My first tattoo

Friday was my consultation with the radiation department and I’m very glad to have a plan now. A PET scan on Tuesday will give us more information about my kidney function (as a precaution) then I will start treatment on Wednesday. I am scheduled for 10 sessions on consecutive weekdays.

You know how I grumble about morning TV on view in the waiting room at the cancer ward – the ads for glossy shampoo, wonder-bras and so on, watched by a miserable captive audience of mostly bald and many mastectomised patients? Well what do you think was featured on the huge TV in the radiation therapy waiting room? Picture a glowing, larger-than-life, roasting chicken on a spit, with dripping fat! Shudder! Not what I wanted to see before my first radiation appointment!

John and I met the doctor who is managing my next treatment and we were very impressed and reassured. Obviously radiology is her thing, and she examined my 2016 series of CT scans more closely than anyone I’ve ever seen, also showing us on a large computer monitor. We could see the offending tumour on my left psoas muscle, and it grew larger only at the end of the year. This creepy blob is wrapped around my ureter, close to my kidney. No wonder I had the renal problem at Christmas and I needed a stent! The stent was visible in the image too like a shiny drinking straw with a curly pigtail.

Dr Daly scrolled so the view traversed my abdomen and she pointed out the various organs. Oh dear, there are many lumps that shouldn’t be there. However, comparing different dates, one tumour actually shrank during my rucaparib treatment, and the others didn’t change size (except for the one causing trouble now).

We will zap two in one go!

I asked about a lump in my belly on the right side which recently has started to ache again. This is the same tumour that was bothering me in 2015. When I started taking rucaparib, it quickly settled down and stopped hurting although I could still feel a lump with my fingers. Dr Daly zoomed in on it in the picture, commented that it is rather large, and said she thinks it is accessible for radiation too. I am really happy about this.

I thought the planning was terrific! Two technicians carefully arranged my torso symmetrically around a green line of light on the bed, and they took notes, photos and measurements of my exact position, to enable precise replication each time I visit. Then they set to work with pens, drawing dots and dashes on my belly. Next they tattooed 4 dots, like freckles (North, South, East and West). Lastly, I kept perfectly still while my bed rolled into the donut for a CT scan. The scan images will show my tattoos. I had imagined one tattoo to mark the target for the radiation but no, I think it’s more a set of registration marks, just like a printing press. Line up my body again exactly right on the bed and the therapist can aim the x-rays to trace around the tumours on the calibrated scan.

This is relatively low dose x-ray radiation using photons in a linear accelerator. Multiple low-energy beams intersect at the trouble spot to intensify the radiation. I think it’s brilliant, because the healthy tissue penetrated by each single beam is not destroyed. It’s just a little dose each day and the damage will heal. Only the tumour (plus a small margin around it) will receive the lethal dose. Huge thanks to the great nuclear physicists who have developed this method!

They warned me that my pains will probably worsen before geting better, due to swelling and oedema. I should also expect nausea and colicky pains from having my stomach and bowel irradiated. The other common side effects are fatigue and burnt skin. Oh well, it still sounds easier than 6 months of chemo!