I am in my last of five weeks of radiation therapy and thought I'd consider what that's been like for me.
Every weekday visit the radiation oncology department in the lowest depths (literally) of Robert Wood Johnson University Hospital. Luckily, RWJUH is about 100 yards from the New Brunswick train station that I otherwise use to get to and from work. Logistically, it could only be more convenient if they came to my house to administer the treatment – except for the humongous x-ray machine that would be a bitch to get through my front door.
Other than Mondays, when I get checked out by Sue the nurse and Dr. Jabbour, every day is pretty much the same. I flash my membership bracelet to "Kelly Radiation" – that is after all how she answers the phone -who swipes me through the double doors. I grab my locker token and go into the changing room to put on my very flattering blue hospital smock. My appointments are generally 4 p.m. or later. I chose the afternoon because it interferes with work less; I have far fewer 3 p.m. than 9 a.m. meetings. The downside is that the days worth of delays often get compounded. It has allowed me to catch up on my pastoral care class reading or work stuff or news while trying to ignore the imposing flat screen tuned to Oprah or CNN.
Being a day-in, day-out thing – I've gotten familiar with both the other patients and the hospital staff. That, in of itself, is a bit strange because whatever acquaintance made is by it's nature brief if intimate.
Once I get in to the darkened room that is "LinAcc #1", I settle into the mold of my upper body that my usual and favorite techs, Kevin and Ann, have laid out for me. Basically, I lie in the exact same position with my arms raised over my head for about 25-30 minutes.
Kevin's good selection of 60's-80's classic rock plays in the background while a woman's voice instructs me to "breath in…breath out" rhythmically. First they use an x-ray to line me up according to the tiny tattoos and marking they made on my torso before the first day. The table jerks up or back, left or right to get me perfectly aligned. The rotating head of the machine spins the zapping head into place to begin the intensity-modulated radiation therapy. It makes seven stops in all – hitting the spot where the head of my pancreas was, from various angles. Each stop is hit in two half doses with the aperture adjusting accordingly. I can tell when the dose is being applied because the instrument clangs loudly, as if revving up. A box that they tape to my belly indicates when my breathing is at its' ebb. The radiation modulates and is delivered on each exhale.
It can be very relaxing and I have nearly fallen asleep a bunch of times, especially in the afternoon. Invariably, Ann will rouse me within a couple of too-shallow breaths. By the time my treatment time is up, my arms and shoulders are numb and I am only too glad to be sprung.
Otherwise, there is no pain involved in the treatment itself. Nor am I experiencing much in the way of negative side effects. Just today I jokingly asked whether I was in some placebo group because I doubted that I could be getting the full effect with so little in the way of side effects. All I have is a little bit of fatigue, especially in the afternoon. I wake up wanting to sleep more every day – but lots of folks experience that. I keep waiting to experience more pronounced fatigue, nausea or any of a number of other GI effects that I have been warned about…but, so far, I have been blessed to have nothing more than the fatigue.
My ankles have been swollen, to varying degrees, for more than two months now - but other than being a mystery, it hasn't been particularly bothersome. They suspect that it is a side effect of one or both of my chemo drugs. I take a mild dose (1,600mg, orally, twice a day) of Xeloda, a chemotherapy drug, that sensitize the radiation – making it work better. Before that, it was gemcitabine delivered via IV once a week.
So, assuming I finish up with radiation sometime next week, I should have a couple of weeks off before I go back to the chemo in mid-June. The plan right now is back to just one month of the gemcitabine chemo and then I will be all done – maybe around the 4th of July.
That's a good thing - especially since I have signed myself up to run the NYC marathon that I didn't get to do on my bday last November. To get ready in time, I need to be training in earnest come July.
On the other hand, completing the chemo/radiation scares me. Right now I feel like I am actively fighting the return of the cancer with these poisons. Still, I recognize that my fate ultimately lies in the absence of these extraordinary medical warriors. That is truly when it will be up to the grace of the Lord and the power of prayer. It is good to know that I won't be on my own.