First Radiation Cycle

Radiation Started

Today was the big day – the first radiation cycle at Juravinski Hospital. This was a bit of an introductory day for us and for the team there. All in all, it’s a very simple and quick procedure. We were told to expect about 30 minutes of time and some waiting. Neither of these were true. Once we got in to see the technician and her assistants it was going to be another 15 minutes. This was not true either. These teams fly through the patients and today was no exception.

They fitted Cindy in her newly minted mask (see the photo below), and did a bunch of initial line up, watching telemetry on screens around the room, and accuracy testing before kicking off the actual procedure. This estimated 15 minutes took literally all of about 5 minutes and we were walking out of the hospital. Lightening fast, which is good considering there are 19 more of these sessions to go!

The Mask – Jim Carrey Style!

Now — this mask. You can see in the picture above it’s quite the large apparatus and movable table Cindy is placed on. The big circular thing beside the technician actually moves around the patient and there is an opposing unit on the other side. These deliver the radiation. In her case, there is also a special mask being used to hold her face absolutely still. If she wasn’t, the required highly accurate radiation wouldn’t be possible. Here is a picture of the mask up close and the green lasers used to align and guide the machine on the mask also. Those pieces of tape (I’m sure medical grade tape:) are also used to align the machines.

She can see and breathe quite easily as it’s not ratcheted down super tight. Just enough that alignment is consistent, and movement is minimized to the most extent it can be. In terms of the procedure itself, there is no pain, no feeling, no nothing really. Just beautiful waves of invisible radiation penetrating the eye and killing the cells.

No Cyberknife

As we noted in an earlier post regarding the use of the “cyberknife”, it has been decided to not actually to use this device. Not to say this is “just” regular radiation, because there is nothing “just” about it. However, this is the more general radiation machine that is used on cencer patients. In this case, they are focused on the eyes of course. With the cyberknife the teams would have had to enter the eye via the lens (the front – where you actually see out of). Having this much radiation transit the lens (and cornea — thanks Mary for the proper term), the team felt was possibly detrimental to the eye. They decided it better to enter from the sides basically to protect the lens.

The other piece of important information is the accuracy of the treatment. The Dr’s are concerned about a 1-2mm (1/32nd-1/16th of an inch for those imperial folks) section of the optical nerve and ensuring that they get enough of it, but not so much that it might preclude further radiation of the brain in the future. That’s not to say they expect to do brain radiation, it’s simply being prudent to ensure that option is always available to her. So to get a sense of how finite that space is, it’s basically the diameter of a pinhead! Not much margin for error.

Treatment Cycle

The entire treatment cycle looks like it should run 20 days, in 5 day blocks (M-F) with 2 days off (S,S). In theory, in 4 weeks from this should be done! Fingers crossed. The doctors did decide to do a longer plan but with the same radiation amount. Think of it as 40 “units” of radiation. This can be given as 1 dose of 40. Or 4 doses of 10. 8 doses of 5. And so on. The magic number is “40” and any combination that gets you there, has been proved to kill the cancer.

Obviously 1 dose would be great, but, as you can imagine that would be pretty massive and too much for the eye. It’s different in solid tumours for example, but a sensitive organ like the eye they like to be cautious. Often we’ve read of 10-15 cycles. In our case the doctors wanted to be even more cautious and opted for 20 cycles. No issues there for us, we don’t mind playing it safe.

Anyway, that’s the quick update. Lots of hospital visits over the next 4 weeks. Short but sweet visits. More updates soon.