Radiation

I will be starting radiation on Wednesday, July 27th.

I met with Dr. Cho, the radiation oncologist, to discuss the radiation process on July 13th, two weeks after my surgery. They wait four weeks between surgery and starting radiation in order to allow the incision to heal, as radiation impedes healing. My next appointment was last Wednesday, the 20th, during which I had a CT scan of my arm and they created a mold in which my arm will be placed for each radiation session. I also got my tattoos - yes, they really are tattoos, except they are so small they look like freckles except that they're blue. The CT scan, mold, and tattoos all help make sure the alignment is exact for each session to allow the radiation beam to hit the tumor area precisely - they want the highest dose to hit where the tumor, with lesser doses targeting the surrounding area, all while avoiding bones and the elbow joint.

Symptoms will mostly be skin-related - burns with maybe some blistering, and loss of hair from the area being irradiated (but not for anywhere other than my arm - i.e., I won't lose the hair on my head). Fatigue may or may not be an issue, but I'm planning for it not to be. Finally, the long-term effects include swelling of the arm and weakening of the bones of the forearm. They are reducing the total dose I'll receive from 7000 (I forget the units) to 6200 due to my previous radiation exposure. In addition to the risk of additional subsequent cancers, they are concerned about damage to the arm bones and elbow joint. I emailed Dr. Pollock at MD Anderson, and he said that this was the dose that they would prescribe as well, which is reassuring.

Radiation will be delivered five days a week, for 31 or 32 sessions, depending on how my skin is doing. The 32nd session would then be on September 9th (I wouldn't receive radiation on Labor Day). I would have a party that next Friday, but it's the weekend of Wisconsin Ironman, at which many of my friends will be participating or cheering, so mark September 16th on your calendars!

I'm told that each radiation session will be very brief, basically a zap - it will take much longer to drive to the East Bank and park than to get radiated. Side effects will take a while to appear, and will continue for a while after completing the sessions. The radiation also continues to work for a while after completing the sessions, for that reason they will wait a month for me to have a repeat arm MRI to determine whether or not I'm in remission.