Medusa and me
A couple of people have asked for details of how the radiation treatments work, so I wrote this out for one of them, and figured I would copy it here in case y’all found it interesting or useful.
So, the treatment process is like this: you go in, partially undress, and lie down on a table. You put your arms over your head (there are handles to hold on to) and there's a special pillow that is molded to each patient (They use a vacuum and you get your own personal pillow.) so you're in the same position every time. There's a knee support too, so it's a little bit like a massage setup. But on a hard metal table with a sheet on it.
The techs slide you under the machine, and use targeting lasers matched against your tattoos (or stickers, for the first couple of sessions and if you opt not to get the tattoos, but the stickers are awful and gave me a rash and they itch. Some people don't do tattoos for religious or personal reasons, and they have to endure a little more discomfort, alas). There are four tattoos, which with this system don't look like the traditional dot pattern--I just have a blue mark over my sternum, one under my breastbone, and one on each side of my ribcage. The techs use the sheet to move and roll your body to line up the lasers.
Then they leave the room and close the vault door so they don't get what I have, only worse.
Machine is on a giant gantry arm that spins and moves up and down and the whole thing looks like something out of Aliens crossed with a stand mixer. The table is on a slider and can raise and lower remotely. In addition to the particle cannon, Medusa has prehensile arms that contain imaging equipment--X-ray and CT scan. These also move around you, and can rotate and turn. The treatment I missed was because the imaging system was down. They do a live image of the treatment area while the treatment is in process, which helps them not zorch important stuff. Like your ribs and lungs and heart.
I get an x-ray: they save the CT scans for people getting internal treatments, I think.
Here's a promotional video from a hospital very excited about their new bug zapper.
Medusa is basically a proton cannon--an actual LINAC, which I think is intensely cool. She shoots protons into my boob, which theoretically kills any escaped cancer cells. I'm getting 24 full-breast treatments and 8 what they call "boosts." which just irradiates the tumor bed, to help limit the damage to my skin and internal breast structures. Her mixer head rotates around you into various configurations, with the imaging head and target moving independently. Medusa's business end has a series of lead gates or combs that look like teeth. They come down across the beam (lens? I don't know what they call that bit.) to shape it so it only touched the areas that need treatment. It zaps several times from various angles--one below and to the side, one above where I can watch its little teeth slide up and down. There's one angle that I find a little scary because while Medusa is rotating into position it feels as if her head is going to snap my arm. But of course that doesn't happen.
The whole process takes about fifteen minutes. You’re not supposed to have any sensation during the treatment process, but sometimes I have a vague feeling of warmth inside the breast.
Side effects so far are some skin burns, edema (also a side effect of the surgery), color change and soreness to the areola and nipple, occasional sharp weird pains that go away again quickly, fatigue and inability to focus that comes and goes, and cheddar cheese tasting like swiss. (I'm not kidding! I seem to have lost some of my palate--this usually comes back again after treatment and recovery.)
Long term side effects might include changes to the texture of the breast, the breast getting smaller or larger due to scar tissue or swelling, and a permanent suntan. This treatment modality reduces the chances of bone damage, or damage to the heart and lungs. I'm really lucky to be getting this--it's pretty new and not every hospital does it.
The treatment is 2 grays a day for 32 treatments, so 64 grays in all. A dose that would literally cook me if it were aimed at my whole body. 5-6 grays is a lethal dose for a healthy adult. I try not to think about this part too much: this machine is actually quite terrifying in its capabilities.
After the treatment is over, there's expected to be about a month of recovery where radiation symptoms persist while my body repairs itself.
So there's far more than you wanted to know about proton treatment. :D
Best,
Bear