Birthday + Radiation Updates + History

I had my birthday this past Saturday:

 Wendy made a Chocolate Peanut butter Cheese Cake.

I got my Margaritas.

 Also my fajitas I wanted... which were burrito sized.

Also gifts.

Radiation + Updates:

I meet with my excellent new doctor- a radiation oncologist, and went over a consultation this past Friday. The hospital I go to has a brand new as modern as can be Cancer Radiation Center.  Many people have misconceptions on radiation therapy- it's not like it was 40 years ago where they did full on mantle radiation where they would blast your entire upper body with radiation, as they didn't have PET scanners or CT scanners in the 1950's and 60's. (however, it's still practiced today- but only in extreme cases with very advanced cancers).  It's an incredibly precise field of medicine.

I have my PET scan on Tuesday, which will determine the state of any cancer that's left, which I'll then review with my Regular Oncologist on Thursday, and meet with my Radiation Oncologist that afternoon.  Most likely my PET scan will be negative for disease given with the way I've responded to treatment, which means I'll have 17 days of radiation therapy- M-F every day for about 15 minutes (very short compared to ABVD chemotherapy). If there is still a little sign of disease  then I will get 20 days of radiation.  If there is a large amount left, which neither doctor thinks there is, then I will have to do 2 more months of ABVD chemotherapy and then probably 17-20 days of radiation after that.  Obviously I'd prefer to have no sign of disease.

What I'll be doing when I meet with my Radiation doctor on Thursday will be quite a bit:  

• CT scan, which they'll use in conjunction with my PET scan from before I started treatment, and the one I will have on Tuesday- and they line them up in their computer and the radiation oncology team decides what the best angle of treatment is for the radiation beams.  The oncology radiation team is made up of my radiation doctor, 2 radiation techs, a physicist, and a radiation diagnostic tech.  Which is why it takes 3 days for them to make the radiation plan- as they're pretty precise, I was quite amazed at their level of detail.
• Be fitted for a cradle for my Radiation therapy, it's Styrofoam/foam filled sort of material that shaped for my body/neck, to keep me in one position everyday I have treatment.
• Be fitted for a protective mask, which is made out of a plastic material that they soak in hot water which become flexible, and wrap it around my face until it sets.
• Get tattoos for where they'll need markers for where to aim for during radiation therapy.  They're very tiny blue dots.  Since I had some swollen lymph nodes on my jaw/head, they make the marks on the mask and cut holes out where they need to get at- instead of you know, tattooing my face (as much as I'd like to go back to the office  with facial tattoos).
• I'll be given an aloe vera  gel to put on the areas where I'll be getting radiation.
• Then I can go.
• I should start radiation therapy around the middle of the week around March 20th and be done around mid April.  After that I have to recover from Radiation for about 3-5 weeks, hopefully not more than that. I should also recieve ANOTHER PET scan and see how radiation went.  I won't be deemed officially in remission until the Scan after that- which would be around mid July, but from my reaction to the end of radiation- they can make an educated guess about it.

For newly diagnosed people, as I'm sure you've heard from countless others: radiation is MUCH easier than chemo (although everyone is different).  The hardest part I was told, was that you have to come in EVERYDAY Monday through Friday.  Which is a bit harder if you have kids, or are working, or you know- 80 years old.

I'll be doing about 3 1/2 weeks of radiation (most likely).  The side effects I can expect for my treatment are:

• Week 1: Not much, but the other weeks might start a little early at the end of this week.
• Week 2: Start to get a sore throat/discomfort.  Possibly a slight cough.
• Week 3: I'll have  a bit of dry mouth, Biotene will help.  Because of where I'll be getting my radiation therapy (clavicle, upper center chest in the center, small bit of my arm pit on the right side, and neck) my lower salivary glads will be affected.  Or as my Radiation Oncologist said "kind of a bat-sign symbol shape."
• Last week and a half: The hair will start to fall out from the lower back of my head, as it's too close to my jaw line.  Which is fine, as my hair is about 1/8" right now.  I'll also have  a "sun burn" from the areas of radiation I'll receive. I might have a bit a fatigue  but nothing like chemotherapy.

Other notes:  

• The cancer in my chest is on the right side of my heart next to my lungs, which is good, because if it were on the other side my left ventricle would be in the way- my doctor liked that as it there will be no radiation exposure to my heart.  
• There will be a small amount of radiation exposure to my lungs though- hence the cough, and it will leave scar tissue in my lungs..  However, my doctor tells me I won't notice, as it's a small amount of lung- and even if I were a professional athlete I wouldn't notice the difference as humans only ever use a small portion of their lungs.
• My risk of secondary cancers is quite low, as my stage of cancer is fairly early, and I'm over 30.  The risk for secondary cancers caused by radiation therapy is higher among younger people- which Hodgkin's Lymphoma is much more common (ages 16-24, mostly in men).  It's a higher risk as their chromosomes aren't quite finished forming, where as mine with my age are.  If I do develop a secondary cancer- it would most likely be a skin cancer (in 20 or so years), which would be highly treatable.
• For the sun burn areas, I'll have an aloe vera gel to put on everyday.  DON'T use hand lotions in the sun burnt areas, or scented soaps.  Use only soaps like Ivory, and the aloe vera gel.
• I'll have dry mouth as the salivary glands in that are responsible for the moisture in my mouth will be effected, however the salivary glads that are responsible for saliva while I eat (which are more near your cheeks, and won't get any radiation) will not be affected.
• Also per my doctor: "eating  a bunch of Doritos if your throat hurts is inadvisable."
• I'll have to get my thyroid checked out annually for any problems, which isn't a big deal.
• It's kind of a drag to have to get up and go to treatment every day for only about 20 minutes, the drive there takes longer than the actual treatment.

Radiation really isn't all that scary, also my hair (minus the back bottom of my neck) will continue to grow during treatment.  As with anything- if you have questions about your own treatment, ask your radiation oncologist at anytime- as you're the one paying him (via health insurance or large sums of money from being independently wealthy).

History Time (via blog summary):

Hodgkin's Lymphoma is one of the oldest medically studied cancers in the world.  It's also one of the first cancers that was met with successful treatments.  

Before 1950- it was a 100% fatal disease.  

Through research, radiation was found to kill the cancer cells, and that's when full on body radiation was done- which for the first time patients were becoming cured, although at a rate of about 30-60%.  Patients though experience severe side effects from radiation.

About that time- chemotherapy was being developed, and the first chemotherapy for Hodgkin's was formed.  It was highly toxic and and didn't increase the survival rate much, but lowered the amount of secondary cancers and future side effects.

Then in the mid 1960's in Italy, ABVD chemotherapy was developed.  It's used today in the majority of early to mid Hodgkin's lymphoma patients.  It was in a pretty rough form of treatment,  used in combination with radiation treatment.

Over the years, research has been refining treatment to be less toxic and have less side effects. Today Hodgkin's Lymphoma is one of the most highly treatable cancers, with survival rates very high, and low toxicity.  It's continues to be refined today through medical research... which if you're interested in, you can donate money for research to the Leukemia and Lymphoma Society here, or any other cancer research here as well.  The medical knowledge doesn't just happen, it takes time, bringing highly skilled people together, and money to do so.