Radiation begins…and so does a new phase of my treatment. I just finished chemo this past Monday, October 10, 2012 but I just couldn’t wait to get started with the next part. So here we go. My new second home will be at the Northeast Georgia Cancer Care Radiation Oncology Clinic. I will go there EVERY day for the next six weeks (except weekends) beginning Tuesday, October 18, 2011. I should be finished up by the Wednesday after Thanksgiving.
I’ve only yet met a few of the staff at the Radiation Oncology clinic but have a really at home feeling there. The Radiation Therapist that worked with me today and got me all setup and tattooed up with my temporary marks was Dave Phan. He was very warm and entertaining. It’s funny how you can be laying out naked on a table and be cracking jokes with a guy you just met. Dave is pretty cool – he’s got an MBA and then decided to go back and get a BS in Science in Radiation Therapy. Now that’s drive.
My actual Radiology Oncologist is Dr. Terry. I chose him for several reasons…Dr. Splichal told me he would be more like the “father” figure type of doctor, which makes me feel more secure. And he is extremely experienced, and gets high marks from everyone I have spoken to about him. I told my surgeon, Dr. Gunn, that I had chosen him to be my “guy” and Dr. Gunn assured me that I would love him. I think he may be on to something there.“X” marks the spotRadiation Machine
Anyways, I had my first visit yesterday (October 12) and got to meet Dr. Terry and one of the nurses. Today I went in for positioning and marking. I had a non-diagnostic CAT scan just to position me for treatment. They made little green “X” marks the spot drawings on me in several places to make sure the radiation rays are positioned in exactly the same place each time. They are covered up with tape so they don’t wash off. They might have to touch them up every couple of days just to make sure.
The treatment will only take about 2 minutes a day. From the time I walk in the door of the clinic to the time I leave will only take about 20 minutes. Once a week I get a films (x-rays) taken just to make sure all the alignments are still correct – a recalibration of sorts. That day might take a little longer. I will also see Dr. Terry once a week. Seems pretty darn easy compared to chemo. The only fear I have is whether I will actually be as tired as everyone has warned me about. Fatigue is not something that agrees with me well.
Notes
Tuesday, October 18, 2011
Tuesday was my first day.Almost looks like a little robot friend with two arms!
This is how the whole process works in general at my clinic. You walk into the office, sign in, go to the Ladies Dressing room and get into a gown, and wait for your name to be called. Usually you are called back within 10 minutes of your actual appointment time which is pretty good compared to other doctor’s offices. I’m thinking that it will get even quicker as the days wear on. For the first three days I have been shoved into a schedule that already has about 60 other daily patients. Starting on my fourth day (friday) I will have a regular spot – same time every day and I think the wait time will be barely long enough for me to strip down, though i’m pretty fast at getting dressed and undressed. I got trained for that after having kids – not a lot of “primping” time for mothers unfortunately. I spend more time making my kids look presentable (and that isn’t saying much if you’ve seen some of the get ups my kids have left the house in) than I spend on myself. It’s actually been a blessing to have no hair for a while – one less thing to have to mess with! But I digress.
So Tuesday I was introduced to my new robotic friend, Varian. He looks like a big robot with a bulbous head and two fat arms…at least in this photo I found. It actually is an impressive and daunting piece of machinery. It means serious business. It looks like it’s gonna kick some cancer butt. There is a table that is slid up under the machine where you are positioned daily based on the X’s mentioned in my previous post. The machine rotates around and “zaps” (this is my non-medical word for the lay person) you according to your treatment plan. I am treated on three different fields which means there are three different positions the machine moves to and delivers image guided intensity-modulated radiation therapy. The first day took about 30-45 minutes because they had to take the weekly films I mentioned in my first post.
For those of you who are information junkies and want to see the actual machine and what I go through each day here is a 4 minute video that describes and shows what happens….
Wednesday, October 19, 2011
Wednesday (and on every Monday, Wednesday and Friday) they applied a Bolus to my skin. Sounds like a really weird word right? It actually feels and looks like a piece of flesh, which is exactly what it emulates. Kind of reminds me of the prosthetic breast implant I bought right after my mastectomy and reconstruction when my reconstructed breast hadn’t fully “settled” in. I jokingly refer to this prosthesis as the chicken cutlet because it looks like an uncooked chicken breast. The reason the bolus is used is to increase the dosage of radiation to the skin. High energy x-rays are skin sparing. Because my treatment plan involves a need for skin irradiation because of cancer cells were so close to the skin in my case, the addition of tissue-equivalent bolus material placed over the radiation field can circumvent skin sparing. Bolus, a flabby, rubbery material, is used to ‘fool’ the radiation beam so it will deposit the maximum dose on the skin surface instead of a fraction of an inch deeper, as it would otherwise. Therefore, a skin reaction is almost inevitable in this scenario. Bolus is usually incorporated into radiation therapy when a surgical scar, such as a mastectomy scar, needs to receive a full dose of radiation therapy. Wednesday only took about 25 minutes from walking in the door to leaving.
Thursday, October 20, 2011
Thursday…In and out in 10 minutes! What a record. Very simple morning. I am having a great deal of pain in my legs, ankles, hips – deep tissue pain. I’ve had similar pain after my Taxol treatments but it has been at day 5-6 with the first three of them. I am now at day 11 of my very last Taxol chemo and I still have this pain. It is possible that it is just extended pain from Taxol because it was the fourth treatment but i’m wary about whether or not this is coming from the radiation treatments. There are many reports of women with the same problems that are in radiation who have not even had chemo. Rats….I have plenty of lortab to knock the pain out. I guess i’ll actually just start using more of it. Was a three lortab day yesterday. See how today goes.
Friday, October 21, 2011
10 minutes in and out. Been using Andree’s Light Cream Botanical Gel with Green Tea and Calendula three times or more a day and have had no signs of burning yet. I have a photo for how the radiation affected my skin after the first week. Not much! Just go to the Photos page and scroll to the bottom and click the link for “Radiation Effect Photos from 6 Weeks of Radiation”. I would link you straight to the gallery but I didn’t want you to see a picture of the radiated area if you haven’t prepared for it.
Weeks 2 – 6
Let’s see…by the end of the fourth week I was pretty badly burned. Worse than any burn i’ve had in my life. I stopped wearing a bras after three weeks (see Photos page to see the week three burn) just because it was more comfortable but by the end of the fourth week it was impossible to wear a bra because it would literally stick to the raw skin under my breast. It was extremely painful. Dr. Terry gave me Silvadene Cream to put on the burn. Its a pretty powerful antibiotic creme used for the treatment of second and third degree burns. I also took a complete week off of radiation just to give the burn time to heal. In hindsight I think I would have applied the Andre’s Botanical Gel while I was still at the clinic before I got dressed. I would end up going to work and forget to put it on until later that night and by that time the damage would have set in. But other than this burn, and having to take a week off, radiation was uneventful and much simpler than chemotherapy. Having to get up EVERY morning and go into the office got to be pretty taxing but I was usually there for 15 minutes or less each time. And I did not get the fatigue I heard so much about. I didn’t feel much more tired than I did during chemotherapy. A little run down all together but nothing chronic or debilitating.
As of November 23, 2011 I am done with Radiation.
Now that i’m done with all of that….it seems like a lifetime ago – and it’s only been a little over a month by the time I got this updated. Next step…..Prophylactic Mastectomy.
Photo Gallery
This gallery will contain photos that show the effects of radiation on my breast implant and my skin. Radiation can alter the shape, size, and consistency of breast implants and can cause pretty significant “sunburns”. This gallery will show the progress of the changes.
