Walkthrough of Radiation Treatment for a Cancer Patient

Walkthrough of Radiation Treatment for a Cancer Patient

Curious what radiation treatment is like for cancer patients? This post will walk you through one day of radiation treatment for a patient with breast cancer (me).

Disclaimer: It is important to note that cancer treatments are tailored to the patient and their pathology, so there can be quite a bit of variation in the way treatment is experienced.

Here’s a peek into my experience getting radiated for breast cancer.

Walkthrough of Radiation Treatment | CoffeeJitters.Net | By Judy Schwartz Haley

My first day with the radiation team did not involve radiation at all.  On this appointment, I spent the bulk of my time in a CT Scan machine (no contrast) that was used to take measurements that would be used to design my specific treatment plan. They spent quite a bit of time aligning my body into a specific position, with my arms up over my head, gripping a post at the top of the bed.

Then I was tattooed: four little dots, one on each side at the bottom of my rib cage, and two down the center, one right in the middle of my breast bone, and the other, just below the bottom of my breast bone. They also placed a bag of chemicals under my head and shoulders; as those chemicals reacted to each other they formed a sturdy foam that conformed to my shape and would be a cradle that would hold me in this position for my treatments.

It took about a month to get the radiation plan squared away.  Then they called me in for another appointment – no radiation this time either, but this was a run through to make sure all of the calculations were in order.  On the last field, they discovered that the frame touched my chest, that’s why they do the run through, so they to called in the dosimetrist, physicist and a physician to make an adjustment to my treatment plan. They also gave me my fifth tattoo two inches below my collarbone.  The next day I went back for my first radiation treatment.

Radiation is administered every day except for weekends and holidays. My plan was for 28 days, which was six weeks once you fit in the two holidays.  The team was amazing. There was always at least two radiation technicians, and usually three or more, involved in my treatment each day.  They worked together, double checking every single setting, and making me comfortable at the same time.

Radiation Treatment

The room in which the radiation was administered was behind a foot thick door.

The ceiling lights had pictures, just like the dentist, only the pictures are nicer.

walkthrough of radiation treatment

Tools are laid out, and ready to go. Those markers, very important medical devices.  These guys scribbled all over me every day.

walkthrough of radiation treatment

When I first enter the room, I lie down on the bed and they put a band around my feet to hold them still, and cover me up with a warm blanket. Oh, I love those warm blankets. I fit my head and shoulders into the foam cradle, and there is a post sticking up at the top of the bed for me to wrap my hands around. The form and the post help a lot with holding still.  The bed is driven around a bit to line my tattoos up with the equipment, and then to make adjustments for each field of the treatment.

The machine that administers the radiation is also capable of taking digital x-rays. Once a week, treatment started with x-rays to make sure everything still lined up correctly (this helps them course correct in case of swelling or changes in weight during the 6 week course of treatment).

There’s Jerrod, drawing lines on my chest. The lines were actually drawn on to make sure I was lined up correctly while they administered the field.

walkthrough of radiation treatment

Brass Bolus

The first two doses of radiation are administered with the use of metal fabric called brass bolus.  The brass bolus is used to help trick the radiation beam into focusing closer to my skin rather than deeper into my body.

walkthrough of radiation treatment

If you think my breast is a weird shape, sitting up like that while I’m laying on my back, you’d be right.  It’s not really a breast. The breast is gone. That’s an implant called an expander that was put in place during my mastectomy, and it makes it possible for me to get new boobs after I’m healed up from treatment.  Aaron calls it my bionic boob.

The expander does require some working around when it comes to the radiation treatments. The brass bolus is used, rather than the foam bolus, because it conforms to the shape of the expander better. You can see from the picture below that its a bit slinky and hugs the curves. Once they get it placed just right, they tape it to make sure it doesn’t move.

walkthrough of radiation treatment

Once they get everything lined up perfectly, the team leaves the room.  There are several video cameras and the room and they can hear me and speak to me, so it’s not like I’m completely isolated. I don’t feel the radiation, but the machine does hum while it’s being administered. Then they come back in, position the equipment to focus on the another area, and repeat.

walkthrough of radiation treatment

Boost

For me, there were two positions with the brass bolus, then two more that focused on my collar bone, and then the final shot involved this contraption; they referred to it as “the boost.”. The purpose of this last shot was to put an electron field right up under the corner of that expande.

walkthrough of radiation treatment

Much of the time while they were lining me up, the lights were out so they could more readily see the lasers and make other measurements with light that was projected on to my skin.

walkthrough of radiation treatment

Every member of this team was so professional, at the same time, they were able to crack a joke, and keep me laughing through treatment.  They made it so I didn’t dread going in every day.

Thank You

Today is my last treatment, so I want to take a moment to shout out to the team. Dr. Janice Kim, Dr. Ermoine, Dane, Jarrod, Randall, Lorena, Jeannette, Sue, Jenny, Talina, Tony, Kelly, Christine, Rowena, and Sheree (and I’m so sorry if I left someone’s name out) – thank you so much for taking such good care of me.  And thank you for tolerating the photo shoots while you were working.

I hope this post will help ease your mind if you are facing radiation treatment. If you have received a cancer diagnosis and are wondering what you can expect from treatment, you might also check out my post: Walkthrough of Chemo Day for a Cancer Patient.

Did you notice that stuff on my head?  Hair!

border-green

You can learn more about my cancer story here:

my cancer story | Judy Schwartz Haley

 

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Bloggers at Work

Bloggers at Work

Step into my office.

my office

This is where I do the very important work of blogging about being a mom. I know. You want to be like me when you grow up, don’t you?

I even have an intern.

intern

Let me tell you, for an unpaid intern she’s quite expensive and high maintenance. She expects a meal, several meals, every day. I’d say something about her expecting me to wipe her butt, but that would be crude.

This is the kind of meal I prepare for my crew every day.

healthy cookbooks

Ok, that’s not true. That’s the kind of food I intend to cook every day.

This is more like the kind of food I prepare for our meals.

unhealthy cookbooks

Well, no, that’s not true either. That is the kind of food I would like to eat, and it implies I actually cook. In reality, I serve freezer lasagna, macaroni and cheese, and anything else that requires less than 5 minutes of time and effort on my part.

So much for being a food blogger.

These are my blogging pants.

froggy pants

What? You don’t match your intern to your pants?

napping baby and mom with froggy pants

Yes, she was taking yet another break. But she does contribute a lot to our team.

Here she is storyboarding my next blog post.

baby coloring

How do you work?

Walkthrough of chemo day for a cancer patient

Walkthrough of chemo day for a cancer patient

Ever wondered what a day of chemotherapy was like for a cancer patient? I thought I’d bring you along today, and give you a snapshot of what cancer treatment looks like. I hope its helpful to the newly diagnosed. Obvious disclaimer: of course, every patient’s treatment is different, and each cancer treatment center is different.

Chemo Day

6:00 AM
Alarm goes off. I’m supposed to get up and take my pills. I’m on a new type of chemo that requires me to take a pill 12 hours, 6 hours, and 1 hour before the chemo infusion starts (the first pill was taken care of last night). I hit the snooze button.

Again.

And again.

And again.

7:00 AM
Actually get out of bed and take the pill. Oops. Time to get the baby and myself ready to go.

7:45 AM
Mom shows up to take us in for treatment. She even packed me a lunch for my long day. Thanks Mom.

8:15 AM
I arrive at the Seattle Cancer Care Alliance. Mom takes the baby with her for the day. Check in for Port Access. (Instead of having an IV put in every time I go in, I have a port that is installed under the skin near my left collarbone. I know a lot of people hate having the port, but I love it. It’s so much nicer than the IVs and for some reason, getting an IV going on me is really difficult.) After the port access is installed I go around for the rest of the day with these tubes dangling from my chest.

Accessed Power Port for chemo

Break into moms lunch while I’m waiting.

9:30 AM
Blood draw for MUGA scan (Multi Gated Acquisition Scan). They take my blood, make it radioactive, and later they will return it to me, then they can track the blood as it makes its way through my heart to determine it’s efficiency. Several of the agents in my chemo are known to cause some heart damage to a small percentage of patients. This scan is scheduled periodically to determine how well my heart is handling the chemo, and whether we need to make any adjustments. This isn’t part of my normal chemo routine.

waiting . . .
Seattle Cancer Care Alliance Waiting Room

waiting . . .
Seattle Cancer Care Alliance Waiting Room

waiting . . .
Seattle Cancer Care Alliance Waiting Room

10:05 AM
The machine that does the MUGA scan is a long narrow bed (generous term) with an arm holding a 2″x2″ tablet that looks something like a small film holder for an x-ray machine. When I lay down, the radiologist attached leads and wires to my abdomen and chest, then another tech came in and they both verified that the blood they are giving back to me, now radioactive, actually belongs to me. The the treated blood goes back in through the port. Then she covered me up with a warmed blanket, they have blanket warmers all over the place here and they are really good about making sure you don’t catch a chill. After covering me up, she help up a wide vinyl loop to stick my arms through so I could relax them and wouldn’t have to hold them in the air at my side throughout the test. Seriously, when I say a long narrow bed, I mean maybe a foot and a half wide, not enough room to rest your arms at your side. The radiologist positions the tablet just above, but not touching, my chest. Then it’s a matter of just laying still for a long time, repositioning the tablet to get another angle, repeat… you get the picture. No pain, just boring laying there and trying not to move – plus I had a bit of a cough, and it was really frustrating trying not to cough.

10:50
Stop by the pharmacy to pick up a prescription – to be honest, it’s a refill of the pills I’m supposed to take 1 hour before chemo because I forgot them at home. I’m really on a roll today. I’m blaming it on chemo brain.

11:00 AM
Take the pills and meet with my Oncologist’s nurse, Martha. I usually meet with either the nurse or the doctor before each infusion. We discuss my symptoms and any questions I might have. I confess I took my pill late this morning, she said it’s no problem at all, I just needed to get the pill in the general time frame. She also said that my blood counts are awesome (yay me!), and my heart is operating well within normal parameters. That’s what I like to hear.

Seattle Cancer Care Alliance Waiting Room

11:30 AM
Check in for my chemo infusion. They give me a pager like the kind you get at restaurants while you’re waiting for a table.
pager

11:50 AM
Pager goes off and I head back to my chemo room (Bay 39 this time) and get settled in. I follow my nurse around, so the bay I’m in depends on the section she’s working in. Joy is so awesome I’d happily sit on a speed bump in the parking lot if that’s what it took to have her do my infusions. Joy orders my meds and then we compare notes on our babies while we wait for the meds to show up (ok, not the whole time, she did check on her other patients).

Infusion Bay for Chemotherapy

12:30 PM
Start Herceptin infusion through the port.

Today’s lineup:

chemotherapy drugs used for treating breast cancer

12:45 PM
The husband finally arrives. Yay! He tries to be here with me for most of this stuff, but he had a critical class this morning, and I really prefer that he not miss his classes.

2:20 PM
Benadryl and Zantac, pill form. Zofran pushed into the line in the port by hand. These are premeds to help prevent nausea and help prevent an allergic reaction. Now we are getting ready start the real chemo: Taxol. Another nurse came in to verify that the meds and the patient both match the Doctor’s orders. They don’t do this for every single medication, just the really big guns. The nurse also puts on a plastic apron, with full length sleeves and wrist cuffs, before handling these really harsh meds.

Chemotherapy Bag

2:50 PM
Sent The Husband to procure treats from the Infusion Unit kitchen: specifically mac’n’cheese, and chocolate ice cream. Please no lectures on health food, it’s chemo day.

nearly 3:00 PM
The Husband returned with the ice cream and tortellini with pesto, they were out of the mac’n’cheese. Totally appropriate substitution.

play around online for several hours . . .

Getting Chemo

6:45 PM
Zoladex: this is a little pellet that is inserted into my abdomen with a needle. The lidocaine shot they give me before hand hurts more than this shot. Then the port is removed and I get a little bandage, and we head out of the building where mom and the baby have arrived to give us a ride home.

Symptoms: The first evening of chemo I usually feel great. The meds they have been giving me to combat nausea are awesome, almost no nausea at all. The biggest side effect for me has been fatigue. It’s just really hard to stay awake sometimes, or to get off the couch at any time. It sounds counter-intuitive, but exercise does help with fatigue. Generally the symptoms accumulate through the course of the week. Tuesday is more foggy than Monday: Thursday and Friday I’m much more exhausted than Wednesday. It’s interesting that there is such a long (several days) delay between getting the chemo and when the symptoms hit their peak. I’m curious to see how my symptoms will change with the Taxol. Many people I’ve met say the Taxol was easier for them to tolerate than the AC I was on before, although there were a few that had a more difficult time. I’ll report back next week with an update.

And for those of you who have been anxious to see a picture of my bald head:
bald head

If you have any questions about cancer, treatment, symptoms, side effects, or how I’m dealing with it all, please feel free to ask in the comments. I’m happy to answer questions.

And if there is anyone out there who has just been diagnosed with cancer, I hope this post will be helpful for you. Hang in there. Bear in mind that every treatment plan is different, and everyone experiences and tolerates their treatment different. I found that most of the worst case scenarios my imagination conjured up were much worse than the reality when I finally faced it. I hope the same is true for you. Best Wishes.

Update

You can learn more about my cancer story here:

my cancer story | Judy Schwartz Haley

 

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