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.