7:15 AM Friday March 14th, 2025
47 Mississippi
Today is RAD 7 day in a sequence of 30 daily radiation treatments to cure me of prostate cancer. Patients are positioned on a moving platform and carefully placed in the "crosshairs of the radiation beam. Once my body is in the precise position, a magnetic lens focuses a beam of photons (X-rays) or protons into my prostate gland destroying the ability of those cancer cells to reproduce and spread throughout my body. The beam is invisible but has been photoshopped into this photograph for illustrative purposes.
My radiotherapy treatments will each take 15 minutes. There are 3 parts to radiotherapy: setup, imaging, treatment. Each session begins with Suzanne and Nagels setting me into the precise position for treatment. Then they depart the suite. The two CAT scan arms roll into place and a live scan is taken. I count 47 Mississippis (47 seconds) for the Linear Accelerator to make the anti clockwise 360 degree sweep of my body. Then a short pause followed by a 40 clockwise sweep giving my prostate a second dose of radiation. Of that time the beam of radiation is on for about 40 seconds rotating counterclockwise, then about 47 seconds rotating clockwise. Most of the time is taken by the CAT scanning arms of the accelerator to give my care team a live image of my prostate for precision targeting and for the technicians to "fine tune" the TrueBeam to have it's greatest effect.
I ask the Ramin, a Radiation Tech if this is a $3.1 million dollar accelerator? He replies: $3.5 million. I feel fortunate that this technology has developed so quickly.
Following therapy I join my tai chi group for our regular weekly practice. Like other Fridays, we enjoy our Salon gathering after tai chi to engage in our ongoing interactive discussions and sharing of ideas and intellectual stimulation. Today we begin with: "Toby, how is your treatment going." I respond by mentioning that I realized on my drive home that my 120 and Beyond plan was very fragile.
7:45 AM Thursday March 6th, 2025 RAD 1
I arrive a little early for my first Radiation Treatment #1 Suzanne, my radiation therapist, escorts me from reception to the radiation oncology suite and the dressing rooms nearby. My instructions are to remove my clothing from the waist down (except for shoes and socks) and put on a hospital gown (one of the drafty ones open at the back). It's funny that I'm concerned that everyone can see my naked butt. There's got to be a gown that is less humiliating.
When I arrive at the oncology suite, I meet the machine that is going to kill my prostate cancer cells. It is much larger than I'd imagined. Suzanne places a step stool next to the treatment table, I remove my shoes, lay back and slot my feet into the previously fitted Vac Lok immobilization devise. I see how the position of my feet in exactly the same location for each of my 30 treatments will ensure that my prostate will line up in the same place for the radiation beam. Otherwise my prostate could be too far to the right or left and the beam will damage other organs nearby. Narges, my second radiation therapist hands me a blue ring (see photo right) to keep my hands on my chest and out of the radiation beams path. Now that I'm laying in the correct position Suzanne tells me: "The machine will move around you. It will not touch you. It will not hurt you. Enjoy the ride." Her words comfort me as I lay inside this large and intimidating machine. A minute later I hear electric motors whir and in my peripheral vision watch as two CAT scanning arms lock into position.
Photo credit: https://bleedingcool.com
Laying inside this linear accelerator I feel like I'm in a Hollywood science fiction movie where I've been abducted by aliens and transported to the mother ship. I awaken to find myself on an exam table being rolled into a very large alien scanner. There I see two large mechanical arms move into view, then a whirring begins and their scanner begins clicking away so they can study my internal anatomy. That's when the alien doctor steps wearing, you guessed it, a white lab coat. "How primitive these humans, they only have one heart and only one tiny prostate. We won't hurt you, enjoy the ride." You never know when unexpected images pop into your thoughts. Humans!
6:42 AM Wednesday March 5th, 2025 We're on our way to Tustin for my first radiotherapy treatment.
Fragile is an excellent word for the day as it describes the shake up in my life after cancer diagnosis. Now I'm paying more attention to each day, appreciating the little things. Before, I was taking things for granted.
We arrive early for my 7am appointment only to discover that they are experiencing technical difficulties with the linear accelerator. We are rescheduled for tomorrow at 12:30 pm. I'm disappointed and Patricia is upset because we've been living in a stew of delays, mostly my fault for taking so long to make the decision to go with surgery or radiation treatment. We've learned that I can drive to these sessions. Treatments will not interfere with my ability to drive. This is a big relief as Patricia won't have to take time away from school for the six weeks of treatment.
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2:36 pm. Stopped to see my Rapport Community friends Jay, Caroline, and Molly. Rapport Coffee and Roasters is a great coffee shop down the hill from our home. It's a new addition to the neighborhood and a place that just seems to be bright and lively each time I stop for a latte. Jay wasn't there but Molly and Caroline (wonderful baristas) hit me with a happy greeting as I entered. Since the beginning of my radiation treatments, I haven't made time in my day for that cup of matcha or my Rapport friends. I see now that that was a mistake because my time with Caroline and Molly was astonishingly up lifting. I didn't realize that a month ago I was in a downward spiral. It wasn't a sadness that I was feeling as much as it was... well I don't know what it was. Suffice it to say I didn't want to go and that was not in my best interest. You see it's the people in our lives that either put us down or lift us up. I just realized that the moments with my tai chi friends and my Community at Rapport Cafe are important to keep close to the vest so to speak. Today having been with both groups leaves me feeling that I can do anything. It's like Daniel's quote from Monday at the gym:
"If you want to go fast, go alone. If you want to go far go with others."
I do want to go far, to the outer limits of my lifetime, and to do that I need to have my family and friends along for the journey. As Suzanne, my radiation technician said: "The machine will move around you, it will not touch you, it will not hurt you. Enjoy the ride.
Here am I with friends and family beginning the experience of that journey, "for all the rest of our days."
Molly hands me her journal and gives me a homework assignment to write something soothing for her as she's just had a devastating break up. Is this that gorgeous guy you introduced me to a month ago? It was your day off but you'd brought him to Rapport?
He seemed like such a nice guy. I guess it's true, sometimes you don't see the red flags until they smack you a good whack.
I look for a table to do her writing but I see all are occupied: there's a table with a guy but his table is nearest the door, too cold for me on a rainy day. There's another table in the corner. I ask if the empty seat is sharable and Monica generously moves me into the chair. She's a wedding planner with over a 100 weddings to her credit but is recovering from a divorce sequence that started back in July.
I tell Monica I have a writing assignment, she's happy not to talk and continue working on her laptop. I finish my Molly writing and return her journal. She's eager to read my posting. I return to my writing station to finish my matcha, which is a most excellent tea experience. Turns out Monica has recently been to both Vietnam and Japan and is yearning to return. I tell her she's a Japanophile and explain that this a way to describe a person who "is particularly fond of Japan and its culture, often with a deep and broad knowledge or appreciation." Monica nods brightly affirming my assumption. Before I leave the cafe I say: "Hey Molly, this is Monica she's going to Japan April 7th. I imagine you two having a spectacular time exploring Japan together. I think I'm being clever as I encourage these two to experience Japan together as a new chapter in their lives.
Scroll down to October 16 for previous posts to this story.
Click HERE for a 9 minute patient education video
https://prostatematters.co.nz/prostate-cancer/prostate-cancer-treatment-intensity-modulated-radiation-therapy-imrt/
