The battle plan is set

Right now is the calm before the storm. My last tests and appointments were on Wednesday. The treatments start in a week. Next Tuesday I have my test run with the machine. The way that works is they use the mask they made last week and attach me to the table. Then they take some x-rays with the mask on. I think that is used to help them align or calibrate the machine. Then they test the machine out to see that the treatment plan they created lines up with the positions on the mask or something like that. They don't actually use radiation during this dry run. Once treatment starts they take new x-ray images about once a week. Also half way through they will run me through the CT Scanner again and change the treatment plan based on the changes in tumor sizes.

The treatment plan starts on Wednesday. I get both the Chemo and radiation therapy that day. Because the chemo room at the medical oncologist is full up that day I will go to the hospital for my chemo. It actually works out better because the radiation facility is at the hospital. This makes it easier to coordinate the two. Right now my radiation treatment slot is 10:00 AM. I need to be there 15 minutes before hand to get the shots for the medicine to protect the salivary glands. The chemo appointment is for 8:00 AM. The chemo starts with fluids for a few hours before they give me the actual chemo drug. What will happen is I will start the chemo first. Then they will take me down to radiation when its time. After that I will head back up to the chemo room. By having the appointments overlap at the hospital it will take less time than going to one first and then to another office (1 minute away :-)). Also since the chemo I am having can last several hours (up to 6 I am told) they want me to bring food to eat. I think it is actually a requirement. Did I mention that nutrition and hydration is a big part of this? One bonus when you have chemo at the hospital is that they feed you. I will still bring stuff with me but those of you that know me know how much I love institutional food.

One thing I should note for those of you not from tiny town is that there are two advantages to having all of the facilities that I need for treatment locally. First is that it really only takes 20 minutes or less to get to hospital where the radiation treatment is. The chemo is in a building in front of the parking lot for the radiation oncologist. That is 20 minutes or less, with traffic, from the time I leave my kitchen to when I check in at the front desk. This leads me to the other advantage, parking. First parking is free. No worrying about finding a lot with space or paying for parking or parking in a garage. Also I generally park within 10 spaces of the door to the radiation treatment facility. All the advantages of the latest in treatment technology with the convenience of a small town. This is fortunate because if I had the cancer 3 years ago I would have ended up having to drive at least an hour for treatments plus add in the time to park in a garage and get in the building. BTW I added a link section with information on iMRT and the radiation treatment center at the Cayuga Medical Center. OK. Back to the main topic.

So Wednesday is the start. Here is the basic outline of the plan of attack. I will have 35 radiation treatments. These are 5 days a week for 7 weeks. Of course they are not open on Thanksgiving so I will make that one up at the end. Starting at the same time is the chemo therapy. This is broken down into 2 phases. Each phase has 3 treatments for a total of 6 treatments. All of the treatments are 3 weeks apart. The first 3 are the big ones. They take longer to administer and have stronger side effects. After those 3 there are 3 more with the same drug but a smaller dose. I think they said 75% of the main dose. It doesn't seem like much difference but according to the medical oncologist it makes a difference in the side effects. Along with these last 3 treatments is an infusion chemo of another drug. This is delivered via an IV pump in a pack over 5 days. The plus side is that the treatment at the doctors takes less time the downside is having an IV in at home for the next 4 days.

The treatment schedule is this. For 7 weeks I will have radiation treatment 5 days a week. At the same time I will have 6 chemo treatments over a span of 15 weeks. Fortunately the last 3 chemo treatments should have less side effects and I will be over the worst of the radiation treatments.

While I am definitely not looking forward to the treatments and realize it will be a rough ride at times I am glad that I am finally going to get started. Going through the treatments is unavoidable and the sooner I get started the sooner I come out the other side.