My inner geek

At my last appointment on November 3, 2016, after deciding to cancel our trip to Nicaragua, I signed some consent forms for radiation treatment.

Planning my treatment involved an MRI Sim and CT Sim, some tattoos, a customized mold of my derriere … and an appointment with a medical oncologist to discuss my chemotherapy.

Remarkably, there was a cancellation that afternoon and I spent the day at the Princess Margaret Cancer CareCentre MRI Sim and CT Sim department.

Okay treatment fears aside … this stuff is way too cool!

They took another MRI and another CT scan so that they can create a 3D computer image of my pelvic area. During the process they mimic a radiation therapy session, without the radiation. This is called simulation planning. Since the technicians can’t physically see the radiation, or the inside of my body they will use the 3D image to direct the radiation beam to target the pelvic lymph nodes and the area of skin where my tumour was removed.

To ensure that my body is aligned with the 3D image during every treatment three small dot-like tattoos, one on each hip and the third at the tail bone, were marked on my skin. They also made a customized mold to help immobilize my pelvis and provide a layer of material for the radiation to travel through before it comes in contact with my skin.

My treatment will be for five weeks, twenty-five treatments, Monday to Friday, starting November 21, 2016.

The sessions are short, generally only 20-25 minutes in the procedure room. Most of the time is spent positioning the body so that everything, some parts of the pelvis need to be moved out of the way, is in the same place each time, the actual period receiving the radiation about five minutes.

I’m also told that the process is painless. Radiation treatment does not hurt.

I have been warned, however, that by the third week it’s going to feel like one helluva sunburn … and the sun don’t usually shine there, unless you hang out at Toronto's Hanlan’s Point. By the third week I will be so uncomfortable that I won’t be able to sit or stand for long periods.

References

What to Expect When Having Radiation Therapy

Cancer.net

http://www.cancer.net/navigating-cancer-care/how-cancer-treated/radiation-therapy/what-expect-when-having-radiation-therapy

Hurry up and wait

Everything happened so fast.

From the time my gastroenterologist made the referral (August 6) to my first appointment with a radiation oncologist, meeting the surgical oncologist, the surgery, and the cancer and AIN3 diagnoses (October 6) only 2 months had passed.

I was impressed with our medical system.

Where were all the wait times?

At the October 6 appointment my radiation oncologist outlined an aggressive five-week radiation and chemotherapy treatment plan. In order to prepare for treatment I would need to have a diagnostic MRI and CT scan, some blood work and an appointment with the medical oncologist who will plan and supervise the chemotherapy. All this was going to happen in three weeks … he wanted to start treatment the first week of November.

The MRI was scheduled quickly. It happened the following week.

Then the waiting started.

After the MRI I heard nothing. I called the hospital.

The CT scan was scheduled for November 2, the first week of November, and they were trying to get it scheduled earlier. They hadn’t booked the appointment with the medical oncologist yet.

Another week passed. I called again.

They couldn’t get the CT scan moved up it would be November 2. No word from the medical oncology department … still.

Another week passed. What about the medical oncology appointment?!?!

“Your radiation oncologist will discuss your treatment plan with you at your next visit on October 27.”

“Why am I meeting my radiation oncologist before my CT scan is complete?” They changed my appointment to after my CT scan.

In the grand scheme of things three weeks was probably a pretty good period to accomplish and MRI and a CT scan but it didn’t feel like the speedy service and care I had been getting up to this point.

I began to get frustrated with waiting.

Oncologists are specialists in a particular field; surgery, radiation, chemotherapy and they only talk to you about what they are experts in. My radiation oncologist was very helpful explaining radiation but not very forthcoming with information about chemotherapy, that would be up to the medical oncologist to discuss with me … and that appointment didn’t happen as i had been lead to believe it would.

I was trying to understand the side effects of both treatments but I didn’t have all the information.

I was trying to plan my time off work. I was worried about finances and vacation time and sick days and short term disability.

I was trying to plan the next couple months of my life.

I also feared that if my treatment was delayed much longer it would be getting very close to Christmas.