Radiation 201

The whole brouhaha about the MRI and the (rather unattractively named) fat necrosis coincided with most of my radiation treatment, so I've not had an opportunity to share all the wonderful things I'm learning about this part of the process. There's a lot of detail here, so I hope I don't bore anyone, but I find this stuff fascinating.

First: I'm down to 10 remaining treatments (out of a total of 35), and it's all gone pretty swimmingly. Yay! Now for the details.

Each weekday morning, I arrive at the cancer center and check-in at the radiation department for my 8:30 appointment. Check-in is so well done, I feel the need to describe it. :-) You just walk up to the reception window and there's a flat screen PC monitor there. Touch it and the list of appointments appears. Touch the row with your name and appointed time (I am "Karen Z") and then touch the "Check-in" button at the bottom of the screen. There. Now the folks in the radiation rooms know you're there and will be available shortly.

After I'm checked in, I walk through a door into the "Gowned waiting area" (that's actually the sign outside the door) and go into a dressing room. I disrobe from the waist up and put on a gown, put my things in a little wooden "locker", and go sit in a chair for a couple minutes.

One of the technicians escorts me to one of the two radiation rooms, which are so, so cool. All sorts of radiation goes on here, for all sorts of cancers.

When they are planning radiation treatment, they put little pin dot tattoos on the affected area. These tattoos are used in conjunction with the many (six? seven?) lasers in the radiation room to line you up the same way every day, so they can be confident they're treating the correct area. In addition to the tattoos and lasers, they also employ other tools to make sure they can line you up with the totally groovy linear accelerator that delivers the radiation. For people with pelvic and abominal cancers, there are custom-fitted foam forms: they put the foam form on the bed/platform and the patient lies down on it. Since it's molded around *your* body, it helps you to lie down in the position they want. For brain and other head/neck cancers, they have these mesh "cages" that fit around the head and shoulders. These cages also provide a grid that enables them to align things with the lasers.

For breast cancer, you lie down on a slightly inclined "board" that raises your shoulders a couple inches above your hips. You bare the breast to be treated, raise the arm on the affected side (my left arm) and rest the arm in some holders that look a lot like the stirrups you rest your legs in when getting a pap smear. They are able to move the bed/platform in very small increments to line up the tattoos with the lasers. They also sometimes use the sheet I'm lying on to move me just the eensiest amount.

When I'm all lined up and everything is calibrated, the linear accelerator (or as I've come to think of it, the "zapper") is positioned over my left shoulder (where the affected lymph nodes were). They leave the room (can you imagine how much radiation they'd experience if they stayed in the room? <shudder>) When they zap me, it's not so much for an amount of time as it is for a dose (of radiation), but the dose typically takes about 30 seconds to administer to the area where the cancer infected the lymph nodes. Then, the technicians (really wonderful, friendly people, btw) come back into the room, adjust me the slightest bit, and reposition the zapper so it's on my right side, pointing at the left breast. They leave again and my left breast gets zapped from the right side for about 20 to 25 seconds. We repeat all this for one more zap on the left side (where the tumor was), which also lasts for about 20 to 25 seconds.

When we're all done, they tell me I can lower my arm, and I go slather aloe all over the area, get dressed, and go to work.

I've got just three more of these types of treatment and then I have seven "boost" radiation treatments. For those treatments, they created a special lead plate that enables them to direct radiation to just the tumor site on my left side.

Now, you might wonder, with all this special radioactive attention, if there are any side effects? Well, lethargy can be a side effect, but given that we were able to avoid my lungs in the treatment, I'm not really experiencing any tiredness. But. Even though I use copious amounts of aloe, and Aquaphor (TM), and olive oil cream, a person can't be given what is, essentially, a sunburn everyday without some skin issues. The area where my neck meets my shoulder on the left side is pretty sunburned. It is dry and itchy and it looks very red and angry. The breast is a little red, but mostly okay, so far. And as I said, just three more of these treatments (with a two day break this weekend) and then my neck can recover.

And there you go.

When radiation is done, the plan is: see Dr. Kuan at the end of March for a check-up and some blood work (to ensure everything is returning to normal). Assuming everything is groovy, I'll wait until mid-May for another check-up and blood check (and port flush--I still have the port and we need to ensure it's not clogged, so they need to "flush" it with saline every four to six weeks). In June, I'll have a CT scan to (hopefully) verify that there is no cancer in my body. In July, I'll have a bilateral mammogram, and if that, too, looks good, I can finally have the port removed. (It's a drag to remove it only to have to put it back in, should a person need more chemo.)

And there you go.