Cancer Update: Salvation via Radiation?

You may be forgiven for thinking that I’ve dropped off the face of the earth, or, even less likely, won the PowerBall, bought Greenland, and am busy fending off a certain marauder. It’s been more than a month since I’ve posted anything and I have lots of excuses for that, all but one of which are mundane. The exception is, however, pretty significant…at least to me. Please allow me to elaborate…

One down; seven to go.

I successfully delayed it for 2 1/2 years but I’ve finally started radiation treatments in an attempt to eradicate the pesky remaining prostate cancers cells that the surgery couldn’t capture. The medical term for this procedure is adjuvant radiation therapy.

The reason my oncologist became relatively adamant about starting this treatment is that the results of the regular ultrasensitive PSA tests I’ve undergone since my surgery have started to trend upward, and the slope of the trend is increasing, indicating that the cancer cells are starting to multiply faster. The absolute numbers are still low, but the upward trend is not good.

So, every weekday* until April 24th, we’ll be saddling up and making the 54 mile drive to the clinic in Fredericksburg (TX) where I lie prone on a narrow bench, lower legs in a custom mold designed to keep me from running out of the room in a panic. I’m listening to piped-in country (yay Texas!) or classic rock, grasping a plastic donut to keep my arms from being torn from their sockets by a million dollar machine, and my pants are pulled down to gangsta height but body discretely shielded from view by a medical grade paper towel. After a bit of remote control repositioning involving lasers and my three (3!) sick tattoos plus X-marks-the-spot Sharpie drawings, the said million dollar machine microwaves what I hope is a very specific region because there are nearby areas that I’d prefer to remain in their original if aging condition. The whole process takes less than twenty minutes, assuming that the radiation therapist (aka Proton Pilot) finds nothing amiss.

Of course, it’s not really a matter of simply hopping in the car, making a drive, getting zapped, and coming home. There’s a very detailed pre-treatment protocol to be followed, designed to ensure that certain internal organs are always precisely where they’re supposed to be** once the daily treatment starts. I won’t go into detail; suffice it to say that there are components of the urinary and intestinal tracts that either need to be full or empty, and if they aren’t, my body could explode. OK, that’s not true at all, at least not the exploding thing. But failure to follow the protocol could result in having to delay a treatment, or, more embarrassingly, having to stand in the corner until I get control of my unruly innards.

My radiation therapist is a friendly and extremely well-informed young woman. She’s quite matter-of-fact but happy to answer my sometimes nerdish (hard to believe, right?) questions. I’m pretty sure she dumbs-down some of her answers to the level of my intellect, but that’s OK.

After five treatments I didn’t expect to detect any side-effects, and that’s pretty much the case, although I feel a little more fatigued in the evening than usual. That might be the effect of the 108-mile daily drive. I’m told that side-effects which might appear will be as a cumulative result of multiple treatments, and some may not even appear until I’m finished with the series, so I’ve got that to look forward to. The oncologist assures me that they’re likely to be mild or even non-existent; it’s his job to present the worst case while preserving overall optimism.

I’m fascinated by the technology being employed during this treatment. It’s a procedure known as Intensity-Modulated Radiation Therapy (IMRT). This procedure involves a complicated piece of equipment the size of a Dodge Ram pickup, called a linear accelerator, or linac. Here’s a photo of the one that’s I’m test driving:

When I’m in position on the narrow table, the radiation therapist first takes a quick CT scan by rotating around my body the horizontal mechanical bits on either side of the centrally-located video screen in the middle of the linac. She’ll compare that scan with the 3D model that the radiation oncologist created a week earlier from a very detailed CT scan, and she’ll to decide whether or not the internal organs mentioned above are appropriately positioned. If they are, then the real fun commences. The Big Giant Head (OK, the actual but less descriptive name is gantry) also rotates. It begins on my right side, stopping periodically to eject massive amounts of energy designed to fatally molest cancer cells. The process is painless, although I hope those cells are experiencing an agonizing death.

I confess to being ignorant about the exact nature of the radiation I’m being bombarded with, but it’s some form of x-ray. I hope to get a bit more education from the radiation oncologist in my weekly consultation next Monday.

One constant through this process has been the absolutely amazing grace that God is pouring out on us through loving, caring, encouraging family and friends…it’s quite a humbling experience. The list of the ways they’re modeling the love of Jesus to us grows longer every day, and while I truly hope that you never have to deal with a medical situation like this, if you do find yourself in challenging circumstances, that you will likewise be lifted up and supported by a host of good people.

*I’ll bet you didn’t know that cancer cells don’t grow on the weekends. Or major holidays, for that matter. The cool — and factual — thing is that the weekends off give normal cells a rest so they can recover; cancer cells can’t do that as quickly so there’s an actual benefit to the time off. [Return]

**Also, I was amazed to learn the extent to which internal organs can play hide and seek throughout the day. I would no longer be surprised to find that my spleen is outside of my body, playing poker with other ne’er-do-wells, while I sleep.[Return]