The radiation I will be getting is called Intensity Modulated Radiotherapy. iMRT for short. This differs from the older style radiation therapy in that it allows them to "shape" the radiation beams to more effectively treat the tumors while reducing the collateral damage. An explanation of the treatment can be found here. http://www.wakeoncology.com/Services/IntensityModulatedRadiotherapyIMRT/tabid/107/Default.aspx
In order to keep this precision my head will need to be kept stationary in the same position relative to the table. To do this they make a plastic mesh mask of my head. When my treatments are done I get to take it home as a souvenir. (I was thinking of getting it mounted in a frame and put on the wall.) This of course is the Hannibal Lecter part.This is used to fix my head onto the table of the radiation machine. Here is a picture of an example of the machine. (I may sneak a picture of the actual machine tomorrow.)
And of course this is the Star Trek part. The images they use for the iMRT radiation are pretty cool. What they will do is make a mask of my head tomorrow and then use that to put me through a CT scan of my neck and head. That imaging will be used in the computer models to identify the tumors and create a treatment plan that maximizes the impact on the tumors and minimizes collateral damage. Its some heavy duty calculations and takes a few days to work up the treatment plan. Then hopefully by Friday they will have me in for a test run. Here they put me on the table an use the mask to hold my head in position. Then the computer positions the table and the machine to treat each tumor.While this type of radiation seeks to minimize the collateral damage they can't eliminate it. With radiation it appears the side effects accumulate over time. So I won't really feel anything the first treatment by the end I will feel the side effects much more. The potential side effects are:
- Fatigue
- Dry Mouth (There are some drugs to minimize it but it can't be eliminated.)
- Sore Throat
- A Stiff Jaw
- Changes in Food taste
- Tooth Decay (Goes back to dry mouth but there are ways to combat this)
- Voice Changes
- Skin Changes something like a Sun Burn
Some of these side effects like fatigue, voice changes and skin changes really can't be combated. The sore throat is treated with pain medicine. The radiation oncologist told me he has 20 different ones including morphine. I let him know that it was pretty much assumed that since I was having radiation and chemotherapy I wasn't looking for organic or homeopathic treatment. In other words better living through chemistry. Bring on the drugs.
The dry mouth and related things are a bigger concern. Apparently saliva is a big help in preventing tooth decay. They suggested I see my dentist for some advice prior to the start of treatment and that is scheduled for tomorrow. (By the way telling the receptionist that you have cancer and need to see the dentist before treatment starts opens up all sorts of scheduling opportunities. No waiting whatsoever for an appointment!)
The other big concern is being able to eat and drink properly. The sore throat gets pretty bad towards the end and one of the keys to proper handling the treatment is eating and drinking enough. To solve this they want to put in a feeding tube in advance just in case. Of all the things that have occurred up to this point this is the only thing that has me a bit out of sorts. I will probably get it put in because it is the right thing to do but its not something I am looking forward to. I did go to an appointment with a specialist to do the prep work for this. Its just something that I need to get my head around.
That's all I have on the radiation treatment. The actual delivery of the treatment is relatively painless and easy. I am told I should be in and out of the facility in 20-30 minutes for each time. That's good seeing as I have to go 5 days a week for 7 weeks. Its not the delivery that is the issue its the cumulative side effects that start to become the problem.
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