HOW TO MAKE A RADIATION BEAM

 https://www.youtube.com/watch?v=kI4Y7gBwTLk

Click HERE for how to generate a beam of radiation

Radiation Treatment: Prostate Cancer (An unexpected yet interesting story.)

7:15 AM Friday March 14th, 2025   RAD #7 

(Radiation Treatment #7

This is the journal of my voyage with prostate cancer. I will post the most recent entry at the top. (You will notice earlier entries going back in time as you scroll down.)

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 41 clockwise sweep giving my prostate a second low 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'm in and out in 15 minutes. No pain. No side effects.

I ask Ramin, the Radiation administrator if this is a $3.1 million dollar accelerator? He replies: $3.5 million.  I feel fortunate that this technology has developed so quickly and is in place. This accelerator has been here 12 years.

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.

 Click HERE to go to my 120 & Beyond website

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: Jacket-hub.com

Laying inside this linear accelerator I feel like I'm in a Hollywood science fiction movie. Have you seen the ones where humans are abducted by aliens and transported to the mother ship to find themselves on an exam table being rolled into a very large alien scanner. 

At the beginning of my first radiation treatment I see two large mechanical arms from the linear accelerator move into view, then a whirring begins and their scanner begins clicking away so they can study my internal anatomy. I have to admit these big mechanical arms were intimidating. Okay, they were a little scary.  In the movie this is when the alien doctor steps wearing, you guessed it, a white lab coat saying something like: "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 during radiation therapy.  "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.

[][][][][][][][][][][][][]

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/

 

Do something each day to celebrate life!

FOOD SAFETY AND 120 AND BEYOND

PART I 

Perchlorate, used in certain types of plastic, a component in rocket fuel, and found in a wide variety of fast food and is popular with foods for children, babies too.

Click HERE for complete article.

This article contributed by Scott

Source: https://www.consumerreports.org/health/food-contaminants/why-perchlorate-has-contaminated-food-and-water-for-years-a1065715826/

PART II

 Click HERE FOR BLACK PLASTIC, HEAT, AND LEACHING CHEMICALS

Source: The Atlantic

Better to be safe: Cooking with black plastic is something we should avoid as heat energizes harmful plastic compounds that migrate into our food. 

"People with the highest blood levels of PBDEs, a class of flame retardants found in black plastic, had about a 300 percent increase in their risk of dying from cancer compared with people who had the lowest levels, according to a study released this year." 

Black plastic food containers may be safe but how do we know if they contain flame retardants some of which are endocrine disruptors that disturb the body's hormone system, and may be associated with thyroid disease, diabetes, and cancer.

“When you’re using black plastic items, there’s going to be a risk that they could be contaminated,” Megan Liu, the science and policy manager at Toxic-Free Future."

This includes black plastic food trays, and children's toys.

HOW TO GET TO 120 AND BEYOND WITH A PROSTATE CANCER DIAGNOSIS

Wednesday March 12, 2025 RadioTherapy Treatment #5 (watch the explanatory video below.)

This morning I found this video accurately describing the Linear Accelerator (LINAC) at the foundation of my radiation treatment. "It customizes  high energy X-rays (electrons) to conform to a tumor's shape to destroy the cancer while minimizing the dose to surrounding normal critical tissue."

Radiation oncologist

Photo credit: Biomedical Engineers TV 

https://youtu.be/DP70cIFiPEo?si=7OC7ee5droI8G9ow

Tuesday March 11, 2025 Radiation therapy treatment #4 today. Today Ella informed me that the radiotherapy accelerator, True Beam, is made by a company called Varian.4  Special note: this photo has been edited to illustrate where the invisible beam is generated.

Because I taught anatomy and physiology for 39 years before retirement, I asked Ella if she would teach me one fact each time I come for a treatment. I want to learn from the experts.  https://jpneylon.github.io/ABR/UCLA_PhysicsReview/0-BeamLine-Components.pdf

Ella tells me that they treat 40 or more patients each day! I told her “thanks for taking such good care of us”

I’ve decided to drive straight home today cause I am eager to write. I want to lay out a map of the world with pinpoints to show where all of my treatment team comes from Dr. Kim was born in Michigan, Ella is from eastern Russia.  Narges is from Shiraz Iran, Sohi was born in Iran then moved to Kerman Italy. Yesterday I imagined a map of the world to illustrate how far members of my care team have come to treat my cancer.

March 10, 2025  zzz

February, 16, 2025 Living with cancer and navigating it’s sometimes stormy seas.  This is the log of that journey. 

Being extra vigilant, Dr. Pasin sent my prostate biopsy out for DNA testing, which reveals that the cancer cells are an aggressive form that requires Radiotherapy.

I was diagnosed with prostate cancer five months ago. Four weeks later it was identified as an aggressive form. Yes it’s stage three cancer which means that it’s escaped the prostate and is out to move freely throughout the body. That is until a month of testosterone suppressing hormone therapy. I’ve learned that testosterone fuels the growth of prostate cancer cells.”  Without testosterone, prostate cancer cells cannot grow and proliferate. Hence, a one month prescription of bicalutamide followed by Lupron injections every 3 months prescribed to block the effect of testosterone and stop the growth and spread of cancer cells. I just had my 2nd Lupron injection and scheduled another psa blood test in preparation for Lupron #3 in May. 

I’ve discovered that having cancer affects not only the patient but the whole family as well.

I've been diagnosed with the low-risk prostate cancer described in this link:  #1 Click HERE for details:   

"Low-risk prostate cancer often grows very slowly, or doesn't grow at all. Because of this, a treatment approach known as "active surveillance" can be considered as an alternative to radiotherapy or surgery. In this approach, the tumor is monitored regularly and only treated with radiotherapy or surgery if it grows." This is the path I'll be considering.

Source: https://www.cancer.org/cancer/types/prostate-cancer/if-you-have-prostate-cancer.html

Though, to be extra vigilant, Dr. Pasin (my excellent urologist) ordered my recent biopsy be sent to a DNA lab for further study to:

"...to determine if there is a genetic mutation that increases risk of the more aggressive form of prostate cancer or if my family is at risk."

But there's a delay, the lab is heavily backlogged: 

I just talked to Paula, Dr. Pasin's office manager. She has traced the prostate biopsy DNA delay back to an outside lab that is seriously backlogged. At my request she will:  A. ask Dr. Pasin to press Dr. Su (at the lab) to expedite. and B. She also agreed to get admin. names and phone numbers at Dr. Su's lab so that I can hound them.  Next, I will research other labs (not backlogged) that will shorten the wait time.   

#2  December 11, 2024 Here's what I've learned since that biopsy. The DNA lab came back with a finding of "high risk prostate cancer."  We later learned that those aggressive cancer cells have "escaped" from the prostate gland into nearby tissue.  Dr. Pasin referred me to a Dr. Paul Kim, a top tier Stanford grad, Yale Med school, radiation oncologist who is an exceptional teacher in his ability to tell us all the most important information in a direct and sensitive manner.  For example: precision-targeted-low-dose radiation will take 6 weeks with that low dose treatment 5 days a week to minimize radiation side effects.

#3 The importance of a second opinion led Patricia (my wife) to online research where she found UCI Health, a  National Cancer Institute-designated comprehensive cancer center.

#4 Click HERE for a decision aid for patients with prostate cancer.

#5   This link describes the genetics of prostate cancer that I've just begun to study since the DNA analysis may require family history information.   

Click HERE for DNA test details:

Source: https://www.urotoday.com/conference-highlights/aua-2021-program/aua-2021-prostate-cancer/131935-aua-2021-genetic-testing-in-advanced-prostate-cancer.html

Click HERE for HOW THE PROSTATE WORKS

While the prostate is part of male anatomy, females have homologous glands: Skene's glands which are a source of PSA, prostate-specific antigen in women.

Click HERE for how to shrink the prostate naturally.

Click HERE for female prostate.

Click HERE for more details

Additional links:

1. From Saint John's Cancer Institute:

https://www.saintjohnscancer.org/urology/conditions/prostate-cancer/

BETTER HEARING, LONGER HEALTHSPAN

Long ago, Apple entered the HealthSpan market by including an expanding array of sensors into their flagship wearables device: the iWatch. By turning AirPods into starter hearing aids and softening the stigma of wearing hearing aids, people can hear better while outwardly appearing to be listening to their favorite playlist. This feature will be available this fall in a software update for AirPod Pros.

Here's some background from The Atlantic.

“Hearing loss is arguably the single largest risk factor for cognitive decline and dementia,” says Frank Lin, the director of the Cochlear Center for Hearing and Public Health at Johns Hopkins University.

Click HERE for the complete article 

Lin and his colleagues have foundthat mild hearing loss doubles the risk of dementia, and moderate loss triples it. In this context, a hearing aid can look almost like a miracle device for slowing aging: In that same study, Lin also found that among older adults at increased risk for cognitive decline, participants who wore a hearing aid for three years experienced about 50 percent less cognitive loss than the control group.

Click HERE for Apple Hearing Health

NOURISH BRAIN NEURONS FOR BETTER MEMORY

 Ever walk into a room and forget what you were intending to get?  This started happening more often (up to 3 times daily) until Dr. Le, my neurologist, recommended B-12, B-6 Folic Acid for its role in nourishing neurons in the brain and nervous system and improving memory. So this would be a perfect add-in if you have a loved one dealing with memory issues.  But don't take my word for it, check out the research.

From WebMD

"Vitamin B12 is an essential nutrient that helps the body create DNA, nourishes the brain and nervous system. It occurs naturally in meat, fish, and dairy products.  A lack of B12 can put you at higher risk for a specific type of anemia that makes you feel weak and tired."

Brain Health

"Vitamin B12 is an essential nutrient for the neurons in the brain. Brain atrophy, which refers to the loss of neurons in the brain, is associated with memory loss and dementia.

In one randomized trial, older adults with early-stage dementia who were given vitamin B12 supplements to lower their blood homocysteine levels demonstrated a slower rate of cognitive and clinical decline.

Another study found that low B12 levels, even within the normal range, contribute to poor memory performance.  More studies are needed before researchers can be certain of the impact of B12 supplementation on memory loss and dementia." 

Reduced Risk of Macular Degeneration

Supplementing with vitamin B12 is believed to lower homocysteine in the bloodstream, which may help prevent age-related macular degeneration, an eye disease that can cause blindness in older adults. In one study of 5,000 women age 40 and up, those who took supplements of vitamins B12, B6, and folic acid had 34% fewer cases of macular degeneration after seven years than a placebo group. Their risk of severe degeneration was 41% lower.

Vitamin B complex and cognition Memory 

FROM THE NATIONAL CENTER FOR BIOTECHNOLOGY INFORMATION   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123448/#B11

• Conclusions:  There is evidence that folate deficiency may contribute to the cognitive impairment of the ageing brain, sometimes leading to reversible dementia but also increasing the risk of Alzheimer's disease and vascular dementia, perhaps by methylation related processes or by homocysteine mediated vascular or neurotoxic mechanisms.

• One reason for the apparently high incidence of folate deficiency in elderly people is that folate concentrations in serum and cerebrospinal fluid fall and plasma homocysteine rises with age, perhaps contributing to the ageing process.
• In a case-control study of 164 patients with Alzheimer's disease, cognitive decline was significantly associated with raised plasma homocysteine and lowered serum folate (and vitamin B-12) concentrations.
• In a prospective community based study of 370 healthy elderly Swedish subjects, folate or vitamin B-12 deficiency doubled the risk of subsequently developing Alzheimer's disease.  Recently the much larger and longer Farmlingham community based study confirmed that a raised plasma homocysteine concentration doubled the risk of developing Alzheimer's and non-Alzheimer's dementia.
• The selective effects of folate deficiency on episodic memory were suspected to be related to encoding and retrieval mechanisms. Wahlin et al extended their studies of the same populations to include a wider range of cognitive functions—spatial orientation, visuospatial functioning, perceptual motor speed, attention, short term memory, and verbal fluency. They found an overall effect of folate status on cognitive function, whereas the overall effect of vitamin B-12 status did not approach statistical significance, although it added to the effects of reduced folate status. In particular, there were specific effects on visuospatial functioning, cognitive shift and flexibility, attention, working memory, and phonemic search, but only marginal effects on spatial orientation, primary memory, and category fluency. The pattern of cognitive dysfunction is claimed to resemble that in normal aging—that is, impairment in tasks that involve little structure, are unfamiliar, speeded, and attention demanding and involve complex processing of information.
• Snowden et al studied prospectively 30 elderly nuns from the same environmental and nutritional background. They died at the mean age of 91 (range 78 to 101) years, and half had neuropathological lesions of Alzheimer's disease. Of 18 nutritional factors examined, only serum folate was significantly negatively correlated with atrophy of the neocortex, especially in the 15 nuns with Alzheimer's disease but also in those with minimal atherosclerosis and no infarcts.
• Unusually, folic acid in the form of methylfolate is present in cerebrospinal fluid in humans in concentrations three times greater than in serum.  The active transport mechanism for methylfolate across the blood-brain barrier strictly limits the entry of the vitamin, perhaps for reasons concerned with the excitatory (convulsant) properties of folic acid.

** Some studies suggest that folate deficiency affects the nervous system only at certain not very well defined critically low concentrations of folic acid or high concentrations of homocysteine.

• Other data, especially in relation to some cognitive impairments in otherwise healthy elderly people in the community, suggest more of a continuum, with folate levels related to performance even within the “normal range.” This raises questions about the optimum nutritional environment for the healthy brain, which may not be closely related to arbitrary blood levels.
• further clinical trials in precisely defined clinical categories are needed, but they should be long term (at least six months to one year) as the impact of folate is slow and cumulative over many months, perhaps because blood-brain barrier mechanisms limit entry to the brain. Small doses over the long term may be preferable to larger doses in the short or long term, not least because of risks to the nervous system, especially in vitamin B-12 deficiency and epilepsy.  It is not clear which folate formulation is preferable: folic acid, folinic acid, or perhaps methylfolate (the transport form across the blood-brain barrier).

*****The best way forward may be to undertake large scale community based studies of folate supplementation or food fortification to explore the preventive potential of the vitamin for mood and cognitive disorders. Such studies are being designed or undertaken for the possible prophylaxis of vascular disease and could be adapted to address the question of preventing or reducing depression and dementia, including vascular dementia, while taking into account the special requirements of the nervous system.

From the National Institutes of Health on B-12 

"Vitamin B12 is required for the development, myelination, and function of the central nervous system; healthy red blood cell formation; and DNA synthesis."

Similarly, supplementation with vitamin B12 alone or with other B vitamins does not appear to decrease the risk or slow the progression of dementia or Alzheimer’s disease in older adults. A Cochrane Review evaluated the effects of vitamin and mineral supplements on cognitive function and dementia in people with mild cognitive impairment. Taking these B vitamins for 6 to 24 months had no apparent effect on episodic memory, executive function, speed of processing, or quality of life, although one study found a slower rate of brain atrophy over 2 years."

Here's Mayo Clinic on B-12

"Left untreated, a vitamin B-12 deficiency can lead to anemia, fatigue, muscle weakness, intestinal problems, nerve damage and mood disturbances.  Research on the use of vitamin B-12 for specific activities and conditions shows:

• Heart and blood vessel disease. Studies show that the combination of these vitamins doesn't seem to reduce the risk or severity of cardiovascular disease and stroke.
• Dementia. Vitamin B-12 deficiency is associated with dementia and low cognitive function, but it's not clear whether vitamin B-12 supplements might help prevent or treat dementia."