Cancer Patients

Radiation: The Last Leg of the Treatment Journey

The following is the latest post in the series Donna’s Journey, which follows Donna’s story as she lives with and recovers from breast cancer.

 

Ready, Set, Go!

Getting ready for radiation was a lot of “hurry up and wait” instead of “ready, set, go!” Since they were just “zapping” me, I anticipated it would be a fairly easy treatment, without a lot of set-up. After all, these machines had incredible imaging capabilities; they would be able to just put me in the machine and it would do its stuff, right? Wrong!

What I forgot in my rush to get this final step over with is that experts had to tell those machines what to do. The set-up process for this treatment involved multiple scans—scans of my chest, clavicle, and part of my neck. These scans were performed with and without contrast, as well as with various breathing regimens to help distinguish my lungs and protect them from the radiation fields.

 

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From my limited view in the scanning machine, I counted seven people around me giving their opinions on how I should be positioned. I heard things like, “If we move her arm just a little more to the right,” “Perhaps if we just tilted her a little more this way,” and my favorite, “Yes, that will work if she can sustain a breath hold for about 40 seconds.” Yikes!

I felt like the specimen in a science experiment! After that initial appointment, the scientists went back to their laboratories to formulate my final treatment plan. I was brought back in for a final check to be sure I was positioned exactly right. Once they all agreed on the placement, they had me lie down on a plastic bag filled with a soft material that would harden into my mold. And then the ink came out—ink, as in tattoos! They marked me on both of my sides and a couple areas on my chest so they could line me up correctly when I came in for treatment. The permanent dots were the size of the tip of a marker.

They used a small light beam to line up the tattoos and ensure I would be in the exact same spot every time I came in for treatment. Because my treatment required the radiation field to hit my neck as well as my chest, they had to create a mask that would hold my head in the perfect position, with my neck immobile. Thank goodness they didn’t need to tattoo my neck for this!

 

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What I expected to be an easy treatment turned into a very detailed and somewhat complicated prep. Could I have been upset with all the time that this took and the inconvenience to my schedule? Sure.

Was I scared about the team’s discussions I’d heard that seemed to show uncertainty? Perhaps.

Did I learn that it wasn’t an easy treatment and that it must be exact so other areas of my body would not suffer the effects of unneeded radiation? Absolutely!

The team, who I affectionately call my “Mad Scientists,” was so precise that I was truly in awe of their knowledge, skill, and quest to be certain that the radiation field was administered accurately.

 

Treatment Regimen and Timing

The treatment was scheduled every day, Monday through Friday, for seven-and-a-half weeks. At first, I was worried about how I would fit this in, but I found that the scheduling team was flexible to my needs. For the most part, my treatment was scheduled at 7 or 7:15 a.m. each day. The treatment center was about 40 minutes away from my home, so these were early days in the beginning of winter in Michigan! I was given a card with a barcode to scan when entering the center. From there, I would go straight to the women’s locker room, where I would change into my fashionable hospital gown. Then I would wait in the lounge for the technicians to retrieve me.

In the treatment room, the technician team would already have my mold on the table when I arrived. They positioned me so that my tattoos lined up with the beams. The next step was to put my mask on and put the mouthpiece in. The mouthpiece was connected to a breathing apparatus that allowed the flow of air. When the team needed to distinguish between my lungs and the rest of my chest, I was asked to hold my breath. Then the air supply was cut for the required amount of time. (I did have a button that could start the air supply again and halt the radiation field if I felt uncomfortable.) After the treatment, the technicians showed me how holding my breath helped them see the difference between my lungs and where the radiation field would hit. This was quite fascinating.

The treatment plan for my chest included what they call “boosts.” For these boosts, they covered my chest with a wet towel before administering the radiation to that area. This was meant to intensify the treatment and accelerate the desired outcomes. They were given every other day for several weeks, but not throughout the full treatment cycle.

 

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Radiation treatment itself was a little daunting, however, because once you are positioned, the technician team has to go to a protected area so they aren’t exposed to the radiation. So there you are, alone in this room, in a weird position with a machine that is supposed to kill off any remaining cancer cells and make the area unfertile ground for the cancer to return.

I couldn’t help but think, “Is this really working?”

Then the machine starts up and swirls around you to position the beams. You are given instructions by the technicians over the intercom. Lights flash on. The machine comes closer. You’re asked to hold your breath, then release, and then more swirling of the machines and lights. Before I knew it, I would hear “OK, you’re all done.” All in less than 10 minutes a day! It really took much longer to drive there, change, and get positioned.

The technician team was a truly unique group of people. They see some of the sickest patients on a daily basis, yet they remain upbeat and encouraging. They always made me as comfortable as possible while making sure they were delivering the exact radiation field as prescribed. What a great team, and thank goodness they always used warm water on those towels for my boost!

 

The Effects

In addition to the daily treatments, I was seen once a week by the radiation oncologist to monitor side effects and skin conditions. I was fortunate with side effects for the most part. I was warned at the beginning of the treatment that I might have some skin irritation, breaking of the skin, and potential oozing in some areas. They compared this to the effects of a bad sunburn but assured me that if it got to that point, I would be treated to minimize the discomfort.

I was also monitored regularly to see if I was experiencing lymphedema. I’d had many of the lymph nodes removed, and this can sometimes cause swelling in the arm because fluids are not draining properly. I was a prime candidate for this side effect, but didn’t experience it until several months after treatment had stopped. I have been able to keep it in check with exercises and a compression sleeve. (Lymphedema is manageable, and if you have concerns, you should speak with your medical professional.)

I was also told that I would experience a high level of fatigue. I did experience this, but not right away. In the beginning, any tiredness that I had was because I was getting up at 5:30 a.m. to get ready to make the 40-minute drive to treatment. After about three weeks, I did experience fatigue from the treatment, as well as shortness of breath. I was determined not to let this derail my life. I would make some minor modifications to my routine, parking closer to the entrance at work, modifying my diet to more nutritional foods that would provide energy, and limiting caffeine intake after 11 a.m.

Near the end of treatment (weeks five through seven-and-a-half), I started to experience the “sunburn” they had warned me about, but only on my neck. This skin became dry and brittle, but I was told not to use any creams or lotions on the area. The skin started to peel, and they were concerned that it would begin to ooze. I was given some saline and an astringent to mix together to use in case the oozing started. Fortunately, I was blessed, and the area, while it peeled, remained dry.

I must say that the physical side effects were minimal, but the emotional ones were much more noticeable. I experienced so much doubt and fear during this time.

I felt like I was going to a tanning booth every day to get rid of my cancer—how could that work?

When I was in chemo, I could feel things happening in my body. Surgery had physical signs that something was done to remove the cancer. With radiation, I couldn’t feel anything happening inside, so I didn’t feel like it was working.

Even with the sunburn, I couldn’t wrap my head around how this type of treatment administered from the outside could be getting rid of the remaining cancer cells on the inside. Yes, doubt and fear were the side effects that played havoc with my mind. I wish I could say that I have a way for you to overcome this, but I don’t. Even with the strong faith I have, I found myself thinking more about the recurrence of cancer than the cure.

 

The Bell

I passed a bell on the wall on my way back to my radiation machine every day. The ringing of the bell signifies and celebrates the milestones of a cancer patient’s treatment journey.

 

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There was a framed saying under the bell: “May the sound of this bell resonate within your soul as you continue your journey. Always remember you are a hero, a victor, a survivor!”

I had stopped a few times on my way back from treatment to read this, but for some reason, I never thought that I would feel this way about my situation. My doubting thoughts consumed me.

During my treatment, despite the many offers from my family and friends to accompany me to the daily radiation treatments, I was of the mindset that this was my journey and I had to face it alone. Perhaps if I had allowed others in, I wouldn’t have had those low thoughts and doubts during this leg of the treatment.

As my turn to ring the bell grew closer, I was adamant that when the time came, I wanted to be surrounded by my family.

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They all came with me to the last treatment and surrounded me with their love and support. This was an extremely emotional experience, and I couldn’t have been happier to be surrounded by my husband and children as I moved forward to the next phase: survivorship!

After the radiation treatment, I had to wait three months before I could be scanned to see if the radiation worked. The radiation was still doing its magic within my body, and my body needed a chance to heal. Evidently, if they scan you too soon, you might have an inconclusive result—like the fine print that says, “Subject to change.”

I am happy to say that all those doubtful thoughts were dispelled after the scan three months post-treatment. The results came back NED—NO EVIDENCE OF DISEASE!

Onward to the next chapter of the journey: the reconstruction phase of both body and mind!

 

Be blessed,

Donna

 

 

The information herein may not be construed as medical advice. The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. It should not be used as a substitute for professional diagnosis and treatment. It is best to obtain medical recommendations from your physician.

 

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