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On 13th December, 2010 (Monday), consultation was arranged to meet with the radiologists in BCCA. They checked on my chest pain (on the right side) as well as other complaints that I had in recent weeks. They immediately ordered one round of radiotherapy for me. Keep in mind that my appointment started only at 2:45pm and the whole process completed by 4:00pm. I considered this very efficient and again I was treated like VIP.
A new term I learned this time is "superficial". Radiation therapy aims to maximize the number of cancer cells destroyed, while minimizing the damage to nearby normal cells. As low energy x-rays do not penetrate very deep into the body and transmit most of their energy into the skin. These low energy x-rays are often called superficial or orthovoltage x-rays. In my case, using superficial rays can kill cancer cells inside my ribs (near the surface) and would not harm my organs underneath. I am sure you know what "superficial" means traditionally and generally. When I heard the radiologists said "we are going to use the superficial treatment on you", I asked "Superficial?" He replied positively and affirmatively. (Hahahah!)
Now 4 days after the superficial treatment, I am feeling better and stronger. Compare with the last radiotherapy (also my first) back on 18th March, 2010, rather than a square shape with a few crosses for aiming accuracy. This time, as you can see in picture below, is a 18 x 10 rectangular shape and a dotted line at the bottom. After setting the machine and the body at the proper position, the radiation process itself took ONLY 2 minutes and I was done for this time. Unlike last time, which I need to return every day for the week!
The whole treatment left me with an impression ... well ... quite superficial! But I certainly hope Mr Cancer - My Friend is being treated well this time. The chemotherapy will start next week and I will be using a different drug. Stay tuned and I will share with you more new terms that I learn in the process!
The title of today's posting "It's complicated!" is actually the name of a 2009 movie directed by Nancy Meyers, played by Meryl Streep and Alec Baldwin. It's about a divorced woman, after a decade, is having "an affair" with her ex-husband. And as the name of the movie suggested, it's complicated!
I am only borrowing the movie name to describe what happened to me today on my treatment.
Today is supposed to be my first day of second chemotherapy cycle. As a routine, I would need to draw blood sample and do the doctor consultation yesterday, in order to check if my body is ready for the treatment. And I did. The trouble is there are certain body conditions changed and I was requested to do more blood tests, a few X-ray, and one more urgent CT-Scan was squeezed in for this morning, hopefully can still catch my originally scheduled chemotherapy (infusion). It's complicated! By the time, all these checks were done, it's already 3:00pm in the afternoon, and due to some "inflammation" in my lung, it's suggested that I shall not proceed with the chemotherapy today and wait for a week, which an anti-inflammation drug is prescribed. Another consultation with my chief oncologist is booked for next Tuesday and hopefully then my body condition will improve and either I am allowed to continue my chemotherapy, or alternatively, we may start another approach of treatment. Kindly take special note that this is neither a bad news nor a good news. It's simply the approach to go forward when the circumstances arise (and allow us to save the debate of all the technical details and different opinions involved here).
Life is not a straight line, as it goes left and right, up and down, and randomly! It is sometime simple and it can also be complicated sometime. There are actually time in yesterday and today that I am unable to understand a few things (both technically and mentally) but the key is to let it (or them) go as we must admit we all have limitations in our part of understanding (and we will never understand). Give ourselves some space to relax, some air to breath, and some time to ventilate. It's complicated but it's okay!
The below picture is taken this morning at BC Cancer Agency (BCCA). This is also the first day treatment of my first chemotherapy session. Since the last radiotherapy session on 23rd March, and then the consultation with the oncologist on 24th March, I was then basically preparing and waiting for today, i.e. the chemotherapy treatment. There was an educational session on 31st March, provided by a registered nurse, to walk me through those important points and what am I going to expect before and during the chemotherapy treatment process. As my case was considered urgent and therefore I was put into "the urgent wait-list" since 24th March, but a few attempts were made and failed, and today I finally "squeezed in", thanks to everyone in BCCA who are willing to work overtime in public holidays like today!
For those that have not attended any chemotherapy session would find this photo useful. One other purpose to show you this photo is to ease your feeling towards chemotherapy. There are really nothing to be scared of. As long as you are willing to understand and appreciate what is going to happen.
There are three major treatment approaches for cancer patients: Surgery, Radiotherapy and Chemotherapy. It is quite common that you will receive chemotherapy as it is a key approach to help control and manage the cancer cell growth, even you have performed surgery or conducted radiotherapy. In short, chemotherapy is a treatment through (chemical and biological) drugs, taken into your body through infusion or orally. Usually, more than 2 drugs will be used, and a treatment cycle goes from 21 - 28 days, and for each patients a 4 - 6 cycles (in total the treatment time will be about 3 - 4 months). What a lot of people do not notice is that you DO NOT need to have the injection everyday. Using me as an example, which Cisplatin and Gemcitabine are used, I only need to go for Day 1 for injection of two drugs, and then again Day 8 for injection for one drug, then rest for 2 weeks, in a treatment cycle time of 21 days. Then, the next cycle starts again. If you notice, basically out of the 21 days cycle, only 2 days (actually a few hours a day) are required for this treatment, and you can do whatever you like in the other 19 days. Consider these your extra holidays!
[*There are quite a few technical information that you may need to digest, especially regarding side effects of drugs and precautions for certain patients, e.g. diabetics, low performance patients, etc. Plenty of information are available and you may find the link from BCCA Chemotherapy Protocols useful.
http://www.bccancer.bc.ca/HPI/ChemotherapyProtocols/default.htm
Don't over-stress yourself to do your own research, as you will be provided with all these essential information at the appropriate time.]
Let's now have a look at the actual scene, and what you would expect when being treated:
The treatment room locates at the 6th Floor of BCCA. It's a very comfortable and homely facility filled with friendly and professional staff. Then, you will be greeted by your assigned nurse and lead to a treatment room. Inside the room, there are a few chairs like the one I am sitting. (*The little pillow on my neck is my private item due to my not-so-straight spine. Otherwise pillows are available there to make you sit as comfortable!) After another detailed information session by your nurse of what to expect during the first day and during the treatment process (content is very similar to the education session), the treatment, i.e. infusion of drugs, starts punctually at 9:00am. You may see in the above photo a few highlights, the infusion is done by a little instrument automatically, it controls the speed of the intake of the drugs and it provides warning sound to alert if the drugs are run low. To show you how BCCA is taking good care of you, it's the warm blanket wrap around your infusion intake point. You feel almost nothing throughout the whole infusion process. Then, it's recommended that you drink a lot of fluids, to help hydrate your body and also to protect your kidneys! What's important here, especially for people outside of Canada, all these drinks, juices, Canada Dry, are free! (Yeah, for medical coverage, it's better to be a Canadian than an American!) You can drink as many as you like! Hahahah!
Depends on different treatment plans, the total time for the process may varies. In my case, it took about 3 hours to complete for Day 1. Then, it will be faster in Day 8 as only one drug will be infused.
The whole process went so smoothly, especially when you are accompanied by family members. In my case, my elder sister, Irene, flew in from London of United Kingdom, who also took the above photo for me accidentally. (*She said she did not remember when she pressed the shutter!) and then of course my dedicated companion who would not allow me to be apart from her for more than 5 steps, i.e. Esther!
Oh, don't get me wrong. I am not suggesting that you should undermine the impact of chemotherapy, and it's side effects, the risk of infections, and various damages that it may cause to your body, etc. All I am suggesting here is that if you can have a better knowledge and understanding of what you are going to go through, the better equipped you are. Then, the actual experience is not that harsh while professional organization such as BCCA actually have tried very hard, with every little details in mind, to make you/us comfortable. To make the process even enjoyable!
