My First Cancer

Radiation Treatment #1 (complete with red laser)

I had radiation treatment #1 today, with 35 more in queue each weekday afternoon through Nov 8. No side effects expected for the nonce.

It was easy and uneventful — well, uneventful to my eye. We’ll hope some little prostate cancer cells met an invisible and violent death, but that was nothing for me to see or even feel. The treatment itself involved radiation doses from nine different directions into a band around my pelvis. Ground zero was the prostate fossa, the area where my prostate resided until surgery.

“Lay still and breathe normally,” they told me as I lay on a hard table. The radiation machine circled my pelvis, and the therapists occasionally tweaked the positioning. Some kind of red laser beamed at me from the ceiling next to a sign that warned, Do Not Look at the Laser. All cut and dried, chop-chop. Except.

Except for the frisson, the palpable sensation I’d not had since surgery four years ago. You know how something can happen, and it just drives home and makes vivid the reality of a situation? Surgery drove home, italicized and put in bold my stark reality of 2007: I’ve got cancer, and that’s not good.

Same thing today at Radiation Oncology at the Seattle Cancer Care Alliance. I can’t remember whether today’s realization came while waiting for my first treatment or while talking to the guy waiting for his last; whether I was arranging the schedule for future treatments or was looking helplessly at the radiation machinery arrayed around me. But that old, familiar reality came back and drove itself home:

I’ve still got cancer, and that’s not good.

Cumberland Gap, TN, VA & KY

It was four years ago today that I had surgery for prostate cancer, and in nine days I’ll begin “salvage” radiation for prostate cancer. Surgery, hormone therapy, now radiation. This strikes me as a lot of treatment in a relatively short period of time — and I spent more than half of the past four years on hormone therapy! All courtesy of the two tiny tumors they found in my lymph nodes after surgery.

The much-awaited phone call came Friday with the date and time to begin rad treatment at the Seattle Cancer Care Alliance. I’m thrilled to get this on the calendar at last, and I’ll be even happier to get the actual treatment underway (remind me of this when the side effects kick in).

Yes, it’s my fault we’ve put radiation off for so many months. Too many travels planned too many months ago, but all the doctors were comfortable with the delay. I’m cutting it close, though: We’ll get back to Seattle on a Monday afternoon, and I’ll report for radiation duty at 9:00 the next morning (Sep 20).

My cancer is microscopic for now and shows up on no scans. So I just have to hope that it resides precisely where the radiation will hit, but there’s no guarantee of that.

As we say all too often in the cancer journey: It is what it is.

Sri Lanka, Aug 2011 (Photo by Rebecca Curry)

Truth be told, my prostate cancer journey has thus far been a relative walk in the park compared to the medically invasive and dramatic, life-altering experiences of others. In the time since my diagnosis, the most disruptive event has been surgery, my radical prostatectomy, and that was only two nights in the hospital, plus recovery.

Contrast that with my friend Toby, who was diagnosed in March with Mantle Cell lymphoma and whose life was abruptly up-ended. He’ll undergo his sixth (and final) R-CHOP 21 chemo treatment today — and that’s just a prelude to his stem cell transplant later this month.

So while they’ve been busy poisoning Toby this summer, I’ve been off traveling in Peru and Sri Lanka, living life much as it was before my diagnosis. (Heck, I was traveling when I received my diagnosis!) Oh, Peru and Sri Lanka brought some unintended weight loss and hot flashes from hormone-therapy, but, as I say, a relative walk in Cancer Park.

That’s about to change with my impending “salvage” radiation. My radiation oncologist is now working on the specific treatment plan — the nitty-gritty to maximize the radiation dosage to offending tissue and minimize collateral damage to the healthy. Sometime in the coming days, a phone call will come with my start date for treatment: then five days a week for seven weeks.

I’m ready — even more than ready. I have my Calypso transponders in place, and on Aug 24, I completed the remaining preliminaries: three tattoos to assist in the targeting of the radiation; a custom-made leg cradle to hold me in place; simulation scans for aiming the radiation, and the official signing of the consent form. All I need now is that telephone call.

Radiation will be my third cancer therapy in four years, not counting the experimental drug I took as part of a clinical trial, and not counting the hormone therapy and the chemo med I’m currently on (both are part of the radiation protocol). But there’ll be no more radiation after this — they just don’t do it twice. There are no do-overs, no mulligans.

It either eliminates the remaining prostate cancer in me, or it doesn’t.