Thursday, 12:55 AM
High-Level Journal Summary: An actual photo of the Gantry Machine which delivers the photon radiation to physically manifested portions of the brain tumor at the National Cancer Institute. This is an amazing machine, even more complex the more I learn.
The main content of this online journal entry? Another layer of depth about radiation. Three questions were well researched, in short form:
1.) What is radiation therapy?
2.) When is radiation therapy used?
3.) How does the doctor measure the dose of radiation?
These are three key items to understand early in the radiation process, especially as significant strikes are being made against cells which can kill anyone, as much as we would probably like to think differently. It is a common disease, and our society is fighting it hard.
Countdowns:
1.) Day 2 of hyper-fractionated radiation and low-dose chemotherapy at the National Cancer Institute (NCI).
• It is very important to note that I get will get a total of 60 "Grays" (Gy) of radiation.
• From a physics standpoint, a Gray (Gy) is simple a joule per kilogram of absorbed energy.
• As of now, I get 1.2 Gy with each hyper-fractionated radiation (i.e., twice per day). Hyper-fractionated radiation happens only for the first 2 weeks before switching to a different form of radiation exposure (i.e., once per day).
• Activity to date gave me a grand total of 4.8 Gy (of 60 Gy total) as of the time I left NCI today. We are well on our way.
2.) Meet with radiologist Dr. Kevin Camphausen on 1/18/08 to drill down on further information about the overall radiation process.
2008 Seizure Activity:
1.) Last Simple Partial Seizure, or SPS, was 2 days ago. In total, I have had a total of 11 SPS's in 2008 so far.
Actual Journal: All of a sudden, it strikes me as important to reveal a few things that are a part of my life during the past month. These things may strike others as quite odd, but they are actually consistent with what I experienced following my 5/5/05 brain surgery. Just a few high-level items:
1.) I have only take 2 showers since returning home NYU on 12/31/07. Normally, I shower and shave nearly every single day. (Sounds gross to deter, doesn't it?)
2.) I have only shaven 2 times since 12/26/07, the day before my second surgery.
3.) My energy levels are scattered all over the place. This is probably caused by surgical recovery, radiation and chemo, and trying to organize all that is happening in my life.
4.) I still keep my house in very nice order, despite all this. This is an important ethic for me.
5.) Oddly, I am very, very clean hygenically. For some reason, the myriad drugs I take do not abuse my body. It is something I do not yet understand.
Cutting to the chase
With that contextualization, here is information about what is happening right now, right in the moment, right in this day.
This is just a simple snapshot of the Gantry Machine that was mentioned in yesterday's journal. This is the $1,000,000+ physics-based machine at the National Cancer Institute (NCI). It seems so simple, but the more I learn, it is an extraordinarily complex mechanism.
The very front part of the Gantry Machine is drawn quite close to my body before the LAO (Left Anterior Oblique), LLAT (Left Lateral), and LPO Left Posterior Oblique) is delivered to me. (See 1/16/07 online journal for more on these 3 techniques used for this brain tumor.) The stroking of this massive machine is quiet, and it is accompanied by music that is played by the crew running this machine. It is almost a surreal experience, in some senses.
Excellent explanation of "radiation therapy"
With all that is happening, I have many people who are helping -- to the extent I am unable to reach out to everyone. What a great problem to have! To this extent, here is the result of 2 hours of concentrated research by my Mom, Susan Miller, on radiation therapy.
I will keep this short and simple, but only because there is so much to absorb on topics like this. I consider them complex to absorb correctly. But with a little it drawn on a regular basis, excellent content can be drawn in short periods.
With that, here is exactly what we are doing. This is radiation therapy.
This is an excerpted, quoted verbatim from a source not provided to me. I highlighted 3 main areas only. I think that these are the most germain and important to conceptualize at this point, especially in advance of meeting with radiologist Dr. Kevin Camphausen on 1/18/08.
1.) What is radiation therapy?
Radiation therapy (also called radiotherapy, x-ray therapy, or irradiation) is the use of a certain type of energy (called ionizing radiation) to kill cancer cells and shrink tumors. Radiation therapy injures or destroys cells in the area being treated (the "target tissue") by damaging their genetic material, making it impossible for these cells to continue to grow and divide. Although radiation damages both cancer cells and normal cells, most normal cells can recover from the effects of radiation and function properly. The goal of radiation therapy is to damage as many cancer cells as possible, while limiting harm to nearby healthy tissue.
There are different types of radiation and different ways to deliver the radiation. For example, certain types of radiation can penetrate more deeply into the body than can others. In addition, some types of radiation can be very finely controlled to treat only a small area (an inch of tissue, for example) without damaging nearby tissues and organs. Other types of radiation are better for treating larger areas.
In some cases, the goal of radiation treatment is the complete destruction of an entire tumor. In other cases, the aim is to shrink a tumor and relieve symptoms. In either case, doctors plan treatment to spare as much healthy tissue as possible.
About half of all cancer patients receive some type of radiation therapy. Radiation therapy may be used alone or in combination with other cancer treatments, such as chemotherapy or surgery. In some cases, a patient may receive more than one type of radiation therapy.
2.) When is radiation therapy used?
Radiation therapy may be used to treat almost every type of solid tumor, including cancers of the brain, breast, cervix, larynx, lung, pancreas, prostate, skin, spine, stomach, uterus, or soft tissue sarcomas. Radiation can also be used to treat leukemia and lymphoma (cancers of the blood-forming cells and lymphatic system, respectively). Radiation dose to each site depends on a number of factors, including the type of cancer and whether there are tissues and organs nearby that may be damaged by radiation.
3.) How does the doctor measure the dose of radiation?
The amount of radiation absorbed by the tissues is called the radiation dose (or dosage). Before 1985, dose was measured in a unit called a "rad" (radiation absorbed dose). Now the unit is called a gray (abbreviated as Gy). One Gy is equal to 100 rads; one centigray (abbreviated as cGy) is the same as 1 rad.
Different tissues can tolerate various amounts of radiation (measured in centigrays). For example, the liver can receive a total dose of 3,000 cGy, while the kidneys can tolerate only 1,800 cGy. The total dose of radiation is usually divided into smaller doses (called fractions) that are given daily over a specific time period. This maximizes the destruction of cancer cells while minimizing the damage to healthy tissue.
The doctor works with a figure called the therapeutic ratio. This ratio compares the damage to the cancer cells with the damage to healthy cells. Techniques are available to increase the damage to cancer cells without doing greater harm to healthy tissues.
Progress being delivered
With all that, here we are. 1.2 Gy, 2.4 Gy, 3.6 Gy, and now 4.8 Gy of radiation delivered so far. And on Friday (1/18/08)? 6.0 Gy, and then 7.2 Gy. We are slowly doing the deadly damage. Amen.
Intelligently, aggressively, we are striking back hard against this fickle, fast-growing brain cancer which can strike anyone. We love life, which is why we are collectively fighting so hard.
