WEEK 1: Radiotherapy Session 1 - 7 & Chemotherapy Cycle 1

November 19: Today I went to SDMC to be “zapped” in radiotherapy, the first of 33 sessions spread over a seven-week period, daily except for weekends and public holidays. I was accompanied by Azmir for my first session. He helped cheer me up with his silly jokes while taking videos and pictures of me throughout the session. The staff were courteous and encouraging – Ms Eng, Ms Lau, Mr Choo, Rizwan etc.

This is a picture of me taken in the middle of the week (Session 4). I will try to take pictures at the beginning of every week to note any side effects to my body.

Back view - Mid-week 1

Front view - Mid-week 1

RADIOTHERAPY WEEK 1 (SESSION 1 – 7)

Session 1 – 19 November 2010
Session 2 – 20 November 2010
Session 3 – 22 November 2010
Session 4 – 23 November 2010 with Chemotherapy
Session 5 – 24 November 2010
Session 6 – 25 November 2010
Session 7 – 26 November 2010

WHAT ACTUALLY HAPPEN IN THE RADIATION TREATMENT ROOM
My visit to the radiotherapy chamber was more or less the same: 20 minute each at most. The first week was a breeze and the treatment showed no severe side effects other than tiredness following the treatment. Dry mouth had started and I felt very thirsty - so liquids must be handy. I also experienced soreness in the throat.

First I was required to lie on the treatment tabletop. The radiotherapists then spent a lot of time aligning a green laser beam to the two “tattoo” marks on both my shoulder made during the planning stage. They measured with special rulers to the half milimetre, checking measurements they had on a Computer screen monitor both in the room and outside the treatment room at their workstations. The measurements were done in the planning stage in the Simulator Room.

Once they got the alignment correct, they would fit in the mask and fixed it onto the treatment tabletop. There were so many masks in the room! (see picture below) They will then leave me alone in the room for the X-ray treatment first. Outside they have a monitor of the room focused on the treatment bed; only the radiotherapist can see me in the room. After the X-ray was taken, they would come in and tell me that the Radiotherapy session will begin soon.

I had to keep perfectly still when waiting for the radiation beam. About a minute or two after they leave the room the treatment area (my neck) receives the radiation as they coordinate their computer outside. The noise is so loud and sounds like a deep but resonating high frequency. I hardly breathe when this happens and will recite Surah Al-Inshirah repeatedly to comfort myself. This surah had been my Cancer Mantra throughout my Radiotherapy sessions. They say you don’t feel anything during the radiation beam but personally I think that on some occasions I’d felt an awareness that something was happening, like a sensation of vibrating penetration. But it does not hurt during treatment.

Then the radiotherapist will come back and say they are done for the day and would clean the markings they made earlier with alcohol prep pads. Sounds simple, really.

CHEMOTHERAPY CYCLE 1

‘Cycle’ used to be such an innocent word for me. But with my treatment being administered in cycles (six of them), the word now connotes many things – ups and downs, highs and lows… and doing things over and over. Try to imagine a roller coaster with six gut-wrenching peaks and drops, and you are seated in the front for its first free-fall - that sums up exactly how I felt about chemo.

Chemo is typically given in cycles, with rest periods between the cycles. This allows the cancer cells to be attacked at their most vulnerable times, and allows the body’s normal cells time to recover from the damage.

The cycle begins...

November 23: I was accompanied by Mom and Sara for my first chemotherapy session. We were at the door of the SDMC Cancer Day Care at 8am and already there was a crowd. Prior to the treatment, complete blood counts, or CBCs were performed to check the number of each type of blood cell circulating in the body. CBC notes the red blood count, platelets and white blood count. My weight was also taken as it is vital that I maintain a healthy weight throughout my treatment.

Normal ranges for CBCs:

• Hemoglobin (HgB) – Normal (Female): 12 - 16 g/dL
• White blood cells – Normal (Female): 4-11 k/ul
  
• Platelets – Normal: 150 to 400 ('000) cells/mm3
  
• Weight – Not less than 50kg

My CBC result on 23 Nov 2010 (and will always be recorded in My Personal Chemotherapy Diary) :

• Hemoglobin (HgB) – 12.4
• White blood cells – 5.58
  
• Platelets – 233
• Weight – 53.6kg
• Result = PROCEED!

Once getting the green light (from my CBC), Dr Kamal (my oncologist) prescribed me with an antiemetic (anti-nausea) drug: Emend. I was asked to take the 125mg capsule one hour before the start of my chemotherapy. While waiting for the treatment to start, I spent my time playing Plants Vs. Zombies on my laptop and getting to know the other patients and their caregivers. And as expected, I was the youngest in Day Care that day, no surprises there :)

By 10.30am, I went on the drip – Cisplatin (50mg) and I felt a bit emotional as the bag of ‘poison’ emptied into my veins. The procedure stretched to four hours because precautions were taken and the drip was adjusted to a slow speed. It turns out to be an all-day affair and it was past 5pm by the time we finished (including radiotherapy Session 4 later that day).

I was exhausted as the chemicals kicked in and slept immediately after dinner.

The first cycle felt like a breeze, until the next day when I felt like life was being drained out of me. The main challenge was to combat nausea and to continuously eat as I had really lost my appetite (the pre-cancer Aida only eats twice a day and now I have to eat 5x a day!). I am grateful that I have my loved ones to go through this ordeal. I wouldn’t have the courage to go through this alone.