Three weeks of radiation

The idea is that, since I have one spot that is chemo resistant, we should kill that spot and minimize the burden of disease before going into the stem cell transplant process. There are several things that need to be balanced when getting radiation therapy. Things like:
1. Using enough radiation to actually kill the cancer, with enough margin around the tumor to account for invisible cells and motion from my breathing
2. Pinpointing the radiation so that it treats a minimal amount of healthy tissue.
3. Keeping the dose to known safe limits for surrounding organs. The pancreas is pretty tough. Kidneys are very weak. Intestines almost as weak.

After a 90-minute consult with the radiation oncologist, we again learned even more about cancer treatment than we ever wanted to. In sum, here's what I'm undergoing.

First, a CT scan to see where my organs and the cancer are. This isn't a full CT scan like I've had in the past. It's just enough to map out my body and figure out how to set up the radiation treatment. With the CT scan, I also get my own custom beanbag. I lay down on the beanbag, and then they sucked all the air out of it, turning it into a rigid shell that is perfectly conformed to my body. When I began treatment a week later, I lay down in that rigid beanbag so that my body can be as precisely positioned as possible.

First day of treatment involves getting several X-rays, making sure I'm positioned right in my beanbag, and marking my skin in strategic places with sharpie so that they can line me up exactly the same way every time. There are these harmless laser beams from the ceiling and the sides of the room that they line me up with.

The actual machine they use to zap me with is a Varian Trilogy machine like the one in this picture. The two arms on the side are used for low-energy X rays. The big round head above is where the treatment rays come from. The whole thing can rotate, so that head can shoot me from above, the side, and below. The machine weighs about 9 tons. It's got a lot of lead shielding inside. And the treatment room is in the basement of the hospital in order to contain the radiation.

I show up, take off my shirt and lie down in my beanbag, arms lying on the bed over my head. They usually scoot and twist me a little to get my body lined up with the lasers, and then they leave the room. The machine rotates and shoots me from the left side for 45 seconds, then from the right side for 45 seconds, then from the top for 15 seconds.

So on Monday through Friday, I'm staying in an apartment across the street from the hospital so I don't have to drive back and forth to Huntsville 5 hours round-trip. Thankfully, the Vanderbilt Stem Cell Transplant (SCT) center is providing that accommodation for me. That's probably where I'll stay during the SCT as well. I'll try to remember to take some pictures to show you.

As of this writing, I've had 8 of the 15 radiation treatments with minimal side effects. I'm able to drive home on the weekends. I'm able to walk and ride my bike. I'm able to work from the apartment. I don't have any real nausea. I have my appetite.

The plan is to complete the radiation by Tuesday, 4/26. I'll get a week off. Then they'll start the preadmission for the SCT on Tuesday, 5/3. Once that starts, I'm stuck in Nashville until I'm well enough to go home--about 35 days.

On a side note: I've found brothers and sisters at Belmont Heights Baptist Church, an easy bike ride from the apartment. It's great to be part of God's family.