~ It was fast, short and intense ~
What is Radiation Therapy
On completion of the 4 cycles of chemotherapy, Dr. Ma arranged a MRI for me to assess the result of chemotherapy on the tumor. It was encouraging, the tumor shrank by about 50%. Dr Ma said it was time to move on to next treatment – radiotherapy which is a cancer treatment that uses high doses of radiation to kill cancer cells and shrink tumors. She then referred me to Dr. Kevin Wong, a radiation oncologist.
I met Dr Wong at Sanitorium; he explained to me how the radiotherapy would be conducted and the possible side effects.
Side effects include:
- Skin reaction similar to sunburn and skin over the treatment area becomes sensitive. Dryness, redness and itchiness may appear. Skin becomes darker as well. Moist desquamation may appear.
- Abdominal discomfort and indigestion
- Diarrhea and/or constipation
- Per-anal irritation and itchiness
- Increased frequency in passing urine
- Irritation during micturition.
- White blood cells may drop as bone marrow may be affected
Precise treatment plan prepared by the oncologist and the radiation therapists could help minimize the possible side effects. They call it the external bean planning. The team had to decide on the dose to apply and the fields to apply with specific calculation by reference to the position of the tumor, my weight etc. The field covers kidney, bladder and other organs.
Simulation
Simulation is a critical preparation step before radiation treatment. It was performed at the simulation room equipped with a dedicated big-bore CT scanner. During the simulation, the treatment setup was simulated by positioning the patient on the flat couch immobilized by specially designed devices. Every time I went for the radiation, I lied on this immobilizing device to ensure I was in the same position for each session.
The team was also making marks on my skin and taking imaging scans. These marks were to be used as reference of position checking at each session. The therapists put markers on my abdominal area then covered them with waterproof tape so that I could keep the markers on and shower.
Tapes or Tattoo
Apparently I was sensitive to those tapes that my skin became very itchy the next day. In addition, those tapes gave me so much stress when I showered as I was so scared that I would wash the markers away. Though the therapists told me not to worry, if that happened, I just had to visit the hospital and they would re-draw the markers. They also suggested to give me the anti-allergic tape.
From my own research, I knew that there was an alternative of making the marks, that is to put “tattoo” markers on. This is basically to mark tiny small spots on my skin with permanent ink. This way I could put my mind in peace and shower comfortably. One disadvantage is, though, the tattoo takes a long time to disappear. I still have my “tattoo” seen today which is 18 months after they were made. Nonetheless, they are so tiny I can hardly see them. They just do not bother me at all. I was happy with my decision.
The Radiation Schedule
In preparation for the radiation sessions, Dr. Ma gave me a WBC booster shot. As my blood platelets dropped as well after chemotherapy, Mr. Ma also gave me a platelet booster. I took the shots with reluctance as I knew they were not solutions to my problem but as Dr Ma “assured” me that for my case, she was very certain my WBC would drop as a side effect of the radiation so I “had” to take the shots. It was the case, except when I was taking a shot, my WBC never went back to the normal range. It is still the case today.
The first radiation was scheduled on 16 February 2021, 4 weeks after I competed the chemo sessions and right after the Chinese New Year holidays. I only had a short break before taking on another challenge. I had to attend 28 radiation sessions at Sanitorium, Monday to Friday and rested over the weekend. This made the whole radiation process lasted for five and a half weeks. During this time, I still visited Dr Ma every week for overall monitoring.
The Routine
From 16 February to 23 March 2021, the 28 sessions went very fast. The only thing I could do was to go from home to hospital then back home. Then I did not feel like doing anything else most of the time.
Everyday except Saturdays and Sundays, I took MTR to Causeway Bay, got out from the Time Square exit then walked about 30 minutes along Wong Nai Chung Road to get to the hospital. The road is a very pleasant walk way with trees all along. It was a good walk I enjoyed it.
The radiation team at Sanitorium was very nice and professional. The sessions took place on schedule most of the time. I just had to lie down on the treatment bed for less than 2 minutes, let the machine rolled around me to have those beams going through my body. I did not feel anything and then it was done.
I walked the same way back to take MTR home. A few times I took the tram from Happy Valley back to Central to see the girls in the office. I enjoyed the tram trips. The tram was moving slowly through the busy areas of Causeway, Wanchai and Central while I was sitting quieting gazing at the scenes outside and feeling the cool winter air. When I was feeling tired, I did a taxi trip home in extravagance ^^.
Minimal Side Effects
Before and during the radiation sessions, Dr Ma, Dr Wong and the therapists kept reminding me of the possible side effects I might have, that I might not feel them in the beginning but more towards the middle of the process and they would be more obvious and intense all the way till the end and might carry on for another couple of weeks before these side effects would eventually disappear.
I became very alert and was very prepared to have the side effects coming. Too much expectation but it turned out that I didn’t have any of those side effects mentioned, well, except for the drop of WBC. The skin on my belly did turn dark like sun tan and that was it. Nothing else.
Dr. Ma did give me a moisturizing gel to put on my belly every day to try to prevent my skin to become too “burnt”. Jan told me after that the gel was actually a very good moisturizing product that helped a lot of preventing the belly from getting burnt. I guess it did help in this case.
My appetite was fine, though my weight dropped slightly from 63 kg to 61 kg during the 28 sessions and another kilo over the next few weeks then it was stabilized till May when I had my first surgery to remove the tumor.
