Northern Lights: Experiences With Radiation
It has been a bitter cold winter here since December. Temperatures of -20 degrees Celsius (-4 degrees Fahrenheit) have occurred on many days. I have been trudging up a steep hill to the cancer center, though, bundled up in a long down-filled coat, tall boots, down mitts, a scarf, and a knitted hat!
I also am still doing my regular walks, both to see the beauty of nature, and to stay fit while going through the 20 radiation treatments for the breast cancer I was diagnosed with last summer during treatment for multiple myeloma.
As you may remember, I had two surgeries for my breast cancer last fall. Fortunately, the reports from the surgeries came back with the results that the cancer had been removed, and that there was no evidence of it in the lymph nodes outside of the margins of the surgery.
After the two surgeries, a team of doctors met to discuss what I should have next in terms of treatment. Having two cancers at once leads to some overlap in treatment, and also some problems with treatment side effects.
Radiation treatment was recommended to ensure that any residual breast cancer cells would be destroyed. It is an irony that excessive radiation can cause cancers, but lower doses given in a controlled, targeted manner to patients can destroy cancer cells. For multiple myeloma patients who have severe pain from lytic lesions, fractures, and spinal cord compressions, radiation can be used for pain control. In my case, the doctors determined that having radiation would not affect any areas of the bone marrow, and thus should not interfere with my blood cell production.
In this column, I would like to discuss those radiation treatments.
First, I needed to have a CT scan, which produces 3D images of the area of surgery, to accurately determine where the radiation beams should be directed. This is known as a simulation. I haven’t had tattoos before, but came away from that appointment with tiny tattoos the size of a pencil mark, and felt pen markings, around the left chest area for the treatments. The tattoos are very helpful in assisting the radiology technicians to focus the radiation beams for treatment. In addition, a computer program was developed from the simulation specifically for my treatment.
Two weeks later, in mid-December, I started the radiation treatments. They are given every weekday, from Monday to Friday. However, because of the holidays for Christmas, Boxing Day, and New Year’s Day, plus monthly maintenance on the machine, I have actually only had one week of five treatments so far.
I am grateful for that, since the treatments have caused some fatigue. I also enjoyed the break it gave me from going to the radiation treatment center day after day. The radiation can also cause a sun burn-like effect on the skin, which can be treated with moisturizing skin creams. The break in treatments also gave my skin time to heal.
The radiation is given from a linear accelerator, a machine that uses high energy to produce particles from atoms of heavy metals. I have to lie down on a metal table, which is raised up underneath the accelerator. After positioning it, the technicians leave the room and speak with me through an intercom. It is really important to stay still, and at times take a deep breath and hold it for up to 25 seconds (I think that my hobby as a choir singer has helped me with this breath control.). The technicians have all been very helpful, kind, and careful, and have made these sessions quite bearable.
I am following the advice given to radiation patients to stay hydrated, get lots of rest, and wear comfortable clothing. I have adjusted some activities to accommodate these treatments. For example, I am just sticking with my usual routine of walking three to five kilometers (two to three miles) a day, and not trying to ramp up more activity, as I usually would in January as part of my New Year’s resolutions.
Overall, the treatments have not been as bad as I had feared. They are not painful and rather easy to take compared to other cancer treatments I have had so far. I have gotten a little stiff and sore from lying still on the table, so am stretching more to ease that.
My family and friends as ever are being supportive to me during this time. I have friends who went through these treatments for breast cancer as long as ten years ago, and they are still doing fine, which is very encouraging to me.
I continue to be off of any myeloma treatments since the beginning of last September, for a total of four and a half months now. My blood counts have held quite steady, including my M-spike, which is at a low level. Otherwise, everything looks fine, so my hematological oncologist has postponed until mid-February any decisions about my myeloma treatment.
What experiences with radiation treatments have you had?
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The quotation for this month is an excerpt of a lyric poem from William Wordsworth (1770 - 1850), English poet:
I wandered lonely as a cloud
That floats on high o'er vales and hills,
When all at once I saw a crowd,
A host of golden daffodils;
Beside the lake, beneath the trees,
Fluttering and dancing in the breeze.
Nancy Shamanna is a multiple myeloma patient and a columnist at The Myeloma Beacon. You can view a list of her columns here.
If you are interested in writing a regular column to be published by The Myeloma Beacon, please contact the Beacon team at .
Nancy, I am glad to hear that your radiation treatments are going well. You are so strong! Your positivity is an inspiration to all who read your columns. Wishing you lots of healthy days ahead!
Nancy,
Thanks for the update and I want to second everything Tabitha said. I always look forward to reading your columns. Hope 2017 turns out to be a great year for you!
Nancy,
I can understand some of what you are going through. In 2003 I had a lumpectomy and radiation. That was about 6 months after I was diagnosed with MGUS. I still have the tattoos. The only thing I have from the radiation is some minor damage to my thyroid so I have to take medicine for that. I, too, wish you a really good year ahead. I do enjoy your columns.
Hi Nancy,
Oh the challenges we face! Thank you for your columns.
I was diagnosed with multiple myeloma five years ago (2012) and opted not to have a stem cell transplant. In 2014 I developed a tumor in the duodenum and it was determined to be from the multiple myeloma. My labs did not reflect the myeloma activity (except for anemia from bleeding tumor) as I had become nonsecretory. The usual labs for monitoring multiple myeloma no longer reflect the myeloma activity. I had radiation five days a week for 4 weeks. It was a tough time, although after a few radiation treatments the pain from the tumor decreased. I took Zofran (ondansetron) prior to radiation and sometimes afterwards due to nausea, which is common when radiating the stomach area. I had fatigue which increased as the treatments went on, and also for 2 weeks or so after they were done. I did not have additional issues – skin or otherwise – from the radiation.
In 2016, I developed a tumor in the small bowel, again from myeloma, that was found on PET scan. For this I had surgery, a small bowel resection, as that area was not a place for radiation. I'm hoping to have another PET scan in February after the 4th round of my current medication regimen to monitor for any issues. My insurance company does not approve PET scans without a fight, although I have a strong case as to why I need them. It is the only way to identify myeloma activity in my situation.
Nancy - Thank you for such an informative column on your experience with radiation. I do not know if you mentioned it in an earlier column, but is there any thought that your breast cancer was a secondary cancer caused by your myeloma treatment? You are quite an inspiration to our myeloma community with what your have gone through and what you are now going through with radiation treatments. We truly appreciate the information you share about your own experiences. I am also inspired with your determination to stay active and how important it is to stay as physically fit as possible under these circumstances. Thank you for sharing that delightful poem - it made my day!
Hello all, and thanks for the nice comments!
Tabitha, I like reading your columns too, which are always thoughtful!
Thanks Ron, and I hope that your injuries are healing well, and that the myeloma is being treated so that your relapse is reversed.
Joyce E., it sounds like we have been thru a similar set of treatments, but sorry you have damage to your thyroid now.
Diane, thanks for sharing about how the multiple myeloma caused a tumor in the duodenum and how you received radiation for that. Good that the radiation reduced the pain caused by the tumor. You were astute to have picked up the tumor from anemia, being nonsecretory with your disease. And then having another tumor removed surgically. It sounds like you have been thru a lot! Hope you continue to be monitored in the best way possible for the myeloma.
Patty B, it's nice to hear from you and I am sure that your husband is lucky to have you as his caregiver! I wanted to share my experience with radiation since it was all new to me and I thought others might like to learn about it too. The poem I quoted from is a favorite that we learned at school in grade six! It reminds me of spring and is called 'The Daffodils'.
Thank you for the update on your progress, Nancy!
My radiation treatment for breast cancer was very similar to yours. I underwent 25 radiation sessions (every week day for 5 weeks). The treatments were not in any way painful, but they were indeed fatiguing. Since I live about 70 km (44 miles) from the cancer centre, the treatments were also a major disruption to my schedule with my children, as I had to dedicate about 4 hours every day to driving / parking / treatment. But, as you say, it is not that bad, and the time passes very quickly.
Wishing you a very healthy and happy 2017!
Karen
I learned a great deal about radiation therapy today. You are very positive and inspiring, Nancy. You're in my thoughts often.
KarenD - Thanks for your post. It is reassuring sometimes to compare and contrast treatments. The driving to and from from the radiation treatment center would have been tiring for you, let alone the treatments! I park off site at our cancer center and can walk in, which clears my head actually. I like fresh air, but it has been very wintery here. Fortunately, we have a 'chinook' wind blowing in, so the daytime temperatures are above freezing now. I still have five treatments to take.
Susan - Thank you, and it has been a pleasure to make friends with you too! I hope that you and Karen have a happy and healthy 2017, and can cope with our challenges too.
Dear Nancy, I await each month to read how you are doing. I am grateful that the surgical option was successful. Thank you for taking us with you on the radiation experience. I have friends who recently had similar radiation experiences. You sound wise about keeping your expectations low for your physical activity, although 2 to 3 miles is an active life. So glad you don't have to take Revlimid right now and your numbers sound great. Looking forward to your next column.
Thanks, Maureen, for the encouraging note! The radiation experience was so out of the ordinary for me that I thought others might like to know about it. I had my last (20th) treatment on Monday and rang a bell at the reception for that! (I was thinking of the L. Cohen song 'Anthem' – "Ring the bells that still can ring"). I am trying to get caught up here from having such a time consuming but thorough treatment, and recovering some energy too, since the radiation causes fatigue. Best wishes to you too, and I hope that you are doing well.
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