On this page I'll describe my treatments and what their general aim is. As i go through more treatments and learn more, I'll continue to add to the entries to fill out the data so the reader may be more informed. I will certainly do my best to be accurate, and I will also make an effort to cite published material or point to a link so the reader will be able to investigate should they wish if it seems appropriate and useful. And if I get the facts wrong, I ask that you let me know so I may correct the record.
Radiation and ChemoTherapy:
I began both Radiation and ChemoTherapies on July 8, 2010. It's generally considered an aggressive form of therapy (as well as the "standard" protocol for fighting glioblastoma multiforme these days to my knowledge) where the chemo, temodor (temozolomide), acts to arrest tumor growth and sensitizes tumor cells to radiation, and the radiation kills tumor cells outright. My understanding is that while this therapy kills tumor cells, it does not eliminate them from the body, but there are other therapies that can be undertaken after killing the tumors to help remove tumor material from the body. I'll write more of therapies that have been shown to do that as I learn more.
The initial treatment is a 6-week course where I take temodor every day for 42 days, and I receive radiation every day Mondays-Fridays for a total of 30 days of radiation treatment over the six week period. After that, I'll have another 4-6 months where I'll take temodor for a 5-day course each successive month for maintenance. I'll also receive monitoring in the form of MRI's from time to time to see what if anything is happening with the tumor remnants they were unable to remove surgically in June. My goal is ultimately to not have any tumor tissue left, dead or alive.
The basic procedure for chemo is for me to take temodar orally once daily in a dose of (1) 140 mg gel capsule + (2) 5 mg gel capsules on an empty stomach with lots of water (8 fl oz. minimum) and generally at the same time every day, so on July 8 I took my first dose around midnight which is typically 3-4 hours after I've last eaten. I asked for guidance at the offices of my radiation oncologist to see if there was an optimal time frame in relation to the radiation therapy i should take the drug considering the radiation sensitizing aspect of the drug on tumors, and was told that there isn't a timing aspect to worry about but that the drug will work into my system best if I ingest at a time after which I will be doing a period of fasting, so eating before retiring at midnight gives my system 7-8 hours to work the drug in before I next eat, so should work in terms of doing some fasting after ingestion.
The radiation therapy is totally cake. On July 1st I went in for a "Radiation Sim" where they lay me down on a bed and fit me for the mask I wear that holds my head in place so they can aim the radiation with precision. To fit the mask they took a sheet of a plastic mesh, approximate 12" x 8", that had been warmed to softening and pulled it down over my face to mold it perfectly to my face and head. It felt like they were pulling a giant, wet, warm, sticky spider web over my face, and oddly enough, that feels good.
For the radiation therapies, I saunter into the office suite of the radiation oncologist in the basement of the Cancer Center at the same time every day and continue to stroll on back to a small waiting room reserved for radiation patients. No need to check in; they have cameras in the waiting room so they know when I arrive, and a technician comes to gather me after a minute or two and take me to the "machine" which is an Elekta Synergy S (Elekta Synergy Brochure - 'Inspiring Clinical Confidence' (North American version) ) I walk over to the machine's bed, lay down, lift my knees for a pillow, and lay my head on a lucite cradle appropriately attached to the therapy table. A pair of techs then place the mask on me to secure my head in place and we run through scenes from Silence of the Lambs for 5 minutes (just kidding ;). After that it's any number of small maneuvers where a tech may rotate the table then revolve the radiation head of the machine about an axis roughly in line with my spine to whatever angle is necessary to focus a beam of radiation at a number of areas in my head including where the bulk of the tumor was removed (which was basically on the periphery of my right temporal lobe, close to the skull and above my right ear) to kill any remaining tumor cells as well as the areas surrounding the tumor site to be sure there's no tentacling of tumor cells occuring from the original tumor site. The movements of the machine and radiation head are precise enough when combined with stabilizing my head to allow them to aim at areas of interest while avoiding things like my optic nerve which I'm kind of using still. The radiation will pass through some healthy brain tissue, but at the dosages used, healthy brain tissue remains unharmed although there may be some temporary side effects listed below.
Chemo and radiation side effects:
In terms of side effects the big one for the chemo may be nausea, but I'm hopeful by following the basic protocol of ingesting it on an empty stomach with plenty of water/clear fluids there won't be any problems. The radiation may cause a drop in my energy levels after a couple weeks so we'll see, but the radiation oncologist did tell me the more active I am within the limits my body currently allows, the better success my body will have in fighting off the fatigue. Considering my energy levels continue to improve each day as I go for my light runs and spins I'm hoping I won't see much drop off. There may also be some temporary short term memory loss and a temporary reduction in cognitive function in a couple weeks. If that happens, "Jeopardy" won't be as much fun to watch, but at least I'll have an excuse for why I didn't put the deck chairs together. I might not even have to take out the trash. Thank you gamma-brain. Anyway, both conditions are quickly reversible with mind exercises, so while I'm hoping for the best in terms of no side effects, I'm not overly worried knowing that there are ways to quickly cope and readjust.
Nutrition:
I'll be writing more about nutrition and exercise and how they relate to therapy and to killing cancer as well as even helping the body eliminate and evacuate tumors in the days to come.
Exercise:
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