wrote, on Friday I remembered to ask if she could come in and have a look. The staff of the radiation center, all women, have always been friendly and warm, and they allowed us a minute before the next patient stepped in. (The machine is in heavy use, apparently as many as 65 - 75 patients per day.)
The Machine - all the name it needs, at the clinic - emits precise bursts of radiation for the treatment of cancer. My initial treatment, for the tumor on my lung, involved two short treatments per day; each treatment consisted of three radiation exposures or "frames" from three different directions. The new treatment for the nest of tumors in my lower back involves 18 frames from nine positions, once a day.
The radiation treatments are designed precisely for each patient. The machine can rotate to focus on the patient from any direction, and the emitting mechanism has movable lead shutters to allow the radiation beam to be shaped specifically for each dose and angle. The patient lies still on a platform, after being raised up to the center of the machine; positioning is crucial, so custom-molded cushions are used. Small permanent tattoos on the patient are lined up with lasers along 3 axes to establish the initial position, and a computer program takes the machine through the gyrations and exposures as programmed by the directing physician.
That's the mechanics of it, anyway. I am always aware that we are hoping this machine will help save my life. I am becoming accustomed to the experiences - the technicians help me into position, and the lights flip on and off in the room as they use the lasers to line me up. Then the table elevates, and the techs leave, and I hear the 8-inch thick (!) lead door close. The machine rotates into the first of its positions, usually from below, and the lead shutters click and there is a whir of something focusing. Then a warning buzz sounds and the machine hums, for several seconds, as the radiation is released. There is no physical sensation; I sometimes think "Die, cancer, die!" as each burst sounds. I count off the exposures and watch the machine rotate around me, and look at my own reflection in the grey plastic casing.
Eventually the treatment is over, and I pull on my shirt and sandals and shuffle out. The physical effects of the radiation don't hit me until about an hour later; I think my new single dose is heavier than my old ones, as the effects are more pronounced. Fatigue hits hard; not mere tiredness, but a feeling that my arms and legs are weighed down with lead. I come home and lie down, not sleeping, but unable to get up; I read a lot. And I've been having a lot of nausea - this morning, I had to be let up from the MRI table while I was sick. Hopefully the 2-day respite over the weekend will let me enjoy a little normal activity, and keep down a few meals.