They Zapped My Brain!

What is it like to have cancer in your body with no symptoms?  Even with chemotherapy and immunotherapy, the only real side effect was losing most of my hair, but I never got truly bald.  Sometimes I feel embarrassed to tell others that I feel good.  I have energy and have made a point of reaching out to people, even entertaining them in our home.  I know this is highly unusual.  I see friends of mine who are struggling with their cancer diagnosis, and I am doing my best to be of encouragement to them.

The last week of May I got fitted for my mask for the stereotactic radiosurgery procedure.  This is not really surgery but a radiation procedure.  The mask is a mesh product that is placed in very warm water.  It is then laid over my head, and the technicians smooth it to follow every curve of my face.  Therefore, I could not open my eyes or mouth.  They left me there for a short time for the mask to harden before they came in to remove it.  I then was given a brain MRI.  Now with that completed, the work went to a Medical Physicist and Dosimetrist.  

The Medical Physicist ensures that the radiosurgery equipment is precisely calibrated. They perform complex calculations to verify that the planned radiation dose will be delivered with millimeter-level accuracy.   

The Dosimetrist works closely with the physicist, and designs and builds the computer-generated 3D treatment models that calculate the exact angles, shapes, and intensities of the radiation beams used in the procedure. So, these are very smart people who do a lot of mathematical calculations to make sure I am safe.

The Radiation Oncologist is the doctor who designs the radiation treatment plans, determines the exact target location and prescribes the radiation dose, ensuring maximum impact on the tumor while sparing surrounding healthy tissue.  I think they are the one who presses the button!

In the meantime, I started my immunotherapy treatments.  It was the same routine as my chemotherapy.  I start at the lab to get a blood draw.  Then an hour later I meet with the advance practice nurse to go over the labs and discuss any other things we might need to talk about.  Then to the infusion area for just a one-hour infusion of the same immunotherapy medication I had received when doing chemotherapy.  Since there was no bad reaction to the meds in the past, it was the same scenario with just the immunotherapy.  

On a fun note, a volunteer stopped by and said that I had won a box of Girl Scout cookies!  What a lovely surprise.  I don’t have a Girl Scout hookup, so getting one of these boxes was a treat.  I requested Thin Mints or Samoas, but unfortunately, her stash did not include the super popular flavors.  I chose the new flavor of the year, Exploremores.  It’s supposed to taste like rocky road ice cream.  Not so much.  Maybe a 10-year-old imagination might make it seem like my favorite flavor of ice cream.  On the other hand, I won a whole box—for free—no strings attached, so I popped open the box and shared cookies with Dennis and my nurse.  

Finally on June 8 the smart folks had the calculation complete for my radiation treatment.  It is very important they get these calculations correct.  The larger of the two lesions in my brain is fairly close to the hippocampus.  

If you have heard of the word but don’t know exactly what it is, I will tell you what it is not.  It is not where hippopotamuses hang out at the zoo.  I had to look that one up because I thought the plural was hippopotami, but learned the other is more acceptable in the English language—who knew?   Hippocampus is also not the University of California at Berkley—the campus where the hippies hung out in my day!  I had to research the name hippocampus because hippopotamus means “river horse.”  Here is what the National Institute of Health had to say about the term hippocampus. “The term was adopted into anatomy by the Italian anatomist Julius Caesar Arantius (Giulio Cesare Aranzi) in 1587. While dissecting the human brain, he noticed a curved ridge-like structure in the temporal lobe and thought its curled shape and horn-like appearance strongly resembled a seahorse.”

According to Dr. Google, the hippocampus is “the central processing hub for memory consolidation, spatial navigation, and emotional regulation.  It processes short-term memories and transfers them into long-term storage across other regions of the brain.  It acts as an internal GPS remembering directions, and navigate familiar routes, and it links specific memories to emotional states, helping to contextualize experiences and trigger physiological responses (like fear or joy) when a memory is recalled.  Therefore, it is very important that there be no damage to my hippocampus.

To make a correction from the previous blog, I was not getting the Gamma Knife (Coca Cola) procedure, although I said I was getting the Pepsi Cola procedure.  Gamma Knife is a brand name procedure.  I will not turn into the Hulk because of gamma radiation!n My actual procedure was on a machine called “TrueBeam.”  It does a procedure called “LINAC” which stands for Linear Accelerator.  This type of radiation machine, which uses photons.  Simple explanation of photons is that a photon is “the smallest possible packet of energy, acting as the fundamental building block of all light and electromagnetic radiation. Because it has no mass and no electrical charge, a photon travels through space at the ultimate speed limit—the speed of light,” once again, per to Dr. Google.  

According to MD Anderson, “Proton therapy is an advanced type of radiation treatment that uses a beam of protons to deliver radiation directly to the tumor, destroying cancer cells while sparing healthy tissues. Protons enter the body with a low radiation dose, stop at the tumor, match its shape and volume or depth, and deposit the bulk of their cancer-fighting energy right at the tumor.”  It is different that the Gamma Knife that uses Colbalt-60 which produces gamma rays.  That’s the best I can tell you.  

This might be an easier explanation from some hospital’s YouTube channel. https://www.youtube.com/watch?v=R1aXtIEDDAc

Back to what happened with me:  I arrived back at MD Anderson Cancer Center Monday, June 8^th.  There was no prep for this procedure—no going without food or water, no putting Lidocaine on my port for painless insertion.  Just show up.  Dennis and I were ushered into a room with a huge machine—huge like a CT scanner or the MRI or PET—except this one is called the TrueBeam (LINAC), a Linnear Accelerator. I had Dennis take a couple photos before he was escorted back out of the room. 

I was laid on the table, and I put the mask over my face.  The radiology technician then snapped the mask to the machine.  It was tight.  She told me to wiggle my face in it to get it to sit just right—there was hardly any wiggle room.  She asked what kind of music I wanted, and it really doesn’t matter to me.  I don’t like music during the MRI procedure because the banging and knocking the machine makes (even with earplugs and a headset) is not in rhythm with the music being played, and I find it annoying.  The LINAC machine doesn’t really make much noise, so I told her the Yacht Rock they were playing already was fine.  They handed me a foam ring to hold with both hands which keeps me from moving my arms or body while the machine is running and covered me with a warm blanket that stays warm for a whole five minutes.  

All of that is okay because when I have these quiet times of procedures that are long, I find it a good time to have a chat with God.  Seriously, that is what I do.  I decided I wanted to tell him about all the people in my family I love so much and how much they have been there for me in the last few months, and how grateful I am for them in my life.  He already knows all this, but I know he also likes when we are grateful, and I give God the glory for these blessings in my life.  It’s funny how that sped the time right up—I had gone through my list of family and everything about them that I am so grateful for when the technician came in and announced she was going to give me a small break.  She unclicked my mask and we chatted for a few minutes.  Then the mask got snapped back on and the machine started up to zap lesion #2.  In all, I was zapped for less than 30 minutes.  No pain, no discomfort other than I could not move.

Now I wait.  I will have a new MRI done on July 28, the same day I will have a body CT scan to see how well all the treatments are working.  Also, in the meeting with the radiology oncologist after the treatment, he stated that he was not telling me that I couldn’t drive for a month, but there is a rare chance I could have a seizure within 30 days of this treatment.  If there is any way I can have other people drive me around, he would encourage that.  Dennis and I both thought that would be the best also.  Why take a chance that something could happen while I am driving?  This would be very dangerous not only to me, but to others.  Fortunately, we go most places together anyway.  In the rare moments where he and I have to be somewhere different, I will try to find someone to drive me.

As I live in this weird state of looking well and feeling well, the truth of the matter is that there is something very sinister growing inside my body.  I cannot ignore that fact, as much as I would like to.  

Your prayers for me are appreciated: 1) that these tumors in my brain will shrink and die, 2) that I will not have any severe side effects, especially seizures, 3) that the immunotherapy that I am receiving will continue to do its work to shrink existing tumors and not make new tumors in my lungs, liver, brain, or anywhere else these things like to hide out in my body, and 4) that I continue to have strength to live my life praising God for his mercy and serving others which includes my family, friends, and especially so many family and friends who are going through cancer treatment and are really struggling.

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