Monday was the first of 5 Review Clinic sessions I’ll have with Dr. James Wright, my radiation oncologist. Every Monday for the next 5 weeks (the last 5 weeks of my treatment cycle) I’ll meet with the good doctor and one of the nurses in the Review Clinic to take a look at how my regimen is progressing.
We started off yesterday with a look the CT pictures they took as part of the planing session. They are a series of cross sections of my head inside the mask used in the linear accelerator. Imposed on this in a number of colours, are bands that define which areas of my head will receive what levels of radiation exposure.
The hot zone, not surprisingly, is the location of my former right tonsil, where they found the tumour. They did cut the tumour out when they took my tonsil, but there are an unknown number of microscopic “roots” that are left behind and need to be destroyed by the radiation. This area of my anatomy is a bright yellow colour in all the various scans.
In the red and blue zones are the various lymph nodes located in and around my throat; down each side of the neck, along the upper edge of the clavicle. Since the cyst that disclosed the presence of P16 was in a lymph node, radiating the lymph system makes sense and gets the next highest does based on distance from “ground zero.”
There’s a green line (I think – I have colour blindness issues) that delineates the outer most reach of the treatment. No radiation above the level of my nostrils. Don’t want to irradiate the grey cells at this point. But then in my case, every cell is a Gray cell! lol… (All right. I’ll be good.)
The clavicle forms the lower border. No radiation below that level. Everything in the middle will receive one of about 11 varying degrees of exposure that were detailed on the CT scans. I was impressed that they could discern all the exposure levels in such detail. Gives you a real feeling that they truly knew what they were doing. That is, until Dr. James Robert Wright made this encouraging, and inspirational statement.
“Yeah… So… there it is. We’ll keep fartin’ around like this for the next five weeks and when it’s all over hopefully we’ll get the results we were looking for.”
Excuse me! You describe this supposedly high-tech, targeted procedure on which I am betting my continued future existence as “farting around” ?? Nice choice of vernacular Doc!
Flatulence references aside however, the good doctor is mostly correct in his assessment. The fact remains that as far as we have come and as much as survival rates have increased, cancer therapy still remains, to varying degrees, something of a crap shoot.
They can take a guy like me, mid-fifties, slightly over-weight, average health, clean removal of the tumour, a ‘species’ of cancer that has the best response rate there is to radiation therapy, and 8 or 9 times everything will work well and you get the results you were hoping for. Then there’s the 10 or 11th guy in the list; all the same parameters, all the same drugs and treatments, and for reasons you and your $100 million cancer clinic have yet to work out, it all goes to hell, the cancer remains firmly entrenched, and the guy dies.
I don’t know if Jim Wright had one of those days last week or not (I was his first appointment on Monday), but I can imagine that after a man like him, who has invested his life in this work, has a case go sour on him it can feel like all he’s doing is “farting around.” We are all prone to feeling ‘useless’ when we do everything right and it still doesn’t work.
However, focusing on the 10th or 11th guy isn’t going to help any unless you’re a research pathologist. For the rest of us we… I need to focus on the other 8 or 9 guys who make it. It’s like Paul says in Philippians:
Finally, brothers, whatever is true, whatever is honorable, whatever is just, whatever is pure, whatever is lovely, whatever is commendable, if there is any excellence, if there is anything worthy of praise, think about these things. Philippians 4:8 (ESV)
So we continue on. Supported by Dr. Wright (whom I still have complete confidence in) and his amazing medical staff and volunteers at the Juravinski Centre, and by the many of you who are out there praying for Roberta and I. If you are inclined to do so add Dr. James Robert Wright and his staff to your prayers; they work hard, care much, and need all the support they can get. Besides, he gave me these lovely lorazepam tables that make sleeping through this a hundred times easier.
I know, but before all you amateur pharmacists (and professionals for that matter – Joan) start emailing me the Wikipedia entries, telling me how highly addictive a drug it is, and regale me with all the side effects associated with benzodiazepines (I can Google it too), I am taking it under my doctor’s care and I’m real good at following instructions. So Chill!
But pondering the doctor’s choice of words aside, I seem to be in good shape; tat is, the treatments seem to be progressing as expected. The sore throat, treated with liquid pain killers, the sleeping aids, the general lack of energy and loss of appetite are all textbook symptoms and appear to be right on schedule. So I am hopeful.
Actually today, I am more concerned for my friend Darby than for me. At 10am today (Wed. Dec. 12) she goes in for a hysterectomy to remove a large fibroid she’s been carrying around for some time now. If you’re praying for me, pray for her too, please!
Till next time … Shalom.