Radiotherapy

As I promised, here you have the post talking about radiotherapy. It uses ionizing radiation (X-rays or radioactivity, including gamma rays or alpha particles), generally as part of cancer treatment to control or kill malignant cells – according to wikipedia. I’ve already taken 22 sessions of concomitant radiotherapy, i.e., accompanied by chemotherapy, and both create a synergy and empower each other. This is translated into about 44 accumulated Gy (gray) in my body -I must reach 58 Gy. For those interested, I’d tell you that gray is the standard unit to measure the amount of absorbed dose of irradiated energy. There are still 7 sessions left, in other words, one week and a half.

The daily sessions started on May 22 at 8:30 p.m., but since it’s a little bit late in the evening, I asked for a change. I managed to get it rescheduled at 4:10 p.m., which is much better than the other schedule. By now I should be almost done, but, as usual, there have been unexpected events. The machine has undergone the annual maintenance: 4 session-free days. A piece has been replaced one week later after the maintenance: 1 more free day, hummmmm. Moreover, the computer system of the whole hospital (HIS) has been migrated during my treatment: 1 more day. In addition to this, Whit Monday (June 5) has fallen in between, and the delay has reached 7 days, therefore one and a half weeks, because the machines aren’t running during weekends.

Let me tell you how this works. When I’m called in, I enter a changing room, I take off my pants and put on a single-use housecoat. ICO promotes recycling, so I’ve used the same housecoat since the beginning, ‘lol. I wait a couple of minutes in the changing room until the machine is ready and then I’m called in again. Below these lines you can see the machine -or BIG machine:

truebeam

It’s called Truebeam, don’t take it as a joke, hahaha. I lay face down on the stretcher, and I have the housecoat raised and the boxer lowered. Then the lights are turned off and the lasers are turned on. As I had already told you, when I got the simulation CT-scan for radiotherapy, I got three spot tattoos on my hips. Such spots are useful now for the positioning of my butt of the stretcher. The technicians grab my hips and handle my body as if it were pizza dough. One jerk, another one, and… I’m ready! I’m asked if my genitals are downwards -I was told once the story of a patient that got the tip of his penis burnt, oops!- and I answer after checking again. Then they enter the exact coordinates to move the stretcher, turn on the lights and leave the room. From that moment on I can’t lift a finger. Once I coughed and unintentionally moved one leg and then, when the session finished, I was reproached – there are several cameras in that room, and furthermore the technicians have images of my bones so they can tell me off. The machine then starts screeching: it’s the motors of its moving arms. The screen you can see on the picture is placed below me and the opposite arm launches the first beam of X-rays (sagittal plane). Then it rotates some degrees and captures another image (transversal plane). These images are overlapped with the simulation CT-scan images and this way the system can precisely calculate the fine positioning correction of the stretcher. Bear in mind that this therapy has to be repetitive and exact during 29 sessions, otherwise, they’d be using a sledgehammer to crack a nut. Immediately after, the stretcher moves automatically, thereby compensating for the deviation, and the head of the linear accelerator -the circular one on the image- comes into play. When it reaches the desired position it remains silent a few seconds, but then… CLACK! the beam stopper opens and the first irradiation begins. The noise is similar to the one of an old intercom when its button remained stuck -peeeeeeeeeeeeeeee!-, and it lasts around 13 seconds. Then the same procedure -move head, wait and irradiate- is repeated twice at new positions. I’m irradiated from behind, from the side, and from the front. In total, I estimate that the process since I enter the room lasts no more than 6 minutes. It’s completely painless, yet I strongly recommend you to have a look at the side effects section. The technicians are really nice, and obviously, seeing them every day during one and a half months, although short time, helps to create a friendly environment.

Here you have a short and interesting video I’ve found on the internet, in case you want to learn a little bit more about this ^^.

I have an appointment with the radiotherapist every second week, alternating with a visit to the radiotherapy nurse. They examine me, ask me about everything, give me pieces of advice and prescribe creams and lotions. The radiotherapist even showed me the CT-scan images on her screen as well as the simulations of accumulated dose on adjacent regions: genitals, rectum, bladder, etc. According to such simulations, which are quite exact because the therapy that I’m following is quite standard and simple, the maximum accumulated dose reached on these organs is negligible 🙂 and I’m very happy not to have fried nuts, hahaha.

Side effects

My groin is suffering like a dog. Right after starting the therapy a tiny blister appeared there. This blister has deflated progressively -I moisturize my skin twice a day with the lotion that Pilar, Arturo’s mom, recommended to me: ISDIN Ureadin Rx Rd-, reddened, and in the end, the skin has opened: it’s a real burn. I have applied cortisone -Betamethasone- in the form of cream to cope with irritation, but now that there is a wound in the right groin and around the anus, I’m putting thyme poultices to alleviate and thereafter an antibiotic cream both twice a day. Bear in mind that this process would be like going to the beach 5 days a week around 20 minutes a day during one and a half months, at noon or in the afternoon -maximum solar intensity at the Earth surface-, and every time “forgetting” to put the sunscreen on the same zone, a part of your back where your hands don’t reach, for instance. This zone would end beaten up…

Acknowledgements

I would like firstly to thank all the technicians that are irradiating me and who don’t have a problem in handling my ass on a daily basis, ‘lol: Rebeca, David, Cristina, Marta, Elitza, and many other whose names I don’t know, unfortunately. I’d also like to mention the nurses Silvia and Cristina as well as Dr. Alicia Lozano.

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