Story 4 Sourcing Strength from Radiation

My initial thought of going through radiotherapy to treat my breast cancer was “yeah I’m so not looking forward to grappling with the conflict of allowing my body to be bombarded with radiation”. The word radiation glowed luminous green in my head, and although I hoped that it would kill any remaining rogue cancer cells, I knew that radiation kills people. I’ve seen the extreme photos of Hiroshima where everything turned to ash. The imagery in my head was of my body slowly turning into tiny grey fragments and disintegrating like those Japanese people. Or would my body remain intact until I fell apart one random month into the future? These thoughts crowded my head but I suppressed them.

I didn’t know how I’d cope with a daily schedule of turning up every single day, five days a week for five weeks, whilst being pleasant to everyone… everyday. The effects of the chemotherapy hadn’t worn off and I still felt crappy. What I came to realize during those weeks is that besides the most obvious gain – an increase in the odds of living – there were unexpected bonuses that I could take home from the whole experience.

For my cancer type, radiotherapy increases my overall chance of survival by about 10%. I needed to know this before I commenced the treatment. My radiotherapy doctor spent plenty of time in our consultation showing me the results of studies with and without radiotherapy for my type of breast cancer. Perfect! I told him I needed that to help me feel good about the whole thing. For my cancer, this radiotherapy has better outcomes than the chemotherapy I’d just finished. Type of radiation for me? Photons. Photons are light particles so I tried to think of it as light therapy. Light as in life, and NOT that going up to the heavenly light thing.

So the next thing I had to grapple with was whether my heart would be damaged by the radiation because my tumour sat right above my heart, and the therapy involves focusing the radiation on the tumour. Well two things saved my heart from damage. Firstly, the physicist, who designed my ‘more complex’ treatment plan algorithm with the configuration of directions and angles of all the beams across my upper body, did an excellent job by bypassing my heart. I saw the images of my CT scan and the intricate beam patterns over layering the top. He said that I’m not the usual patient (yes I keep hearing that) as no one has ever asked to talk to the physicist before. It’s not that I don’t trust people’s words, it is just that I understand better when things are more tangible and then I feel like I get it then. I wished to see what they are talking about not just hear it from their mouths. He went through the plan report in detail explaining the acronyms and jargon terms for me. And I had questions that only he could answer. Serious questions about radiation that had been bugging me the whole time but I was too scared to know the truth till I was near the end of treatment in case I backed out and didn’t complete it. I’ll get to that soon.

The beam configuration over my left chest wall and shoulder.

The second heart saving measure relied on remaining perfectly still. I had to hold my breath to push my chest cavity out and drop my heart away from the deadly beams. Perfecting this technique became my goal. Thanks to the staff who reassured me all the way through the process, I began to look forward to holding my breath twelve times each day for the 80 second period it took to radiate me. These long breaths could have been broken into 40 seconds instead but that meant more time taken up. At first I tried to imagine that I was surfing. I envisioned taking a breath before enduring a massive underwater hold down but this backfired because the reality of a surfing hold down is that if you panic you can drown. That scenario was too confronting. Instead, I imagined I was diving down to a deep coral reef on snorkel, which stretched time into 80 seconds. In my mind I could see the anemone fish close by, and high above, the Barracudas circling backlit against the sun. There was also a cheeky green moray eel but not wanting to involve sharks, I soon ran out of new things with this adventure. I then developed a whole string of different walks that I knew well, adding in as much detail as I could. (One of these is a childhood walk or rather run you can read about in my memoir story Freedom Creek). Using this visual imagery relaxed me, and kept my heart rate down, and allowed me to hold my breath for the duration of the walk, sometimes with air to spare. Later, practiced this in the spa at home, and made sure I used my method of taking up the air slowly and ‘locking the chest’ compartment while I held onto the bottom of the pool. I then practiced this while body surfing and then when my skin became strong again, I could do it whilst surfing. I even taught me daughter my technique so she has more confidence surfing. I wasn’t expecting that!

On the radiation bed

Another bonus I didn’t expect was becoming comfy in my own skin…without boobs…fast. I thought I had come to terms with losing the ‘girls’ but actually I hadn’t. My mind was still catching up with the reality of the surgery that removed a part of my femininity. At the time all I could think was that the boobs were bombs implanted inside me which needed defusing by removal before they exploded and sent me to oblivion. Due to my skin feeling too sensitive during the radiotherapy treatment I couldn’t wear any restrictive clothing like bras or synthetic materials. At first I felt resentful that I couldn’t wear my padded bras and feel normal after all I had been through. My boobs had come off nine months earlier and I no longer had any cleavage, I had a flat pre-prepubescent chest. I ended up wearing skimpy tops like halter necks with no padded bra for boobs. It was summer and it was hot. Before long I felt normal and attractive again in my attire thanks to being forced to go without the fake boobs day in and day out during the treatment. I worked out that if I chose the right top such as a gathered style at the front, then I looked sexier than some of my old outfits with the padded bra. Now six months on I remain equally comfortable wearing or not wearing cleavage. Without undergoing the radiotherapy I doubt I could have reached this mindset so fast.

As it turned out, in the end I didn’t have to worry about coping with the daily radiotherapy treatment session. I looked forward to seeing the staff who looked after me, and I enjoyed great conversations with everyone from the manager to the radiologists to the nurses, the other patients, and even their partners. One time my daughter came with me and the ladies were happy to show her everything and let her check out what they did with the machine behind the window. I asked if she could take a photo of the screen on the machine, which was great because only then could I actually see my heart dropped back in the cavity with my breath holding technique in action. These people are a special type to care for us when we are at our most vulnerable and I am so grateful to them for their warmth and the humanness that they gave me.

A photo my daughter took

Towards the end of the five week treatment, I was walking past the wooden book swap cupboard in our neighborhood, and as I peered in I found the book ‘Shockwave Countdown to Hiroshima’ by Stephen Walker. I took it but I couldn’t start reading it for a while. Then I couldn’t put it down. Some of the assumptions I had about Hiroshima were wrong. Hundreds of thousands of people perished, but miraculously, some survived. The author interviewed a handful of Hiroshima survivors who were healthy, even though they were relatively close to the T-shaped target Aioi bridge where the bomb known as ‘Little Boy’ landed two hundred meters away. The bridge itself survived. Not everyone who survived suffered a long term decline from radiation sickness. Today, radiation is being used to save lives. My body and my life may have been saved thanks to a technological breakthrough that wreaked horror in 1945.

Now to that serious question for the Physicist. Yes the physicist not the physican. How does the photon ray bombardment compare with the rays that victims experienced in Hiroshima and Nagasaki? What I really wanted to know is if the long term side effects would be the same. Photons used in radiotherapy treatment are non-ionizing radiation and have less energy than ionizing nuclear reaction radiation. The rays passed right through my body rather than linger. On the back of my shoulder there is a dark patch of skin where the rays exited my body away from my organs and bones. This is amazing technology. My bones should be quite intact and my heart has been protected. I wondered about my circulating blood being irradiated but I suppose as it keeps moving, and cells keep turning over then it should be fine too.

Exit point of radiation can be seen as the red circular area on my upper back

So I have no regrets about going through this treatment. My concerns and fear were replaced with good things. I’m glad I asked the questions about the treatment, but I should not have been such a chicken and asked them way earlier.