Radiotherapy

My radiotherapy has gone really well, and is now nearly over. I’ve had 15 sessions that target the whole breast, and I am now half way through the 8 sessions which are a boost to the tumour site. So, my last visit to the hospital for active treatment will be this Thursday, 7th September.

Radiotherapy itself is really straightforward. On arrival at the radiotherapy unit at the Royal Free, all patients scan in their barcode on their appointment card and then sit in reception half watching Homes Under The Hammer/Bargain Hunt/Escape To The Country on the TV in the corner. I was intrigued to see that the radiotherapy unit is next door to the heart attack centre, so I was expecting some kind of  “24 hours in A&E” action to be played out as we waited (especially as the sign is in red) but nothing so far.

Once called for your treatment, you trot off to one of the cubicles to disrobe the part of you being treated and put a gown on. In my case, that’s top and bra off then a scratchy NHS hospital gown on backwards. Most patients seem to be very relaxed about this and don’t fasten the gowns at the back, so there are flashes of bare flesh on display. With my hot flushes, a bit of a breeze is always quite welcome anyway.

In the radiotherapy room itself, I lie on an adjustable bench, pull my gown down, rest my head in a padded doughnut cushion, and have arms overhead on padded rests.  The radiotherapists ask that you relax and don’t move, and they actually move you. It’s rather strange lying there half naked, being gently pushed in to the correct position as they call out a variety of measurements to each other, and say things like “11.7” and “good coverage”. There are also green laser lines across my body to ensure I’m in exactly the right position for the treatment.

The radiotherapists are a wonderful team. They explain everything they are doing, and patiently answer all my questions. At one session, one of them apologised for her very cold hands and rubbed them together in a bid to warm them before touching me. They also cover up my left boob (the one not being treated) with the gown once they have me aligned under the machine. I was so touched by this small kindness.

Once positioned, they say they are leaving the room. At this point I always feel I should say “Okay, thank you, see you in minute, bye!” but I’m so keen to not move even a millimetre that I just produce a little incoherent squeak.

At this point a loud alarm goes off, and then the machine starts to move around the bench. It settles in two places, so my body gets blasted from both sides by the special cancer killer rays. The machine makes of lots of impressive clicking and whirring noises. It’s all completely painless and there’s nothing to see. The total breast treatment took 4 minutes – it takes longer for the radiotherapists to expertly align me than the actually radiotherapy takes.

The boost sessions are even quicker. For this, the radiotherapists attach a kind of lens to the machine (it puts me in mind of a dalek’s eye) which points directly at the tumour site. A gel cover is put over my breast, and then we’re off again. I incoherently squeak, the alarm goes off, the machine clicks and sixty seconds later it’s done.

There are two computer screens in the room, and on it are the exact measurements the radiotherapists are to follow, plus a picture of my insides.  I was fascinated by this. During surgery, clips were left in my breast at the tumour site so that the technicians could see from the CT scan exactly where to target the cancer killing rays. The clips are harmless. One of my questions to the radiotherapist:

“Will the clips set off the machine at the airport?”

The answer is no. We then laughed that our underwire bras usually set off the machine anyway.

One day I noticed that the screen saver on these screens is a kind of mission statement for the hospital. It’s the values with which the staff intend to interact with each other and their patients. It was surprising to see something so corporate in a healthcare setting.

Hampstead Heath

I’ve been lucky to have my treatment through the summer months. I often walk across Hampstead Heath to get to the hospital, it’s a five mile round walk, and quite hilly, so good exercise. I’ve also cycled to the hospital, if I can carry what I need in my pockets, as wearing a rucksack is a little uncomfortable now. Then some days I’m just too pooped, and drive.

Side Effects

Once a week a nurse sees me to inspect my skin. All ok so far. The skin is red where it’s being treated, especially in the crease under my boob, and the armpit where clothing rubs. So when at home, I do a Charlie Dimmock and go bra-less. And suncream is now obligatory as the skin is super sensitive to burning for at least a year.

Fatigue is still my companion. I struggle to stay awake beyond 9pm, and sleep for about 10 hours a night. But my sleep is now punctuated by hot flushes which wake me up at regular intervals. The bed covers get thrown off, the cat gets a strop and I lie there like a star fish until I cool down.

Hot flushes are from taking tamoxifen, and I think they add to the fatigue. I’m having about twelve a day, so I’ll be having acupuncture at Maggies at the Royal Free as this can provide relief. I shouldn’t be using deodorant because of the radiotherapy, so what a great combination: summer heat, hot flushes and no deodorant.

Hair

Hair, seven weeks after chemo

Look, no bald patch! Fair enough, there are quite a few white hairs, but I’d rather look like a version of Cruella Deville than have bald patches. This is seven weeks after my last chemotherapy, and I’m so relieved to see my hair regrow. Eyebrows and eyelashes haven’t got the memo yet about returning, but apparently this is normal.

I’ve continued to go to spin classes at the gym. They wipe me out, but it’s so good to get an endorphin rush and rebuild my fitness. It’s always saddened me to see the young women at the gym who feel the need to wear make up when working out. Well, I must confess that I will not now leave the house without painting on my eyebrows, including going to the gym. The other day, I was sweating profusely in spin class – the class is sweat inducing enough as it is, let alone with hot flushes. So, I rubbed my dripping face with my towel,

“oh shit, did I just wipe my eyebrows off?”

Chemotherapy effects

My sense of taste has fully returned. Hooray! I have now resumed my tea habit, and wonderful it is too.

Also, I no longer need to take Aciclovir, as my risk of getting shingles should have receded as my immune system will have rebuilt itself.

My finger and toe nails are hanging on, and I keep them painted with dark varnish to protect them. I do have Beau’s lines on my toenails, a side effect of docetaxol chemotherapy, but these will grow out.

Beau’s lines on toe nails

Goals

I set myself a new goal of cycling a sportive at the end of August. I signed up for The Hertfordshire 100. In previous years I’ve cycled the 100 mile and 100 km routes, but this year it was just the short, 32 mile, for me.

It was a beautiful day, the sun was warm but not hot, and it felt unspeakably good to be out in the fresh air, cycling on country lanes, with lots of great camaraderie from fellow cyclists. I stopped just once, at the well stocked feed station. Whilst the hills hurt a little more than usual, I was delighted to complete the sportive. What a feeling.

It left me exhausted for a few days afterwards, but it was worth it.

I’ve also had a piece published on Shine’s website about getting through chemo. It’s good to feel my experiences may be of use to others.

Shine Cancer Support Blog

Oh, and I’ve entered the ballot for next year’s Ride London 100.

Return to work – the next goal

 

Throughout my treatment, I have stayed in touch with work colleagues, and they have been hugely supportive. Last week I popped in to say hello to my team, and it was great to see everyone again. My plan is to return to work in October on a phased basis, gradually building up days and hours. It’s difficult to know how much the fatigue will impact me, especially as I will need to play catch up for a while. I’m looking forward to getting back to work, but also quite apprehensive. I haven’t had a break from work since I started working full time in 1991, so this is all new to me.

This will also coincide with not going to hospital on a regular basis. I see my oncologist at the end of September, but will then not have any appointments until January 2018, when I will have an MRI and mammogram. Strange as it may seem, there is a comfort in going to the hospital so frequently, and in being able to be so focussed on my treatment and recovery. Many cancer patients say the hardest time (psychologically) is once treatment ends. So, I’m doing what I can to prepare for this.

Gratuitous photo of the cat. Well, why not?