Planning Cancer Treatment: Part 1


Cancer sucks.  I don’t want it, and I do not wish it on anyone else. 


The technology, science, and art of treating cancer fascinates this closet-geek. 


Yesterday was Day 1 of the cancer treatment planning stage. This plan will take up to 10 days to craft and perfect.  Here is the sum of my contribution to the plan’s development: 

  • Lay down 
  • Don’t move 
  • Shut up (this part is very important) 

The technician did the rest of the work.  He talked to me through the process, detailing each action taken and its necessity or significance. 

“Lay Down” 

We were greeted by the radiation machine as we walked in.  It’s like the room was built around the machine. Imagine the world’s largest doughnut with a table that slides through the hole in the middle.  That is the machine the oncologist gets misty-eyed about. That’s one big doughnut too!!! My role is to lay down on the table, allow the tech to rightly position my head, neck, and shoulders so he could complete the following tasks. 

The technician placed a thin metal strip along my neck's five inch incision.  The machine does not display skin and flesh during the imaging process.  The planning team must know the incision’s exact position.  The metal strip readily identifies the incision on the images that are forwarded to the planning team.  We moved straight to creating the cradle and mask once this strip was in place. 

“Don't move” and “Shut UP” 

It was imperative for me to remain stationary while the technician crafted a cranium cradle and mask that will immobilize my head, neck, and shoulders. The team and the Big Doughnut demand consistency.  The entire plan is predicated on me being in the exact same position every time I’m on the table. He fashioned the cradle first. 

The cradle started out as a solid chunk of rigid foam.  The technician moistened the cradle and rested my head upon it.  The moisture made the cradle pliable which enabled the technician to shape the cradle to the contour of the back of my cranium.  He began prepping the mask while the cradle became rigid once again. 

The mask started out as a large head-and-shoulders silhouette made of mesh netting.  It was placed in hot water for seven minutes. The tech removed the rectangle,  knocked the excess water off, and laid the rectangle across my shoulders, neck, and head.  He worked quickly because the material would cool off and harden in a few minutes. He attached nine fasteners to the table and shaped the mask to be very snug around my head, neck, and shoulders.   I laid there motionless and speechless on the table for five minutes after the sculpting was complete to allow the mask to cool down and solidify. The cradle and mask were solid and complete. I felt like Hannibal Lecter in “Silence of the Lambs” (Senator?  Love your shoes!). I stayed the course of my three part role as the tech started the crucial task of imaging the lymph system in my neck. 

The tech shot a high-contrast dye into my bloodstream through an I.V. and stepped into the control room to map out the lymph system in my neck.  My head, neck, and shoulders are locked down to the table as the table slides in and out of the Big Doughnut. This table surfing went on for a few minutes.  He occasionally asked how I was doing and watched for a thumbs-up signal from the control booth.  

My contribution (lay down, don't move, shut up [I felt like I was overqualified for my role!!!]) was complete.  The rest of the planning is now up to the team and directed by the oncologist. 

The scan of my neck is now available, but the system does not recognize all the details.  The team will input data that represents my specific conditions. From there, they will build the treatment plan and configure the system to hit precisely targeted areas in my neck.  All this information will be passed to the oncologist, who will study the data and send the plan back with the necessary corrections. The team and oncologist will keep passing the plan back and forth until every person involved gives a green light on the plan.  A dry run of the plan comes next. 

Think of the dry run as the dress rehearsal before opening night.  I will be there to do my best Hannibal Lecter imitation. The technician will operate the Big Doughnut and test the plan.  Other team members will be there to verify that all is well.  Day 1 of radiation treatment will begin once all the team members give a green light on their parts.

Day 1 of radiation treatment should be just like the dress rehearsal.  This same routine will be repeated for 30 to 35 days, business days that is.  Day 1 should be around July 18 (barring any setbacks), with the final day of treatment being around Labor Day.  I am guessing I’ll need the rest of September to fully recover. I will meet the Chemo doc tomorrow and will share that part of the overall treatment plan. 

As mentioned in previous writings, radiation treatment has a cumulative effect. The side effects  become more pronounced with every passing day. The first few days will be side-effect free. The side effects will gradually become noticeable, and the team will do everything possible to manage the side effects while continuing the treatment plan.  The ideal is to keep moving forward until the plan has been fully executed. 

Mom tells me of how things have improved since her battle with cancer.  It still sucks to go through the whole thing, and it is nice to know that it is a lot better than it used to be. 

Have you undergone radiation treatment?  Tell the tale please. 

Have you been at the side of someone whose endured the treatment?  Please share your experiences. Same event, but very different experiences for me and my Wendy.  We'd both to hear your thoughts and feels as a powerless spectator.


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