Okay, so it was only three days of treatment and I didn’t start the chemo drug until Monday night (doctor’s order), but it’s a milestone. I didn’t have any negative side effects. There were a few stomach growls and odd feelings or twitches during those three days that made me wonder. However, it was just my mind searching for something to happen.
As expected, the first radiation session took a while. The same two technicians who handled the simulation were there along with two other people. I wasn’t sure if they were the same as the last time. They spent what seemed like a lot of time getting me in the proper position. I never felt I was properly in either the upper or lower molds. Since I was face down, I couldn’t know for sure, only that it didn’t feel right. They did get me in the position they wanted and said everything lined up correctly. After that they gave me my first treatment. I think I was in the treatment room a little over a half hour.
For my second treatment I only had two technicians and they were not the two I had worked with previously. Also, we were in a different room. I really like the two “new” technicians. The woman who seems to be in charge explained the process and told me I would see them and be in that room for the rest of my treatments unless a problem occurs. The second and third treatments went much faster than the first and I felt I was properly in the molds. Once in the proper position a treatment still takes around ten minutes or so. I think the actual radiation takes just two or three minutes, but they have to get some images first.
The chemotherapy isn’t a big deal since I am taking tablets rather than having to get it through an IV. I take three 500 mg Xeloda tablets after breakfast and three more after dinner on the days I have radiation treatments. At this point, it’s like taking any other medication.
I am happy with the way the first three days of treatment went and the fact that I felt fine afterward. That gives me confidence going into my first full week. I believe I have a very good chance of getting through it with no, or few, problems.
Saturday, November 30, 2013
Sunday, November 24, 2013
Treatment begins
Treatment starts tomorrow. I am happy to get started. It seems strange to feel that way, given all the possible side effects that can occur. However, it’s the real beginning of the process to being cancer free. I do feel some apprehension because so much ahead is unknown. The list of possible side effects from the chemo drug (Xeloda) is long. Instead of the list, someone could have just written “Anything you can think of and a few things you never would have”. In addition, different people experience different side effects at different times with varying severity. Some even make it through will very few problems. I don’t expect any problems tomorrow or any day this week. I do expect something sometime. I don’t know what it will be or when it will happen. That is what is causing my apprehension. But for now, let’s just get it going.
Friday, November 22, 2013
Simulation
After dealing with everything involved in the ultrasound, it was nice to have a relatively simple procedure. I arrived at the radiology department before 1:00 on Thursday of last week to begin the prep. One of the technicians came to the waiting room and gave me two medicine bottles filled with an iodine-based contrast solution for my GI tract. I had to drink one then and the other thirty minutes later. It had a sort of fruit flavor – not too bad, but not too good either – and it made my tongue bright red.
The technician came back for me just before 2:00 and took me to the CT room. After I partially undressed, he, another technician, and two other people who I assume were students came into the room to help get me situated on the table. Dr. Langer, my radiation oncologist, came in a few minutes later. One technician inserted an IV catheter in my right arm for an IV contrast solution that would be given during the procedure. Next I had to lie on the table, face down, with my upper body on a hard, square doughnut sort of thing. The purpose was to let my stomach hang down through the opening, which would pull the organs in that direction and away from where the radiation would be aimed. It wasn’t comfortable, but it was bearable.
The technicians took some time to get me positioned properly and create molds so I will be in the same position each time I have a treatment. The molds were large plastic bags with some sort of material inside. One of the guys called them bean bags. When I was in the position they wanted and that I could live with, they removed the air from the bags and depressions were formed where my arms and legs were. After that, they sent me through the CT scanner twice; the second time with the IV contrast solution to show my circulatory system.
Small marks were made on my body for reference points. There is an X on each hip and a vertical line below the base of my spine. Round, clear bandages were placed on each mark to help preserve them. With those marks, the body molds, and the fiducial markers inside me, it seems there shouldn't be a problem getting everything aligned.
My treatment schedule should be set in a week or so.
The technician came back for me just before 2:00 and took me to the CT room. After I partially undressed, he, another technician, and two other people who I assume were students came into the room to help get me situated on the table. Dr. Langer, my radiation oncologist, came in a few minutes later. One technician inserted an IV catheter in my right arm for an IV contrast solution that would be given during the procedure. Next I had to lie on the table, face down, with my upper body on a hard, square doughnut sort of thing. The purpose was to let my stomach hang down through the opening, which would pull the organs in that direction and away from where the radiation would be aimed. It wasn’t comfortable, but it was bearable.
The technicians took some time to get me positioned properly and create molds so I will be in the same position each time I have a treatment. The molds were large plastic bags with some sort of material inside. One of the guys called them bean bags. When I was in the position they wanted and that I could live with, they removed the air from the bags and depressions were formed where my arms and legs were. After that, they sent me through the CT scanner twice; the second time with the IV contrast solution to show my circulatory system.
Small marks were made on my body for reference points. There is an X on each hip and a vertical line below the base of my spine. Round, clear bandages were placed on each mark to help preserve them. With those marks, the body molds, and the fiducial markers inside me, it seems there shouldn't be a problem getting everything aligned.
My treatment schedule should be set in a week or so.
Wednesday, November 13, 2013
A bit of good news
It’s not often that stage II cancer is good news, but when there is a chance you have stage III, it is. The CT scan conducted in early September indicated five or six lymph nodes were inflamed. Dr. Arshad, my gastroenterologist in Bowling Green, said the CT scan didn’t provide the detail necessary to determine if the lymph nodes were inflamed because of the presence of cancer, an infection, or something else. Last Thursday’s endoscopic ultrasound indicated there is only one, 2 millimeter lymph node considered to be abnormal. There is a small chance it is malignant. One rectal cancer study found that lymph nodes of 1 to 2 mm had a 9% malignancy rate and lymph nodes of 2 to 5 mm had a malignancy rate of 17%. The odds seem more in my favor than I thought two months ago.
The procedure included the placement of six, gold fiducial markers as mentioned in my previous post. They are very small – the diameter of a small mechanical pencil lead and less than one-quarter inch long – so the monetary value of my body did not increase significantly. My hope is they will greatly increase the accuracy and efficacy of the radiation treatments.
The prep prior to the procedure went well. I got through Wednesday’s fast on sweet tea and Pepsi. There were only a few times my stomach made noise. Mid-afternoon I took four Dulcolax tablets and around 5:00 started drinking the MiraLax solution. The worst of it was over before 8:00 and I slept well that night. Thursday morning I started the other half of the solution shortly after getting out of bed, even though the directions said I didn’t have to start until 10:00. I wanted to get it over with well before going to the hospital. I never felt especially hungry or weak. I did drink some Gatorade, which may or may not have helped.
After the Propofol wore off, about the time Mom and I got to Denny’s for an early dinner, I felt fine. I ate too much, but the double cheeseburger I ordered looked and tasted very good. My stomach grumbled afterwards for a while probably due to the shock of all that beef after having nothing for about 45 hours. However, I made it through the night with no problems as a result of the dinner or the procedure.
The procedure included the placement of six, gold fiducial markers as mentioned in my previous post. They are very small – the diameter of a small mechanical pencil lead and less than one-quarter inch long – so the monetary value of my body did not increase significantly. My hope is they will greatly increase the accuracy and efficacy of the radiation treatments.
The prep prior to the procedure went well. I got through Wednesday’s fast on sweet tea and Pepsi. There were only a few times my stomach made noise. Mid-afternoon I took four Dulcolax tablets and around 5:00 started drinking the MiraLax solution. The worst of it was over before 8:00 and I slept well that night. Thursday morning I started the other half of the solution shortly after getting out of bed, even though the directions said I didn’t have to start until 10:00. I wanted to get it over with well before going to the hospital. I never felt especially hungry or weak. I did drink some Gatorade, which may or may not have helped.
After the Propofol wore off, about the time Mom and I got to Denny’s for an early dinner, I felt fine. I ate too much, but the double cheeseburger I ordered looked and tasted very good. My stomach grumbled afterwards for a while probably due to the shock of all that beef after having nothing for about 45 hours. However, I made it through the night with no problems as a result of the dinner or the procedure.
Wednesday, November 6, 2013
Fasting again
On tap tomorrow is the endoscopic ultrasound. The prep and the procedure are much like a colonoscopy. The procedure will be in the afternoon, which means I have to fast all day Wednesday (liquids only), take four Dulcolax tablets mid-afternoon, and do half the prep (MiraLax) late in the afternoon and into the early evening. Thursday morning I will do the other half of the prep. My colonoscopy in September was early in the morning and fasting and doing the prep the day before wasn’t a problem. I expect this will be a bit more difficult from the standpoint of having to fast for more than a day and a half. Doing without even one meal is not something I like to do.
This ultrasound is being done to get a better look at the rectal cancer. By using an endoscope with a transducer on the end and placing it adjacent to the lesion and the wall of the colon, a more accurate picture can be obtained than is provided by a CT scan. It is also possible to view adjacent organs and, especially important in my case, nearby lymph nodes. The resulting images will be used with next week’s CT scan (the simulation) to design the radiation treatment.
In addition to the normal endoscopic ultrasound, I agreed to participate in a clinical trial that entails placing small, gold markers (fiducials) near the tumor during the procedure. The expectation is that the markers will help the radiologist better aim the radiation treatments. Traditionally, small marks are made on the body with permanent ink to serve as reference points. Those marks can move relative to the tumor, especially as the body changes over the course of treatments, so they aren’t exact. I will still get those external marks, but the fiducials will provide additional references. I thought that if it helps aim the treatment, it’s a benefit to me. Also, since it is being done as part of the ultrasound I was having anyway, it doesn’t add another procedure or any inconvenience on my part. It only adds about ten minutes to a procedure that was forty-five minutes to an hour long.
I started my pre-prep Monday night by eating a sweet potato for dinner – no meat. Throughout Tuesday I ate low fiber foods; again, no meat. My hope is that will make the prep easier. Being limited to clear liquids all day Wednesday with the prep not starting until late afternoon will be especially challenging. It is interesting that the list of “clear” liquids includes broth (which I do not like), coffee and tea without cream, and Coke and Pepsi products. Tea and Pepsi will be most popular with me. Gatorade is highly encouraged. I can tolerate it and will make myself drink some to get the electrolytes, but it isn’t especially appealing.
My next post will report on how the prep and procedure went. At least the likelihood of some sort of surprise during the procedure, like finding cancer during the colonoscopy, is very small.
This ultrasound is being done to get a better look at the rectal cancer. By using an endoscope with a transducer on the end and placing it adjacent to the lesion and the wall of the colon, a more accurate picture can be obtained than is provided by a CT scan. It is also possible to view adjacent organs and, especially important in my case, nearby lymph nodes. The resulting images will be used with next week’s CT scan (the simulation) to design the radiation treatment.
In addition to the normal endoscopic ultrasound, I agreed to participate in a clinical trial that entails placing small, gold markers (fiducials) near the tumor during the procedure. The expectation is that the markers will help the radiologist better aim the radiation treatments. Traditionally, small marks are made on the body with permanent ink to serve as reference points. Those marks can move relative to the tumor, especially as the body changes over the course of treatments, so they aren’t exact. I will still get those external marks, but the fiducials will provide additional references. I thought that if it helps aim the treatment, it’s a benefit to me. Also, since it is being done as part of the ultrasound I was having anyway, it doesn’t add another procedure or any inconvenience on my part. It only adds about ten minutes to a procedure that was forty-five minutes to an hour long.
I started my pre-prep Monday night by eating a sweet potato for dinner – no meat. Throughout Tuesday I ate low fiber foods; again, no meat. My hope is that will make the prep easier. Being limited to clear liquids all day Wednesday with the prep not starting until late afternoon will be especially challenging. It is interesting that the list of “clear” liquids includes broth (which I do not like), coffee and tea without cream, and Coke and Pepsi products. Tea and Pepsi will be most popular with me. Gatorade is highly encouraged. I can tolerate it and will make myself drink some to get the electrolytes, but it isn’t especially appealing.
My next post will report on how the prep and procedure went. At least the likelihood of some sort of surprise during the procedure, like finding cancer during the colonoscopy, is very small.
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