Radio Therapy and Radiotherapy

The radiotherapy suite at Ninewells is located in the Princess Alexandra Cancer Treatment Centre. I’m not sufficiently in-the-know about…

The radiotherapy suite at Ninewells is located in the Princess Alexandra Cancer Treatment Centre. I’m not sufficiently in-the-know about the British monarchy to know who Princess Alexandra is, though one of my English friends assures me, “Oh, she’s ever so nice!” And I haven’t been curious enough to look up why the cancer treatment centre is named for her — I assume she’s a patron of the hospital? Or made a sizable donation at some point? Or maybe hospital administrators in Dundee have a special fondness for that particular royal? In any case, the radiotherapy suite has been the most aesthetically pleasing stop in my Ninewells tour. It’s fairly bright and new, with light-colored wood and attractive chairs. And five state-of-the-art machines to target your tissue with high-powered radiation.

At my prep appointment, I was given a blue smock covered in velcro and a plastic bag to put my own clothes in. Then a trio of the nicest radiographers took me in for my CT scan. I was glad that my friend Keely, who had breast cancer a few years ago, told me what to expect. The point of the prep appointment is to figure out where to set up the guidelines for the radiation machine so that they target the right area. They make all sorts of measurements and then apply stickers with various shapes in magic marker. And you get a tattoo — I tried to convince Dave when I got home that my tattoo was practically a half sleeve, but he said, “I watched Breaking Bad. It’s just a pinpoint, right?” OK, fine. It’s not very showy, as tattoos go. But considering it functions like a beacon for powerful radiation beams, it’s pretty impressive.

I also got my schedule for treatment. At last — the longed-for “end date”! Of course, I know that the last day of radiotherapy isn’t really the last day when I have to think about cancer treatment; I have a number of follow-up appointments throughout the summer, not to mention the usual battery of annual scans. But at least I had the date for when daily trips to Dundee would cease, for when I could think about maybe traveling somewhere further than eastern Scotland, for when my plans for the week wouldn’t have to account for medical appointments.

After the prep appointment, I still had a few weeks before radiotherapy began. Being covered in the stickers bothered me more than I expected. It was like seeing my torso marked for dissection, a constant reminder of the radiation invasion to come. Then there was the practical matter of just trying to keep the stickers attached. Every shower, every dressing or undressing, every activity that might potentially work up a sweat, I had to consider whether the stickers would be affected. I felt like I was babysitting these dozen adhesive disks, trying to keep them alive and nourished, abstaining from any activity that might harm or dislodge them.

I wasn’t entirely successful. Several fell off, and I couldn’t find all of them. I called the radiotherapy department to report my failure to preserve my stickers, and they said, “Oh, that’s fine. We really just need three of them marked with the X to stay on.” Well, that would have been handy to know sooner! All that wasted energy caring for those silly stickers.

When the day finally came for the first radiotherapy session, I felt anxious. Sure, I was just lying on a table for a few painless minutes and then it would be over. But was I actually beginning a daily ritual that would end up killing me with a cancer that was far more pernicious than my pesky cells? Living in the mental space of “what if?” is terrifying and exhausting. It’s also a difficult place to vacate. The entire drive to Dundee my brain was churning with inchoate thoughts. Nothing on the radio or my iPod was soothing. I couldn’t read in the waiting room. I sat there feeling like the tense knot in my stomach was a black hole threatening to suck my whole being into it.

As in most doctor’s offices, there was a radio station playing in the background, and as I normally do, I had tuned it out as white noise. But then I heard someone on the radio talking, and her words cut through the white-noise filter and my scrambled thoughts and the black hole of tension. She was talking about Jesus. Specifically, she was talking about Jesus’ words in Matthew 6: “Can any one of you by worrying add a single hour to your life?”

I honestly wondered if I was having an experience of miraculous divine communication or a mental crack from the stress. Could other people in the waiting room hear this?? I didn’t know about any Christian radio stations around here. And even if there were, would Ninewells Hospital really be playing that as the background noise in their waiting rooms? How was it possible that I was hearing an Anglican vicar offer a meditation on Jesus’ words about worry and trusting in God’s provision? This was both comforting and slightly creepy.

As it turns out, BBC Radio 2 has a daily “spiritual thoughts” segment, and as it turns out that day the Rev. Kate Bottley was presenting a reflection on trying not to be so anxious about her daughter’s exams results, and as it turns out this segment airs at 9:20 am which is the exact five minutes that I was sitting in the waiting room. So as it turns out, I don’t know if the rest of the U.K. needed to hear the words of Jesus about worry that morning but I certainly did. And as it turns out, sometimes God uses BBC Radio 2 as the vehicle of miraculous divine communication to break through my fog of fear and loosen that knot of tension in my gut.

Which is not to say that I then skipped merrily into the treatment room. I changed into my lovely velcro smock, the trio of radiographers positioned me on the table, and we embarked on our daily ritual of pleasantries, positioning, and radiating.

Compared to almost any other treatment regimen, radiotherapy is quick and (mostly) painless. That said, it still has its minor indignities and inconveniences. In the process of aligning the stickers and marks and tattoo, the radiographers have to shift and tug at various body parts — hips down, shoulders over, right ribs pulled and left ribs pushed. It feels less like your singular body than disconnected pieces that won’t cooperate by sliding easily into place. The maze of lasers that they use for precise alignment makes me feel like I’m playing the role of “Body” that jewel thieves have to drag through a laser tripwire security system, like something out of Entrapment.

Then they leave the room, and a big neon light comes on: “BEAM ON.” For at least the first half of my treatment regimen, that sign was my cue for anxiety. Thanks to the word of the Lord via BBC Radio 2, I also managed to consciously pray. Nothing especially articulate; mostly prayers that these beams of radiation would help and not harm. That I would be protected from carcinoma and sarcoma and any other deadly word that ends in -oma. And even thanks that I live in a time and place where treatment is possible. For the first few days, it felt like the “BEAM ON” lasted for minutes. A few days ago I forgot to get anxious and I decided to count how long it actually lasted. There are two rounds of radiation at different positions, each lasting less than 20 seconds.

For the past few weeks, every Monday through Friday I drop off Andrew at school, and then I drive north to Dundee. I cross the Tay Bridge, and I note whether the tide is out leaving a scattering of sandbars or whether the tide is high with silvery waves. I drive past the new Victoria & Albert museum construction site and notice how much progress has been made. I park in the lot outside the Princess Alexandra entrance with my free parking voucher that I got the day before, and I casually glance to see how many other cars also have cancer vouchers for free parking. They adorn the dashboards of Porches and Polos, Vauxhalls and Volvos. I head down to the radiotherapy suite with my Lego Star Wars bag containing my smock and a book, just in case I have to wait. I almost never do; usually they take me right back into the treatment room. Position, tug, zap — I’m usually out in 15 minutes, sometimes closer to 10.

Now I’m nearly done with radiotherapy. The staff have all been lovely, clearly well-trained to deal kindly with vulnerable bodies and fragile emotions. But I won’t miss seeing them every day. My skin has been holding up pretty well, and I haven’t had a serious edema. The fatigue has increased, and it hasn’t felt the way I expected. I’ll be going about my day, feeling fine, and then I hit a wall of crushing tiredness. I have some soreness both in and around the treatment area. And I continue to pray that there’s nothing more serious going on that I can’t see or feel. I review Matthew 6: “Your heavenly Father knows what you need . . . therefore do not worry about tomorrow.”