Today, at 1:20PM in St. John’s Hospital basement radiation wing, a bright, airy facility managed by friendly, competent techs, nurses and other staff members, I was given the first of 44 doses of Intensity Modulated Radiation Therapy aka IMRT, under the outstanding supervision of Dr. Lisa Chaiken.
As explained by the Cancer Treatment Centers of America, IMRT uses advanced software to plan a precise dose of radiation based on tumor size, shape and location. A giant, revolving, computer-controlled machine called a linear accelerator (“Linac” by the techs) delivers radiation in “sculpted” or “carved” doses that match the exact 3D geometrical form of the prostate. In my case, since the cancer is already in the left seminal vesicle, that will also be included in the precisely targeted radiation field.
With IMRT, the radiation oncologist can adjust the intensity of radiation beams across the treatment area as required with laser confirmed accuracy. (You can actually see the brilliant green light of the laser emanating in a needle thin beam from the treatment room walls.) This translates as the ability to deliver higher radiation doses than by traditional radiation therapy methods, while minimizing exposure to healthy tissues.
What concerned Jeanne most was: Will I be tired after treatments, so that she should be there to drive me home. Somehow, I just don’t expect to feel excessive fatigue, though we will judge that as the treatments proceed. However, it is worth mentioning that, because the treatment effect is “cumulative,” somewhere around the mid-point (say around 22+ treatments) I may begin to feel fatigue.
To prepare me for the procedure, thanks to Jamie, one of the radiology techs, I now have three minute “tattoo” crosses inked right, left and center onto my pelvis, and covered with transparent patches to protect them. The tattoos will serve in the coming treatments to set up and align the path of the Linac.
As I settled into the specially tailored plastic body mold, I found myself feeling quite comfortable with the procedure: no anxiety, no dwelling on possible negative side effects (urinary distress, anal irritation up to and including the charming condition referred to in doc speak as “hamburger ass”).
When I left the treatment room that housed the 12 foot tall linear accelerator, I was offered a daily treatment time of 9AM for the remaining 43 does of IMRT, However, just to be safe, I rejected that in favor of a regular daily time of 4:20PM. That way, if there is a build up of fatigue, it will not have a negative impact on my entire day. Anyway, I am ready to put myself in the hands of Dr. Chaiken and her experienced team.
Ready to? Seems I already have.