I met with the Radiation Oncologist today. It was just a consultation and took a rather long time, but I came away from it with some renewed optimism. He looked over my bone scan and the one area that jumped out as most affected actually corresponds with what feels to be the source of most of my pain which is just on the top of my right hip near where the spine connects. (He had a medical term for the spot, but I can't remember what it was.)
Anyway, I go back on Monday for a simulation. As explained to me, this is kind of a dry run at the treatment. They'll put me up on the table in a cat scan which the doctor will monitor and mark on the screen in real time. Where ever he marks, the machine will point a laser at my body to mark the location for the radiation to be pin pointed. Once they have all the necessary spots isolated, the will mark them with what he called tiny tattoos. These will be alignment points for when I go back for the actual treatment so that they can be assured that they are hitting the correct spot consistently. After that, we will determine a date and time slot for the first treatment some time later in the week. I will then have to go back to receive a treatment every day at the designated time for 2 weeks or so. The nurse told me that each visit will require a half hour or so for them to set everything up and line up the machine with my "tattoos", then the actual treatment will only take about 3 minutes.
He seemed quite confident that this will help to alleviate my pain though he cautioned that it won't happen overnight and I probably won't start actually noticing improvement til near the end of the two weeks, but should continue to improve over time following the completion of all of the treatments. Ironically, there should be little to no side effects save the possibility of having irritable bowels as a result. Considering this is the opposite of the side effects I am experiencing from the pain medication, I'm hoping that they cancel each other out leaving me with normal bowel function. I really appreciated him explaining it all out for me, even so far as to put in layman's terms how the radiation actually treats the tumor. As I understood it, the reason for the delayed result is that it doesn't really kill the tumor as much as it renders the tumor's cells unable to reproduce so as the tumor cells die out from their natural life cycle, there are no new ones to replace them. Makes sense to me.
I'm usually not one to jump the gun with either good or bad news. I generally try not to dwell on what may happen. A phrase I've often told my wife is "I'm not going to worry about it until I actually have something to worry about". It's been difficult to live up to that with this cancer business is largely full of unknowns. Many people have asked me what my prognosis is and the fact of the matter is that, at this point, it's too early to even speculate. However, there were a few things about today's consultation that make me cautiously optimistic about this radiation treatment. First, the doctor was very matter of fact and made this sound very routine. He didn't give me any best case or worst case scenarios nor talk about chances of success. His language was more along the lines of "This is what we will do. This is what will happen." Second, he conveyed that the treatment wasn't a must have. He even offered me the choice of whether to go ahead with it, stating that we could just continue with my current treatment and let the Xgeva do it's thing over time. He seemed equally confident in the outcome of either procedure, but the goal in doing the radiation is to get this pain out of the way quicker so that I can resume a more normal lifestyle while continuing with the rest of the current treatment.
Many people have kindly offered me help saying "anything I can do..." but really there hasn't been much that we've needed help with. I've been saying all along that if I can just get this pain out of the way, and stop taking the pain medication, the rest will be much easier to deal with and it removes the most prominent of the unknowns that I'm facing which has been "when will the pain stop?" because if the pain stops, I can get back to my normal routine. I can get out of the house, go back to the office, attend social gatherings, etc. and that will do more for my morale than anything else right now and will probably help my wife's morale as well as she'll no longer have to worry about my comfort level day in and day out.
Here's hoping that the radiation ends up being all that it's cracked up to be.
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