How Does Radiotherapy Work?

/edit @630PM

To Uncle J and Aunty AK (pretty sure you both will be reading this hehe):

Thank you so much for the lovely flowers, they were a wonderful surprise. Very touched by the handwritten note as well; really appreciate your kind words of encouragement and support. Would love to thank you both personally next time. God bless!

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Radiotherapy means the use of radiation, usually X-rays, to treat illness. X-rays were discovered in 1895 and since then radiation has been used in medicine for diagnosis and investigation (X-rays) and treatment (radiotherapy). 

Doctors have a lot of experience using radiotherapy in medicine. About 4 out of 10 people with cancer (40%) have radiotherapy as part of their treatment. It can be given in various ways, including from outside the body as external radiotherapy, using X-rays from linear accelerator machines, electrons, and more rarely other particles such as protons. 

Radiotherapy destroys the cancer cells in the treated area by damaging the DNA within these cells. Although normal cells are also affected by radiation, they are better at repairing themselves than the cancer cells.

Source: Cancer Research UK

I have gone for 3 radiotherapy sessions so far, and it has been really manageable. It is always at the same treatment room, with the same staff. That's really good because patients feel comfortable. Also, when you look up at the ceiling, there's a giant projection of a mountain and the sea. Makes you feel like you're on top of a mountain!

Did I mention that they play pop music too? It's great as it feels as if time passes really quickly. The second session was as long as 2 Bruno Mars songs, and 1 Capital Cities song. The third session played the extended version of Justin Timberlake's Mirrors... and as soon as the song ended I was already done! For one of the sessions, classical music was being played for another man who had treatment before me. Before my session started:

Me: Eh what happened to the pop music?

Radiotherapist: Haha, you like ah? Ok play for you.

Teehee now I use songs to have an inkling of how long every treatment takes.

In total, I'll have to go for 17 sessions. My last one will be on 20th March (my sister's birthday!). I was told that the first 4 sessions will be abit longer (~15 mins), and I'll have a doctor's appointment every Monday after treatment. Treatments will usually only last 5-10 minutes. As mentioned in the previous post, during treatment, I'll have to fit myself in the body mould and have my arms over my head. Most importantly, I can't move! I'll wriggle my fingers from time to time so that they won't freeze. 

When I get home, I'll apply lavender essential oil on the affected area, so that the skin will not be too dry. So far so good, no red patches whatsoever. 

Aaaaaand... I have to update everyone that my hair has been growing!!!! Eyelashes and eyebrows too. My eyebrows are actually growing so much I have started tweezing the stray ones lol. My head now is filled with baby hair hahaha I feel like a giant baby

Tadah!!! Shadow of my baby hair 

Flashback: While in SGH

Saturday, 13th September 2014

At Changi General Hospital, A&E

Only 2 weeks ago, but so much has happened. It was a Saturday morning, and I had woken up with a swollen face/neck and a terrible cough. I have been coughing (with on and off fever) for 3 weeks, and my face has been swelling for a week as well. After 3 trips to 3 different GPs, I wanted to go to see the sinseh (Usually that's what people do right? If western medicine doesn't work, TCM to the rescue!). That morning, my dad returned from a flight and was still shocked that I was still having 'flu' — and worse, with a swollen face. I was sent to A&E at Changi General Hospital after breakfast.

The doctor could not figure out what was wrong with me — could it be a drug allergy? But she ruled it out because I've been taking normal cough mixtures and panadols... If it were to be a drug allergy, surely it would have sprung up at least once the past 22 years. So I was sent for the full checks — X-ray, urine and blood tests.

I was on drip, resting on a corner couch, almost sleeping. And then I was gently shook awake... "Amanda, the X-ray shows a mass in your chest. Do you smoke/drink? Do you have a family history of cancer?"

The rest was a whirlwind. I was transferred to Singapore General Hospital in an ambulance — lying in the stretcher, I was breathing through a portable oxygen tank, having a drip, and clamping my legs over a mega machine which was apparently able to keep track of my heart condition (side track: I have Wolff-Parkinson-White syndrome since young, an abnormal extra electrical pathway of the heart).

I stared out of the window as the trees along ECP swooshed by. When I awoke, I was being admitted into SGH already.

Monday, 15th September 2014

In the operation gown, face still as swollen as ever

Major test day! I was going for a biopsy to find out what exactly the mass in my chest was. It was scheduled to be at 9am, and I had to fast from midnight. As they wheeled me from my ward into the waiting area, I was so nervous I teared.

I had two major concerns:

- If the biopsy were to be unsuccessful, they would have to proceed with surgery to get a 'sample' of the growth (i.e. cutting my chest open)

- What if it's cancer!!!!! (Yes, I still had the little hope that it was just a benign mass)

The biopsy only started at 1130am. The local anesthesia was injected four times to numb the area for the pin-hole operation. I was on the super flat operating bed, and it became really uncomfortable because I kept coughing... I coughed so hard my chest hurt so badly, and tears started welling up in my eyes (I was in pain because of the cough, and not the biopsy). All these while they were poking me with the biopsy needle.  It was to the extent of not being able to breathe properly, so the doctor decided to take a short break. He gave me the plastic mask (the kind for general anesthesia) to inhale something that managed to suppress my cough for awhile. Thank God the biopsy was done 15 minutes after that, because my coughing kept going on, I felt my chest was going to burst.

The doctor then inserted the femoral line at my groin area — it is thicker than the normal drip line, and needed to be stitched. This was going to be there until the end of my first chemotherapy cycle. This line would allow them to draw blood, insert the drip, insert my chemotherapy drugs etc (basically everything).

I was in a daze lying on the bed face-up, staring at the white ceilings as they wheeled me back to my ward — I only turned to my side when the nurse accompanying me touched my hand and said, "stay strong, okay?"

"Okay."

Tuesday, 16th September 2014

Went for even more scans/tests in the morning... but the afternoon one was the highlight of the day — the bone marrow test. This test is to show whether there are cancer cells in my bone marrow. I've heard from everywhere that it would hurt. Well, thankfully the pain was manageable. In fact, on a scale of 1-10, it's only 2-3! They had to inject local anesthesia three times though. Apparently my bone is VERY hard hahaha the female doctor, Dr Kaavya, had difficulty and had to even get the male doctor to help her out with the pushing of the needle into my hip bone. Well, she says it is a good sign that my bones are strong. It means they are healthy!

On another note, the gynaecologists came to speak to me about the option of taking out one of my ovaries before chemotherapy. There was a risk that chemotherapy would affect my fertility in the future. BUT, the operation for this is major, and requires general anesthesia. If I decide to go through with this, chemotherapy would have to be pushed back 1-2 weeks, as my body will need to recuperate after the surgery.

My first thoughts:

- Having children in the future is important to me — but with this, does my body have the luxury of time to push back chemotherapy?

Thursday, 18th September 2014

I woke up at 4am to go to the toilet. The lady at the next bed was struggling for her life. Through the 2-3 days that she was here, I have gathered that she has brain cancer. The whole nurse team and two doctors were by her bed — they even pushed a trolley with orange sides and an orange box. I have never seen this trolley before... it meant that it was serious. I turned on my side and managed a glimpse of her.

At 5am, I stirred from my sleep and saw that family members were already gathering at the next bed, saying their last goodbyes. I couldn't help but tear. When the nurse came by to draw my blood, she decided to move me to a private room for the morning until everything was over. That was very thoughtful of her — I don't think I would have been able to take it. Not right now. 

Have been taking steroids, which suppressed the cough and got rid of the swelling!

Anyway, they forgot to take my breakfast order the previous day... so I was eating oatmeal and bread (definitely not my first choice). Breakfast was supposed to be muffins! I tried my luck, and asked one of the nurses to check if there was any extra left in the kitchen. Well, there weren't any left — so after her shift, she kindly surprised me with a pack of 3 muffins from the bakery downstairs. Nurses are the best people on earth!

Highlight of the day: Joel is finally home for 10 days!!!!! So so blessed and grateful that he's back. I know I initially told him that I was gonna be okay on my own — but he flew back anyway. Besides my family, he's my other pillar of support and with him going through the first phase of chemotherapy with me, I won't be going to battle alone.

Decided that I would be starting treatment the next day. Dr Tiffany said that chemotherapy would have an extremely low risk on my fertility — this confirmed my decision to go on with treatment immediately and to forgo the removal of one of my ovaries. The surgery is complex, and there was even a risk of my heart stopping?! I don't need that! Plus, any form of surgery would definitely weaken the body, and I wouldn't want to fight a war that way. My first priority is to kill the cancer cells!

Friday, 19th September 2014

Chemotherapy starts today! Chose to go for the R-EPOCH treatment rather than R-CHOP. Well, it was created to reduce recurrence, and to diminish the need for radiation. CANCER CELLS BE GONE!!!

Have been looking and reading at what to eat (e.g. antioxidants), what to avoid... 

Also, used pinterest for hairstyles (pixie? bob?)... I contacted Lucas my hairdresser, and he was going to come on Monday to cut my hair! Pretty excited.