Life – Terror. Ecstasy. Fight. Denial. Flight. Failure. PAIN. Forgiveness. Reconciliation. Hope. Love. Peace – Death.
Radiation therapy, also known as radiotherapy, is a cancer treatment that uses high-energy rays, like X-rays, to kill cancer cells and shrink tumours, either alone or in combination with other treatments e.g. hormone drugs, chemotherapy even surgery.
Radiation therapy damages the DNA of cancer cells, preventing them from growing and dividing, ultimately, leading to their death. You are not radioactive after treatment, so it is safe to be around other people, including, pregnant women and children.
It all starts with a Planning Day [Tuesday 17th February].
A surprise enema! Joy!
Then a CT scan and [another] set of tattoos, tiny markers etched onto the hips to align the Ray Gun! Followed by a final CT scan to compare and contrast with earlier, MRI and PET scans.
I have had been treated with an alternative type of Radiation Therapy, twice previously. High intensity proton beam, Stereotactic Ablative Radiation Therapy (SABR), I still have those tattoo markers. A significant difference between SABR and standard Radiotherapy is just 3-5 infractions over 1-2 weeks compared with 20-50 sessions, 5 days per week, over 4-12 weeks.
After a planning day, a treatment schedule is agreed. The following day (18th), I was called by a receptionist, with my start and end date. Unfortunately, it meant cancelling a trip to Lake Bled, Slovakia (4-8th March).
Patients are required to arrive 45 minutes before each session to satisfactorily complete pre-radiation preparation. Monday (24th) 7.30am arrival for an 8.45am Zap. Already feeling tired as I hadn’t slept much all weekend, nerves? Tuesday, (session 2), after a decent nights sleep plus a slightly later start, I felt less fatigued.
Early Symptoms, side-effects – The gruelling, every day schedule takes it out of you (and your partner). Itchiness to skin, more than usual, I suffer with chronic psoriasis, my skin is already vulnerable. Tired, (more than usual), becoming symptomatic from the radiation, (stiffness, joint pain, loose bowel movements), towards the end of week one heading into week two.
20 sessions. 4 blocks of five (Monday to Friday), with weekends off to allow the body a couple of respite days. A final session Friday 21st March. Crucially, in time to commence our epic trip on schedule, 25th March.
Clatterbridge Cancer Hospital, Liverpool
Don’t bother signing in at main reception. Continue down the stairs to area M3, a Radiology specific, reception. Fuck knows why it’s M3 (-3) as it is only one flight of stairs down? Complimentary tea/coffee/biscuits with a, hi-tech, perm a-boil, hot water dispenser (that nobody can operate). First session, staff are all over you, ‘what’s your name’, DOB? At least 3 times.
Preparation Part 1 – Enema (two boxes of enemas were provided at the end of the planning day)? For the past two months, prior to my planning appointment, I have had constipation issues (side effects from medications)? Day 3, trying to pre-empt any bowel movement problems, I had taken a laxative, Senna the night before. I jumped the gun and commenced Part 1 before being instructed to. The pre-radiation scan revealed all. I was, ‘ever so nicely’ bollocked!
First rule of Fight club – Wait until they say, ‘start your Part One (enema)’?
Part 2 – The water. 15-20 minutes after completing part 1 drink 3 cups of water. Patients are expected to accomplish this within 15-20 minutes. The bowel and bladder need to be emptied (enema) then the bladder filled again, expanded. This allows the radiation to work optimality?
Clatterbridge Radiology Waiting Areas 2&3
A large, wedge shaped courtyard with modern, bright, décor. A Cavernous, open plan, area, a 3 floor atrium with enormous, ceiling sky-lights, offering, open views of the outside sky. A series of 12, bright yellow, numbered doors, set around the perimeter of the open-plan, waiting area. Each yellow door is named after a tree, Birch, Larch, Juniper etc.
Outside of the rooms, spread sporadically, are, trendy, sofas, chairs and tables, creating a series of private, intimate clusters, within the large space. On average there will be 20 people seated (patients plus companions). The colour scheme reminds me of where I used to work, The Liverpool Institute for the Performing Arts (LIPA), which has a similar sized atrium also, bright yellow, also like Clatterbridge, punctuated with, occasional splashes of, multi, rainbow, colours.
Within are, 3 water dispensers, two manned, sub-receptions, two large, wall mounted, TV’s, one instructing patients to the various treatment and consultation rooms, the second showing terrestrial TV programmes. Every 30 seconds there is an audible, ‘ding-dong’, alert. Directly opposite the atrium entrance are two disabled toilets, [enema facilitating rooms]!
All in all Clatterbridge does not look or feel like an, A-typical, hospital set-up. Rather more like an open space purposefully designed, to create a relaxed ascetic. More akin to a modern, minimalistic, trendy, hotel than an NHS hospital.
Staff in Radiology waiting areas 2&3 dress in hospital fatigues. They are, typically, aged 30-40, are super friendly and ooze empathy. Over a 4 week treatment period you get to recognise staff, patients, [often couples, patients and companions]. Patients with many types of cancers, at varying stages, each with their own story. Everybody says, ‘good morning, good afternoon, good luck’ to each other!
Sometimes I play a game of, ‘who is the patient, who is the supporter’? Many, patients and companions, are sad faced, tired, fearful (resolved)? Some are not, some ooze hope and optimism. A multi ethnic, eclectic, group of individuals, involuntarily, brought together by an unwelcome, common, thread, cancer.
The Cancer Bell
Mounted on a wall, ruffly in the middle of the room, is a large, brass bell, with a thick, cord. Patients are encouraged to ring the bell to signify an end of their treatment, or, after having been informed they are cancer free after a consultation. Everybody present, patients, supporters, staff, applauds enthusiastically. It can be hugely emotional for both patients and spectators. Some take photographs, some tell their stories, out loud, to anyone and everyone.
15-20 mins after Part 2, TV one, displays your name, John Reynolds – Juniper 7.
I am reminded of the Matthew Kelly TV show, ‘Stars in Their Eyes’, a normal looking contestant will enter a door, as themselves, to re-emerge, as a celebrity.
Patients enter [Yellow Door 7, Juniper], into a small, private, changing room. Shoes and trousers are removed. 2-3 minutes later, a knock at the door, patients are greeted by a, really young looking, radiologist (17-20) who escorts you, to the radiation treatment chambers. They always ask, ‘how are you feeling today’?
There is a corridor that circumvents the 1-12 yellow tree doors, rather like a running track around an athletics stadium (the communal waiting area). A short walk to the Radiation chamber. 2 young looking radiologists manoeuvrer you, positioning you, onto the machine bed. To protect your modesty, the genital area is covered by a disposable, paper towel, boxers are dropped to reveal marker tattoos, some further too-ing and froing, minor body adjustments, aligning marker tattoos to measurements taken during planning day, utilising a ceiling mounted laser beam to match earlier scans – 1-4 minutes.
The radiologists all appear to be (are) very young, teenage looking but probably early twenties? I do wonder how they cope, how they, routinely, deal with perpetual suffering? They are permanently surrounded by suffering? How can a young human psyche stand such, never ending, trauma. They have to be a special kind of humans?
The Zap – (3-5 minutes).
The Radiation Machine – a bed feeding into three, large, movable, parts. Thick, arm-like, components that, when in operation, move close to and rotate around the body, laying on the bed. There are foot locators, a head locator and a small, wedge that forces you to bend your legs at the knees.
Once in position, above are nine ceiling tiles, within a 3 x 3 square, all with images of blue skies and fluffy white clouds, a bit like the Simpsons Cartoon Introduction. The centre tile has a cross slot for a [green], laser beam. The tiles are backlit, or are meant to be. Juniper has only 4 of 9 tiles lit….after a week, it began to bug that all the tiles were not lit!
Final adjustments, the young radiologists confer, they agree we are set and ready to go. A warning buzzer, ‘see you in a few minutes.’ They retire to a control room. Shortly after the machine sparks into action. A pre radiation, scan is completed, viewed and discussed. They are examining the (fullness) of the bladder and bowel.
The thick scanning arm component retires, back to its starting position, and the radiation begins. The operating noises change. A slightly higher pitched buzzing. 2-3 minutes max. You feel nothing.
The, ever so young, radiologists return, ‘that’s it john, you are done…, do you have anything planned for the weekend’? I Return to Juniper 7 changing room, dress and out thru the yellow door, to the atrium, ‘Tonight Matthew I am……’
All done and dusted, including prep, one hour tops.
Week Two
After a late (12.30) Saturday night socialising, followed by a long Sunday, walking, then travelling. I slept, fitfully [Sunday] from around 4.00-8.00pm whilst on the train and whilst watching TV after arriving home. I gave in and went to bed (and slept) from 9.00pm right thru to 7.00am Monday.
Monday (week two), awake but already feeling “fatigued”? Stiff, ackey? Like you feel right before you come down with a bad cold, man flu? Arms & legs mainly, especially near to joints? Cold, colder than normal, cold all of the time? First session of week two (the 6th of 20) off the back of a hectic weekend in London. My first solo session (Gail was baby sitting Fen).
The end of week two
Halfway point (10 of 20 sessions completed) – Surprisingly? If anything, it all felt a bit easier by Thursday, Friday. Challenging, yes, the seemingly endless, every-day-ness of it all is difficult. Providing it does not take a drastic turn for the worse it is doable.
Thanks for Reading
#peace
Dying to Live 