Nuked Me and I'm Even Mo’ Better: A TrueBeam Radiation Machine Gets Results

This week we completed four radiation treatments and celebrated San’s birthday. I haven’t written about the radiation treatments and San didn’t want me to post the mushy love poem I wrote for her here, but suffice it to say that between being radiated (I am reminded of James Agee’s line about “the cruel radiance of what is”) and being a poet, I’d take poet every time.

Not that the radiation treatments have been that hard on me. Learning to live with cancer is learning to live with some pain, and between the meds prescribed to curb it and the small nuclear detonations along my spine and back to eradicate it, we have made significant progress.

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Doc Tannehill and his team at Arizona Radiation Oncology Specialists have been friendly, efficient, and caring; I have only good things to say about all of them. I praise them and their work because, as has been the case with the Four Winds Cancer Clinic, I think it is important for readers to know that there are caring and compassionate places for chemo and radiation treatments. There are genuinely good people in the cancer business who, once entrusted with our care and well being, do, in fact, not only come through for us, but also go the extra distance. And I praise them because I don’t think they always know that the seemingly small acts of human kindness they show to me and to other patients are appreciated and remembered.

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My “external beam” radiation treatments last about 12-15 minutes, but only a portion of that time is reserved for the beam to do its work. I arrive in the chamber where two or three radiation therapists await my removal of shirt and cane. We exchange friendly banter, mostly about food (I told them about my cookbook, Food Talk: A Man’s Guide to Cooking and Conversation with Women) and how I feel (“not bad, considering”). We are then ready to begin.

With care two therapists help me down on the single-sheet covered but still cold metal slab, making sure my head and body are properly aligned with the beam. They are careful that we move down slowly, as my back is sensitive to sudden movements and the last thing any of us want is more pain that might interfere with the procedure. They want me to be comfortable, which is at best an ambiguous state on a metal slab, but we all work together to achieve it. Once down and flat, I move my arms above my head and clasp them together for the duration of the treatment.

I have some permanent ink targets marked on my chest and a series of pinpoint tattoos that will remain on my body for the rest of my life. Some measurements and calculations follow, using the ink targets and tattoos to make sure that the precise area of my body that needs treatment gets it. The therapists, if necessary, adjust my treatment position by tugging on the sheet. I am instructed to remain still, breathe normally, and the treatment begins. 

The therapists play music from the 60s – 80s and it is easy for me to close my eyes and just lose myself in it. Of course the old music takes me back to earlier times and remembering those times is a good way to distract me from the otherwise serious and potentially dangerous work being done to me. The good news I guess is that there aren’t any horror stories in circulation, at least none that have reached my ears. Besides, here I am. It is what it is. The “cruel radiance of what is” is something I am learning to understand anew. 

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A word about the TrueBeam Radiation Machine. We indeed have been fortunate that Doctor Robin referred us to this particular radiation oncology treatment center, not only because of the quality of care offered by the doctors and staff, but also because they operate a state-of-the-art/science TrueBeam radiation machine, a very effective cancer-fighter that so far has produced great results for a variety of tumors. From an ABC15 news article in which one of the senior doctors, Dr. Maggass, is interviewed:

“When patients get the treatment, the machine shapes radiation beams that target the tumor with a higher dose of radiation, which shortens the length of treatment, said Maggass, who has been a radiation oncologist since 1987.

You kill the cancer while minimizing the dose of radiation to surrounding normal tissue.

Arizona Radiation Oncology Specialists was the fourth in the nation to get the technology last Fall. They were the first in the Southwest.

"It's very well tolerated [by patients]," Maggass said. "People only have minimal side effects and have an excellent chance of being cured of this cancer."

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I lie on the slab listening to old tunes and try to think positive thoughts. I pray. I meditate on “getting better,” where better means shrinkage of the spinal tumor and a major lessening of pain. During my meditation there comes a soft whirring from the cool looking machine circling my body – imagine a miniature space satellite with attachments and my body as the chubby human tube in the middle of it – and the soft buzz of what I assume is the targeted TrueBeam nuke at work.

The whole procedure is over in no time. The therapists ease me up to a seated position where my personal measure of success is that I can still breathe. I am not speaking figuratively. One of the side effects of both the tumor pressing against the nerve sack on my spine and the presence of a small fracture at T8 on my spine has been difficulty breathing when I rise up from an incline. It’s normal. Nothing to worry about. I admit it was pretty bad before I began treatments. And so that is why I have been heartened to actually see, to feel, improvements in my ability to breathe normally after each of the targeted treatments, particularly this week. Now that’s progress!

More good news: When we meet with Doc Tannehill he tells me that I only have two more treatments (total of 10) instead of the initially prescribed six (total of 14). If this is because they use such a cool and efficient cancer-killing, tumor-reducing machine – which I assume it must be – I am once again blessed and very grateful. He also adjusts my meds in response to my feeling less pain with the old Gabapentin anti-seizure capsules than I did with the Dexamethasone steroids, and our mutual desire to get me off the steroids as soon as possible. We are both pleased and part happy.

San walks with me slowly back to our car. I am still walking with a cane. Although we are making steady progress on the back pain, it is still there. But in an hour or so it will be far less so. By evening and another round of pills I’ll feel much better, maybe even well enough to dance a little jig. Or not. But either way I will feel better. And in our little family we will all be happy about that.

Bedtime will be early for everyone. One of the side effects of my treatment is an emotional drain on those who share responsibilities for my care – in particular San and Nic. This week has been particularly draining as the move back into our house and the sundry issues that arose from it consumed their time and effort, and because we wanted to reserve enough energy to make San’s birthday special, at least as much as we could. Alyssa was a huge help. And last night’s birthday dinner at home, a feast she and Nic made of white chicken enchiladas, cilantro brown rice, homemade salsa and guacamole, and a delicious chocolate cake with raspberry frosting left all of us ready for sleep not long after we finished eating.

Monkey, the family cat now all moved in and perfectly at home on the couch, was already purring …

I tilted back in the new comfy recliner. I opened my iPad and read a little bit – The Kings of Cool by Don Winslow – and then woke up this morning with it still open on my chest.

There was still some morning pain. I eat my yogurt and swallow the pills. It’s not over yet.

But all in all, a pretty good week. And I resolve to make next week – as my old rock n roll pal Drew Thompson used to say – “even mo’ better …!”

With a little help from my friends … always with a little help from my friends.

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