at the start and then place BB points on it
3. We will go ahead and take the image and following the image, we can remove the BB marks
4. However, to make sure you are in this same exact position every single day during treatment, we will place 3 permanent marks in those spots
5. They will be the size of a small freckle and can last till … many years
6. It will feel like a sharp pain of needle prick and the one anteriorly tends to hurt the most as it is the closest to the bone
7. After you go home, you can rub off the marker but the tattoo will not be coming off