Radiation.. so what’s it like?

I’ve finished the first 7 of the 25 radiation doses I need. So far so good! The side effects are supposed to kick in hard next week, so I’m just living in the moment until then.

What is radiation?

Radiation is like a strong x-ray. You can’t see or feel it, but it is waves of energy that target the area where the cancer was to kill any cancer cells still kicking around and prevent the cancer from reoccurring. 

From the Canadian Cancer Society:

How radiation therapy works

Radiation therapy works by destroying cancer cells and damaging a cancer cell’s DNA so that it stops dividing and growing. Radiation therapy can shrink a tumour or completely destroy it. It is most effective on cells that grow and divide quickly. Cancer cells tend to divide more quickly than most normal cells. This makes them more likely to be affected by the radiation (be radiosensitive) than normal cells.

Even though cancer cells and normal cells react differently to radiation, it’s very hard to destroy cancer cells without damaging some normal cells too. Damage to normal cells causes side effects. Normal cells are often able to recover better from radiation damage than cancer cells. The goal of radiation therapy is to give enough radiation to destroy cancer cells in your body but not so much that normal cells can’t recover.

http://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/radiation-therapy/?region=on

The process

Every day I go to the BC Cancer building in Vancouver for my radiation treatment. Within the 12 hours before my appointment, I need to empty my bowels. Then, an hour before treatment, I have to pee, then take a couple of nausea prevent pills, and then drink a bottle of water (500mL). The goal is to have a full bladder for the treatment.

I’ve been commuting from North Vancouver, taking the bus, then the Seabus, and then the Skytrain over to the cancer centre. It takes about an hour to travel, plus time for any delays waiting for the next bus/train. The round trip with treatment is probably about 5 hours a day.

I now aim to just be at the cancer centre an hour early so I can do all my prep work there. Looking for bathrooms on the transit route was just too tricky. The nice waiting room in the radiation department has washrooms and a TV and nice chairs, so I spend an hour there.

15 minutes before my appointment, I strip down and get into a gown. Their gowns aren’t ideal. One is completely see through and the other is too small. They are both like robes rather than a traditional hospital gown, so I’m using both. The see through one underneath with the smaller thicker one on top. Then I sit in the waiting room with the other patients and their families, trying to keep my legs together, my boobs covered, and my bladder full, but not full enough to make a mess. HA!

There are 4 pods, or rooms, for radiation treatment in this facility, each one with their own team. This is nice because it is nice to get to know the radiation therapists that are helping me each day. I’m in Pod D and there are a couple of students who are learning the ropes working with the team.

When it is my turn, they grab me a warm blanket from the blanket warmer (the best part of any medical treatment is their warm blankets!). I go into the thick walled, dim radiation room and take off my baseball cap, and my outer robe. I open my inner robe and lie down on the cold stainless steel slab. 

Using my 5 placement tattoos I was given in my planning session a few weeks back, and a laser alignment beam from the ceiling, they adjust me this way and that to get me in the same position. Sometimes this is quick, and sometimes it takes 10 minutes of fiddling. The movement shifts they need are usually just a millimetre or two, so they tell me not to move, and they shift me on the robe and thin sheet placed under me. 

When they think I’m in the right place, they cover me up with the warm blanket, then leave the room and close the big lead filled door. Outside the room they have a little office where they can see me on cameras and can adjust the slab I’m lying on. They take a couple quick scans or x-rays which I suspect they overlay with my original planning cat scan images to make sure I’m in the exact same position.

The first couple of times they came in at this point to shift me this way or that but now they are familiar enough with me to get me placed right the first time. 

They can also see from these scans if my bladder is full enough. A couple times I was only 40 and 50% full. Being 100% full isn’t easy. I find I have to drink water before the hour mark to start the hydration, in order to be 100%.

When I’m aligned perfectly, to prevent any unnecessary radiation to areas that don’t need it, a green light starts blinking on the ceiling. When it turns red, a loud buzz can be heard and then the radiation attachment starts completely below me, and then slowly goes around my abdomen, ending below me. This is repeated 3 times. The actual radiation time must be only 3-4 minutes but I’m sure I’m in the room for at least 20 minutes. 

Once a week I meet with a radiation oncologist doctor for a check up on my side effects. I also have blood taken once a week to check my blood values. There is a slim chance radiation can tank my values and delay treatment but it isn’t expected for me.

Side effects

I’m receiving radiation to my pelvic area, and my para-aortic region. Because these areas contain my stomach, intestines, and bladder, the side effects can be significant. I was told to expect about 25 days of side effects, which should start in my third week of treatment.

The reason for having a full bladder, is a full bladder helps lift your intestines up and away from the radiation area. However you can’t get them out of the way entirely though, so the side effects are caused by the radiation affecting the healthy cells in the bladder, and digestive system.

The expected side effects are nausea, extreme fatigue, diarrhea, burning during urination, and cramping. Holding a full bladder is supposed to get more difficult. Their weekly questionnaire for me mentions things about diapers, urine and stool leakage. Gah! I’m hoping to not have anything like that. The doctor today told me I’ll probably eventually need to shift to a “BRAT” diet – Bananas, Rice, Applesauce, and Toast, to manage the expected digestive upset with a dose of Imodium. Yum.

So far so good. I had some stomach issues last week, gagging, and sensitivity to smells, but who knows if it was related. Being away from home with different food and a case of home sickness may have been related too.

I’m also achy with sore knees, back, and neck, but I think it’s a combination of a return to exercise, sitting on a different couch, sleeping on a firm mattress, and maybe a touch from chemo still. I think the commute is good for me though, getting me moving and walking, up hills, and up and down steps.  

Life between treatments

I’m staying with my friend in North Vancouver. On the weekend we were able to go for a couple of drives, including to Squamish and Harrison Hot Springs. We were taking advantage of the nice weather and me feeling well.

I’m so eager to go home, but it is a month away from now so I try not to think about it too much so I don’t fall apart. This will be the longest Jeff and I have ever been apart. Thankfully we are in touch all the time with iMessages, Facetime, and phone calls. My brother and mother are coming out to visit for a few days next week so that should help pass more of the time.

OH!

And in other news, my hair is growing back! I have fuzz on my head and stubble on my legs. This will be short lived when it all falls out again when I restart chemo in January, but I really don’t mind have some fuzz growing in the meantime!