Radiation 101

I thought I'd do a little post about radiation because as I thought about it, it's one of those hidden, unglamorous things about cancer that the average person probably doesn't know too much about. Heck, I sat down with my radiation doctor for an hour and still didn't really know what to expect. I knew about the burns, the fatigue, and the possible side effects, especially being a left-sided patient (unfortunately where your heart resides so there's always a remote possibility of heart damage in the future). But I still didn't really understand what happens, and it's a common refrain I've heard from my fellow cancer peeps. I mean, really, you see people receiving chemo in movies and TV - if it's lighthearted, then it's Samantha eating popcicles with the girls, having a few hot flashes and drinking a cosmo. If it's dramatic, it's somebody hunched over a toilet, puking their guts out as chunks of hair coat the bathroom floor. The truth is somewhere in the middle, but at least it's protrayed. The only time you are exposed to radiation - pun intended - is either Cher getting scrubbed down as the alarms blare (am I dating myself here?) or Russian sailors basically melting before your eyes after trying to fix the leaking reactor. Cancer radiation isn't movie-worthy. It's boring and it's slow (reaction-wise, you don't really have most effects until the last week or two), there are no cool IV's to show...there's just a big huge machine that makes a sound like an x-ray, and then you go home. So here's a quick synopsis of what the radiation train is like.

You can see the redness on my chest and neck here.

First, you start with a CT scan, or some similar procedure. I actually had two, one to see if the cancer in my inoperable lymph node was gone, which it was, and then a second one, which everyone has, which is basically the map on which your plan will be implemented. All of the radiation oncology doctors confer, come up with a plan based on I'm sure, many factors, and then it all goes into a computer and the plan is mapped out. You then go in for x-rays, to make sure you still line up with the plan, you get some tattoos (not in the places I expected, I have three across my mid-line, one near my armpit, and I think there may be one somewhere else. They are just pinpoints, not the ink I like. :) Then you go in prior to your first treatment to make sure that the machine is calibrated correctly to you and that all of your points match up. Then you start. You go in, they line you up with the coordinates, and it starts. They put a bolus on you, which is a gel-type pad that keeps the radiation beams at the surface of the skin. I get zapped 4 times, for about 10 seconds each. There are these metal "teeth" in the machine that move around and open up to the shape that needs to be radiated, and then it happens. The table raises high, you are about 5 feet up in the air, and there are lasers all over the room, but you don't see the radiation beams, and you don't feel them. Some people say they feel a bit of heat, I actually felt a bit the first few times, but not after that. The number of treatments varies depending on more numerous factors, including cancer type, stage, age, aggressiveness, location, etc. etc. I am scheduled for 33 treatments, 28 regular treatments and 5 boosts (boosts are radiation treatments that are concentrated only along the scar line, a place where cancer can often recur). The treatments go from the bottom of my neck to a bit under my bra line, from the center of my chest to the mid-line of my rib cage. I started the boosts yesterday, even though I have two more regular treatments, because over the holiday weekend all of the radiation seemed to catch up with me and my underarm is very burnt and painful, so hopefully this rest will let it heal a slight bit and I can make it through the last two next week. Considering how very fair I am and how I got red so quickly, I'm still doing okay comparatively, but damn it hurts!


Showing the huge contrast of my butt white skin and the red burnt underarm...

Just because I know you wanted to see a close up :)