Chestnuts, Radiotherapy, Tattoos and Linear Accelerators

I felt chestnuts (marron) couldn't be left out of blogs about food and breast cancer, no guesses for why. I don’t sleep that well at the moment; I’m waking up in the middle of the night and feeling wide awake. On one occasion I snuck downstairs and helped myself to dollops of Marron straight from a jar my sister gave me. It did the trick and I fell asleep quickly afterwards. A Charlotte a La Mousse de Marrons was one of my mother's signature adult dinner party desserts and as children my sisters and I would look forward to eating the left-overs for our breakfast the following day.  I've written up the recipe for this in my https://wordpress.com/post/kathiescakes.wordpress.com/923 blog, but I thought I'd write about my experiences of Radiotherapy here. 

Apparently radiation kills cells and destroys their DNA.  Healthy cells can grow back but the cancer cells don't.  Having had a lumpectomy there was always a chance that a few cells might have scuffed off during the operation, so I had radiotherapy to ensure that any microscopic cells that were missed don't proliferate and come back to haunt me.

The radiotherapy experience has been an eye-opener. Thankfully my anticipation of the excitement to come had been dampened by my Nuclear Medicine experience (see my previous blog) so I didn’t find myself making radioactive cakes in advance. In preparation for my treatment I went to the Marsden’s CyberKnife department (it feels like yet again like I’m about to be the central character in some futuristic movie) where I had a CT scan. The CT scanner was not the kind of noisy claustrophobia-inducing tube that I’ve seen people disappear into on TV, thank goodness; the experience was more like having a massive electronic doughnut move back and forth around me) to help with locating the points for the tattoos they gave me.  I returned home with 4 tattoos. Each of them look like tiny biro spots; their positions were carefully measured after a CT scan, in order to mark my skin so they could line me up in the right place during the treatment with the Linear Accelerator (it delivers high energy x-ray radiation).  I asked the nurse how many people asked for hearts / butterflies etc. and not surprisingly he told me that unfortunately they didn’t do that there.  Perhaps when all this is over I may get a more elaborate tattoo – but not right now!

By the time I got around to having my treatment sessions I was definitely in Sci-Fi world.  I had to lie on a table, to relax like a piece of meat (and fight the urge to help them by moving myself) whilst the radiographers adjusted my body position using laser beams to line up the tattoos before leaving me alone in the room whilst the treatment was delivered.  The Linear Accelerator machine itself was robotic, with x-rays delivered by a large round treatment arm and two smaller x-ray panels on separate arms; they swivelled and rotated around the table in a kind of slow weird dance, moving in and out in turn.  The smaller arms checked my position and the table was programmed to move me more so that I was in precisely the right place for the delivery of the treatment.  Contrasting with the modern equipment, above the table where I lay I looked up at a lit ceiling panel showing a scene of the sky with floaty clouds and branches with blossoms and leaves.  It was quite peaceful and not at all frightening.  

During my treatment sessions I was told I could listen to music and asked what I would like.  “Classical”.  They told me they had a classical tape and I lay back waiting for some soothing Mozart, Schubert or Bach – but no, I was treated to  Sabre Dance – Aram Khachaturian and Johann Strauss Sr. – Radetzky March!  Fortunately the music wasn’t too noisy and blended in with the sounds of the machines whirring around me.

I generally didn’t have to sit too long in the hospital before going into the radiotherapy sessions but when I did, it sometimes helped to chat to others and I discovered all manner of stories about how they came to be there.  On one occasion I sat next to a woman who was travelling from Leicester every day for her course of 15 radiotherapy sessions – sometimes by train but, when she was too exhausted, at others chauffeured by her husband.  She had been diagnosed with Stage 4 pancreatic cancer last February and had been given just 3-4 months to live.  She couldn’t have surgery right away as there were complications with an artery being affected so she had had to endure far too many cycles of chemo and radiotherapy – but there she was, looking good, with a reduced sized lump and more positive prognosis, 8 months later.  We marvelled at how incredible it was to be on the receiving end of state of the art treatment.  But it is not just the destination but the journey there that interests me: the treatment makes you well in the end, but along the way there are many joys that come with it.  On this occasion we watched a little toddling girl with her father who was quite enchanted by the fish in the obligatory waiting-room aquarium. With a bit of help she clambered onto a chair next to me and I couldn’t help but admire the shiny blue patent leather shoes with red and white flowers she was wearing.  “She chose the shoes herself” her proud father explained, “she ran into the shop and bit them”.  I must remember this when I next go shoe shopping.

Afterwards

So far (four days after the treatment has finished) I don’t believe I’ve felt any side-effects from the radiotherapy, though I have been warned that the radiation effects are cumulative and it will continue to destroy cells after I’ve finished my treatment.  In a few days I'm likely to start feeling exhausted and in a bit of pain (as if I've got severe sunburn). I’ve been religiously using moisturising cream on my breast to help manage the burns / blisters that I’ll probably get, and also keeping myself active but resting when I feel tired. I've a telephone appointment next week with a nurse to follow up on my progress.  Wondering how tired I'll be then and whether I'll drop off to sleep mid-sentence.  I stupidly clicked a Facebook button and found myself signed up to raise money for Breast Cancer Now by walking 100 miles in October. Probably overambitious and stupid, but I did it all the same and I know that walking is a very good way of getting exercise, it also helps with fatigue and might help keep some of the aches from the oestrogen-suppressing hormone I’m on at bay. By the day after my final radiotherapy session I’d walked nearly nineteen miles and felt exhausted but somewhat smug. Time for some Charlotte a La Mousse de Marrons?

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