Treatment
Yesterday afternoon I began my radiation therapy. Let the radiation flow.
A linear accelerator used for radiation therapy in action. These powerful pieces of equipment have an imposing presence and a sci-fi personality of their own. I named my companion for the next seven weeks "Rad."
A total of thirty-six Intensity Modulated Radiation Therapy (IMRT) sessions is prescribed by my personalized treatment plan. The number was arrived at by my radiation oncologist, a radiation physicist and a dosimetrist. After reviewing my three-dimensional planning CT taken last week, they calculated a complicated equation based on area, volumes, densities, dose modulations depending on the areas being radiated and other factors this lay person can only guess. They arrived at a total dose divided by the maximum daily dose. The result: 36–seven weeks (Monday through Friday) and one day. Barring unexpected equipment failures and rescheduled appointments, my last treatment should be on November 8.
According to the patient information brochure provided by Varian, the manufacturer of the linear accelerator that is producing my radiation beams: “IMRT allows doctors to customize radiation dose by modulating, or varying, the amount of radiation dose given to different parts of the treatment area. This modulation is done in highly accurate, three-dimensional detail according to the shape, size and location of the tumor…”
Those of you who have been following my case might be wondering, “what tumor?” Your question is justified. The last you heard of my tumor was that I gave it, along with the healthy remains of my prostate and some of my pelvic lymph nodes, to the pathology lab at Little Company of Mary Providence Hospital in Torrance, California, last June. That brings me to today where I am a patient with advanced, metastatic disease but no tumor to target. In my case, we are looking to hunt down renegade cells in a location that a military strategist would call “the area in which the enemy was last observed…”
My androgen deprivation therapy is a systemic approach intended to slow down the growth or proliferation of prostate cancer cells within my body by cutting off their fuel supply: testosterone. IMRT is being used to kill any cancerous cells that may still be hanging around my remaining lower lymph nodes and the “prostatic bed.” The radiation is targeted to my lymph nodes and will also provide “blanket coverage” to areas of my pelvic area–where any metastatic cells are most likely to be hanging out since going AWOL from my prostate. It’s a sound approach and the best one-two punch we have. I’ll take all seven weeks and one day of this second punch.
As I settled onto the radiation table today, the technicians located my three marker tatoos (yes… permament, man-made beauty marks) and positioned me with accuracy. I looked into the accelerator’s eye and thought “my goodness… I never thought I would be here addressing you as a patient…” These machines cast an imposing presence and have their own robotic personality. I honestly found myself having a quiet dialog with it. I hoped it was having a good day and that it had thoroughly memorized the plan of attack for my case, down to the nanometer. Even post-surgery, there is still a lot of sensitive stuff down there that I want to keep as healthy as possible.
Of course, the gargantuan machine did not reply. It just stared back at me, perhaps remembering not to get too involved with its patients. I, on the other hand, decided to make the best out of our new relationship. I named my accelerator Rad, both in recognition of its job and after an intriguing remote-controlled robot my sons owned when they were younger. Like the Rad of days gone by, my new Rad would perform amazing feats guided by controls a good distance away from it’s internal processors and components. However, instead of shooting a series Nerf darts at its enemy, it would spew beams of killer radiation. I wanted to laugh at the analogies and scenes that were forming in my imagination but I couldn’t. I was under strict DO NOT MOVE orders. And, if I had lapsed into one of my ADT-induced laughing fits, this first mission would be doomed.
After an initial image was taken and reviewed by the radiation oncologist located somewhere else in the building, I was told the session would start.
Visions of Star Wars paraded through my head as Rad went on the attack.
Prompted by electronic impulses sent from the room next door, Rad engaged and, like a dutiful field soldier, began dispensing his arsenal. Rad move left and right, above and below me. I could hear the buzz of the accelerator as it shot out its powerful beams and the high-pitched whir of the multileaf collimator (120 leaves to be exact) as it adjusted to shape the beams to specific areas of my anatomy.
It was a form of artistry. I so wished that they would blast the soundtrack from Star Wars, provide a laser light show and sounds from video games to complete the sci-fi battle that was running fast-forward in my head. But they didn’t. It was almost anti-climatic. Within minutes, my first treatment was completed. Only 35 more to go.
In about two weeks, I will know what side effects of radiation I might experience, including fatigue (sure.. I’ll take double helpings…), diarrhea, pain while urinating, external redness and mild skin burns in the treatment areas, and hair loss in the treatment area, among others. Right now, I am not counting on any of these, but I am mindful of them making a potential appearance. Rest assured, I am heeding the advice of the patient brochure and will definitely not be exposing my treatment area to the rays of the sun! As with the ADT, I will take my medicine as it comes.
Before leaving for my first radiation session this morning, I opened a gift from my wife. (I had mentioned a while back that I wanted something masculine to wear as a reminder of my commitment to fighting this cancer.) The box contained a set of dog tags. The larger tag was engraved with the words: “BELIEVE all will be well.” On the flip side was the Chinese symbol for long life. It was perfect! There was also a smaller unengraved tag. Before I went to the outpatient radiation center yesterday, I had the smaller tag engraved with my affirmation in return: “I WILL.” It includes the date of my diagnosis, 04.13.2010. These reminders will remain around my neck until the day that I am declared free of cancer.
I WILL BELIEVE. I WILL win this battle.
A linear accelerator used for radiation therapy in action. These powerful pieces of equipment have an imposing presence and a sci-fi personality of their own. I named my companion for the next seven weeks "Rad."
A total of thirty-six Intensity Modulated Radiation Therapy (IMRT) sessions is prescribed by my personalized treatment plan. The number was arrived at by my radiation oncologist, a radiation physicist and a dosimetrist. After reviewing my three-dimensional planning CT taken last week, they calculated a complicated equation based on area, volumes, densities, dose modulations depending on the areas being radiated and other factors this lay person can only guess. They arrived at a total dose divided by the maximum daily dose. The result: 36–seven weeks (Monday through Friday) and one day. Barring unexpected equipment failures and rescheduled appointments, my last treatment should be on November 8.
According to the patient information brochure provided by Varian, the manufacturer of the linear accelerator that is producing my radiation beams: “IMRT allows doctors to customize radiation dose by modulating, or varying, the amount of radiation dose given to different parts of the treatment area. This modulation is done in highly accurate, three-dimensional detail according to the shape, size and location of the tumor…”
Those of you who have been following my case might be wondering, “what tumor?” Your question is justified. The last you heard of my tumor was that I gave it, along with the healthy remains of my prostate and some of my pelvic lymph nodes, to the pathology lab at Little Company of Mary Providence Hospital in Torrance, California, last June. That brings me to today where I am a patient with advanced, metastatic disease but no tumor to target. In my case, we are looking to hunt down renegade cells in a location that a military strategist would call “the area in which the enemy was last observed…”
My androgen deprivation therapy is a systemic approach intended to slow down the growth or proliferation of prostate cancer cells within my body by cutting off their fuel supply: testosterone. IMRT is being used to kill any cancerous cells that may still be hanging around my remaining lower lymph nodes and the “prostatic bed.” The radiation is targeted to my lymph nodes and will also provide “blanket coverage” to areas of my pelvic area–where any metastatic cells are most likely to be hanging out since going AWOL from my prostate. It’s a sound approach and the best one-two punch we have. I’ll take all seven weeks and one day of this second punch.
As I settled onto the radiation table today, the technicians located my three marker tatoos (yes… permament, man-made beauty marks) and positioned me with accuracy. I looked into the accelerator’s eye and thought “my goodness… I never thought I would be here addressing you as a patient…” These machines cast an imposing presence and have their own robotic personality. I honestly found myself having a quiet dialog with it. I hoped it was having a good day and that it had thoroughly memorized the plan of attack for my case, down to the nanometer. Even post-surgery, there is still a lot of sensitive stuff down there that I want to keep as healthy as possible.
Of course, the gargantuan machine did not reply. It just stared back at me, perhaps remembering not to get too involved with its patients. I, on the other hand, decided to make the best out of our new relationship. I named my accelerator Rad, both in recognition of its job and after an intriguing remote-controlled robot my sons owned when they were younger. Like the Rad of days gone by, my new Rad would perform amazing feats guided by controls a good distance away from it’s internal processors and components. However, instead of shooting a series Nerf darts at its enemy, it would spew beams of killer radiation. I wanted to laugh at the analogies and scenes that were forming in my imagination but I couldn’t. I was under strict DO NOT MOVE orders. And, if I had lapsed into one of my ADT-induced laughing fits, this first mission would be doomed.
After an initial image was taken and reviewed by the radiation oncologist located somewhere else in the building, I was told the session would start.
Visions of Star Wars paraded through my head as Rad went on the attack.
Prompted by electronic impulses sent from the room next door, Rad engaged and, like a dutiful field soldier, began dispensing his arsenal. Rad move left and right, above and below me. I could hear the buzz of the accelerator as it shot out its powerful beams and the high-pitched whir of the multileaf collimator (120 leaves to be exact) as it adjusted to shape the beams to specific areas of my anatomy.
It was a form of artistry. I so wished that they would blast the soundtrack from Star Wars, provide a laser light show and sounds from video games to complete the sci-fi battle that was running fast-forward in my head. But they didn’t. It was almost anti-climatic. Within minutes, my first treatment was completed. Only 35 more to go.
In about two weeks, I will know what side effects of radiation I might experience, including fatigue (sure.. I’ll take double helpings…), diarrhea, pain while urinating, external redness and mild skin burns in the treatment areas, and hair loss in the treatment area, among others. Right now, I am not counting on any of these, but I am mindful of them making a potential appearance. Rest assured, I am heeding the advice of the patient brochure and will definitely not be exposing my treatment area to the rays of the sun! As with the ADT, I will take my medicine as it comes.
Before leaving for my first radiation session this morning, I opened a gift from my wife. (I had mentioned a while back that I wanted something masculine to wear as a reminder of my commitment to fighting this cancer.) The box contained a set of dog tags. The larger tag was engraved with the words: “BELIEVE all will be well.” On the flip side was the Chinese symbol for long life. It was perfect! There was also a smaller unengraved tag. Before I went to the outpatient radiation center yesterday, I had the smaller tag engraved with my affirmation in return: “I WILL.” It includes the date of my diagnosis, 04.13.2010. These reminders will remain around my neck until the day that I am declared free of cancer.
I WILL BELIEVE. I WILL win this battle.