Radiation. Let’s review.

I started radiation this week. I think that there are so many greatly misunderstood aspects to cancer and treatment, but radiation has got to be one of the biggest ones. I certainly didn’t know what everything was before I started this journey and I think the vast majority of people think chemo and radiation are the same thing. Either that or they have no clue what the differences are. I’m not knocking anyone, but the farther into this journey I get I am flat out amazed at the lack of public knowledge regarding cancer treatments. Everyone knows about cancer, and everyone knows someone who has gone through treatment. But how many people actually have any understanding of what that entails? A shocking few.

Radiation and chemo both have the same goal – to kill cancer cells. In doing that, they kill healthy cells as well – but the healthy ones will regenerate themselves while the cancer cells generally aren’t able to do this and they die. That is pretty much where the similarities end. Chemo is administered via an IV or central line (port) and go throughout the entire body. The impact from the drugs are felt throughout the body, especially in the rapidly reproducing cells which is why hair falls out, the digestive system suffers (nausea, vomiting, any variety of poop issues), skin and tissues are extremely dry, etc. Radiation is administered by a machine to a very specific part of the body. It can’t be felt and doesn’t stay in the body, so I am not radioactive – and I don’t glow (yes, people actually think that happens). Side effects are generally only felt in the immediate area of treatment (skin burns) except for overall fatigue which I’ve been told can be quite extreme. All side effects depend on the treatment as well as the individual. Note: There are other methods for giving chemo and radiation. I am referring to my treatments, which are the most common uses as far as I know.

In my case, unfortunately, the cancer cells did not respond to chemo so they were regenerating even during treatment. This is a possibility in radiation as well, but the number of cases that don’t respond to therapies are generally very low. My lack of response was very, very rare. Sucks for me but good for everyone else. I’m always happy when I hear about people who had great responses to chemo because it gives me hope. We decided to do chemo after surgery because we want to be as thorough as possible since my cancer was so aggressive. There is no way for us to know if it worked since the tumors were removed during surgery, but we are hopeful. The same is true with radiation – it is very rare for a person to not respond to treatment, but it happens. We also have no way of knowing because there are no active tumors in there (knock on wood). But we are using every defense we’ve got to make sure that all of those cells are out of my body.

I’ve had the nurses take pictures so I can share what radiation is like. No one is allowed in the treatment room during set up and even the nurses leave during treatments so I am in there alone. If you missed my earlier post on getting set up for radiation, you may want to go back and read that first. Here is the treatment room, I love the sign:

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Here is the door – it is automatic because it’s so heavy. The walls of the radiation room are six feet thick and made of concrete. It makes me feel pretty safe. 🙂

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And the star of the show, here is the radiation machine (linear accelerator?)

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Obviously, I lay on the bed and I’m pretty sure everything in this room except for the cabinets moves and rotates. The entire machine spins, the bed moves back and forth, up and down and rotates as needed. The top of the machine in the picture above is where the radiation comes from and not only does the entire machine spin, but there is a circle in the top of that extension which spins and has a window that precisely controls the radiation field as you will see in a moment. The radiation is so precise that I don’t need any shielding for the rest of my body. I can keep my jewelry on and my phone in my pocket (or my hand) during treatment. I lay down in the bed which already has my body mold under the sheet. I position myself in the mold with my left arm over my head and my head turned to the right. They move the bed back and up so I am pretty close to the main extension of the machine. Then the nurses line me up using my tattoos. The tattoos were not what I expected. They are done by lining me up precisely and then putting a drop of ink in the spot and inserting a standard needle. That’s it. They are tiny. I got four done. One on either side of my rib cage, one in the center of my chest and one on my left shoulder. Here is the shoulder one. It looks like a blackhead or a tiny black mole:

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Once I am lined up, they move the entire bed to certain coordinates. Then the radiation machine sets itself up for treatment. For every treatment, the macine spins to get the correct angle on my body. Here we are set up for the first area (collarbone). My arms are obviously out of position for the photo and to retain a small amount of privacy:

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In the top circle where the radiation comes out, there is a rectangle glass window. Directly inside this, there are metal (steel?) bars attached to the top and bottom. They slide towards the middle and can completely cover the inside of the window or slide open to completely expose the inside. These bars are used to create a pattern of where the radiation should hit – this is how they avoid organs, treating healthy areas, etc. Here is a picture of the window ready for my first treatment (collarbone area):

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As you can see, there is a light inside this rectangle which is used by the nurses to verify the treatment area. Here is the same light hitting my collarbone area (lymph nodes are under there):

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The nurses verify placement, mark the bottom edge and the light inside is turned off. They mark the bottom so that in the next step they can line up the top of the light to make sure I don’t have a gap on my chest that doesn’t get treated. Everyone leaves the room and I hold very still. During treatment I hear a slight click from within the machine and then a hum when the radiation is applied. For my collarbone area there are two hums because they use two different frequencies. Treatment time varies depending on the barometric pressure in the room and other variables, but is around 10-15 seconds.

Then we move onto my chest wall. We use a “bolus” which I always think of as an IV thing, but in this case it just means a wet towel over my chest in the treatment area to bring the radiation more towards the surface. Here I am with the machine spun further to my side and with the towel applied to my chest. Again, my arm is out of position to make this a picture appropriate for the internet:

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The chest wall only has one treatment on each side so once the inside is done, the machine swings all the way around and treats the other side. Each one is done in 10-15 seconds. Then I get dressed and am on my way. Rinse and repeat for 5.5 weeks. Side effects generally show up 2-3 weeks into treatment from what I’ve been told. I hope you enjoyed your education.

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2 Responses to Radiation. Let’s review.

  1. jdolce27 says:

    Thanks for posting this – especially with the photos! I’m all tatted up and am starting radiation next week. I wasn’t entirely certain what that would entail so it was reassuring to the see the step by step photos!

  2. This was a great blog! Before my radiation I had no clue how it was done, especially the tiny tattoos lol . This was very well documented 🙂 Just a word of advise my skin under my breast was extremely raw, as soon as u see anything tell your nurse so you can get a RX for cream, it works wonders! Best of luck to you! Be strong!

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