Radiation

Radiotherapy is done. One more mile marker in the rearview. One more thing to recover from. Though chemo was easier than I expected, radiation was harder than I expected. Both my medical and radiation oncology teams have been great, and I felt like I was in good hands during both, so that wasn’t the reason. I think part of it was that I knew better what to expect with chemo than I did with radiation. I also saw a couple of people my age during chemo, but I didn’t see anyone my age during radiation. Most folks were in their seventies and eighties that I sat in the waiting room with and have already achieved an age I might not see. I was fully clothed for chemo, but I had to wear a gown on top that opened in the front for radiation, and a lot of my chest was exposed during each session. Radiation was every day for three weeks, whereas chemo was one long day every three weeks. And though I knew I’d have to do chemo, I didn’t think I’d have to do radiation based on my mid-chemo PET scan. Radiation, start to finish, just felt more ominous to me.

For each session, I had to pass through a large door that was maybe 12 inches thick. And it seals you into the room alone during the session, although the radiation therapists can hear and see you on monitors from their room. I told the therapist one day, “You know, that door is intense. I feel like I’m going into space.” And that feeling only intensified once I was on the table. I needed a stool to get on the table, which made me feel small and fragile. After the therapists got me into position, the first time tattooing three reference dots on my chest (my first tattoos, in fact), and left the room, the machine would extend out and begin its rotations, and I would feel like I was in orbit, only I couldn’t see the stars. Just a sign on the ceiling with the radiation symbol and a warning that I was in the path of radiation. You know, just in case I hadn’t realized that. When the machine was over me, I was staring at a reflection of my tumor and could watch the field adjust as the machine rotated to the left. When it was under me, I could only hear the radiation being delivered, an eerie sound. The first session, everything felt immense, and I felt so small. I couldn’t help but tear up. I still can’t put my finger on the sensation. The radiation therapists would play music during the session, which helped. My favorite day was the one where “Moonlight Sonata” played.

Going into radiation, the radiation therapists and doctors told me it would be easier than chemo because I wouldn’t feel the radiation. But that’s not entirely true. Sure, you don’t feel the radiation going in, but radiation does cause pain, and that pain varies depending on the radiation field. My radiation field in the front stretched mid-breast on one side of my chest to the edge of my breast on the other, and from the top of my abdomen to just below my chin (because my tumor extended into my throat into the retropharyngeal space). The radiation also entered each side of my chest and a large stretch of my upper back along my vertebrae.

Among the more common side effects, my radiation oncologist said I was likely to experience a sore throat which would improve 2 to 4 weeks after radiation therapy was over and that I might experience difficulty swallowing. A kind person online told me it felt like swallowing an egg. About a week into radiation, I did indeed get a sore throat, but it was much more intense than I expected, and the difficulty swallowing was also hard. I could only eat soups for several days, and even those were painful and difficult to swallow. I lost 5 lbs. in a week. It’s been 7 days since the end of my radiation therapy, and my throat is much improved. I sometimes have pain and stiffness in my upper body in the morning upon waking, but it quickly goes away. Even with applying aloe vera as instructed at least two times a day, the skin on my neck and my back has grown red. My oncologist expected this, but it’s still an alarming reminder of what my body has been through. And I’ll have to be careful about sun exposure to my neck and upper body for the rest of my life.

I think the hardest part of radiation, besides the sore throat, was having to do it every day for three weeks during a pandemic. That was more exhausting than I thought it would be, and I feel like this is where a lot of the radiation fatigue came from. But the fatigue, too, has improved.

I’ve been so fortunate in my care team. They’ve been attentive and supportive. Everyone knew when it was my last day and cheered me on. Everyone gathered for my ringing out ceremony and clapped for me, which made me tear up again, bringing me full circle. My chemo team was kind and supportive, too. Even now, this surprises me. I’ve had so many negative experiences with healthcare professionals over the years that I don’t think I’ll ever get used to nor take for granted the quality of care I’ve received at my cancer center (for regular readers of my blog, please note: I am not talking about Huntsman, where I had several negative experiences, a couple of which were traumatic).

I hope to find out where I stand this week. I don’t know the size of my residual tumor, whether or not I’ve achieved remission, and what my prognosis is now. I’m just grateful to be at the end of treatment. Cancer teaches you quickly to take one day at a time, if you weren’t already doing so. When there’s pain or nausea, I put it within the boundary of the day: Today I’m suffering, but tomorrow may be different. I wrap the good days around me like a warm quilt, letting each moment stretch out and out. Because tomorrow may be different.