Preparations for treatment

It has been a busy few days as I have been getting things pulled together. My first radiation session is scheduled for this Thursday 2/12, and I will have sessions 5 days a week for 8 weeks. So if all goes well, I’ll be done on April 9th.

Visit to the dentist. For neck cancer patients, radiation therapy weakens the jaw bone to a point where it will be unable to support dental implants for at least a couple of years.  So the radiation oncology doc at Georgetown said: “Go to this dentist. He knows all about neck cancer-related issues, and will take good care of you. Don’t go to your regular dentist because they won’t know about this stuff.” Sure enough, Dr. Razavi DDS of McLean, VA, has been working with neck cancer patients for over 20 years, and quickly convinced me that he knew what he was doing. After a brief discussion about the pros and cons of leaving behind a wisdom tooth deep in my right jaw (that has never popped through the gums & hasn’t given me a moment of grief in 48 years), we decided to leave it in place since the radiation strength on my right jaw will be significantly less than on my left side (where the throat tumor is located). The good doctor also took molds of my top and bottom teeth for fluoride trays. Because of an anticipated permanent drop in salivary gland function, I will need to self-administer fluoride treatments from time to time for the rest of my days. During the radiation treatments, the fluoride trays will also provide spacing of 2-3mm between two gold crowns and my cheek. Apparently, the gold reflects the radiation beam and causes a very high concentration zone right next to those crowns, so the trays will protect my cheek from getting cooked. We wrapped up with a routine cleaning & a fluoride treatment, and I left with a clean bill of health from the doctor & a significantly lighter pocketbook (this guy isn’t in my insurance network).

Simulation. Positioning of the head and neck is very important when you’re trying to focus a high-power electron beam on a couple of smallish cancer tumors without causing too much damage to surrounding healthy tissue. So the simulation involved making a mesh face mask that will hold my head and neck in exactly the same position during a given session and from one session to the next. It looks like this:

radiation mask image

It begins as a flat sheet of moist mesh in a three-sided frame, and is stretched over the face and clipped into brackets at the base of the head. I am fortunate not to be claustrophobic, because that thing took about 20 minutes to dry and become rigid enough to remove. I also got a tattoo dot on my upper chest (unimpressive artistically, but my first body artwork nonetheless!) to assist in mask and body alignment. Simulation also involved another CT scan, which will apparently help the radiation team to program the radiation machine.

I go in tomorrow (Monday 2/9) for a PET scan that will (a) help to more accurately identify the radiation target area, and (b) allow us to see if the cancer has spread beyond my throat and neck. About an hour before the PET scan itself, a glucose fluid with a reflective/fluorescent marker with be given to me via IV, and the idea is that the glucose will be absorbed most by those cells that are working hardest (i.e. fast-growing cancer cells), so the cancer areas should light up in the scan. They asked me to eat a carb-light/protein-heavy diet today and then basically not eat tomorrow, so those cancer cells should be craving sugar by 2:00 pm tomorrow.

Thanks to all of you who sent your good wishes via Facebook & who submitted comments here. More soon.

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5 Responses to Preparations for treatment

  1. Nancy younger says:

    My thoughts and prayers are with you. You are intelligent and strong and will see your way through this From experience I can visualize and understand (although no one can thoroughly.if it’s not yourself ) what you are about to endure. I have seen the mesh face cover at cancer center. I am clostrophobic and they spooked me :). Love Nancy

  2. Jan Ellison says:

    I’m following your updates, Sean, and wishing you the best with all of this. I know you’ll lick it. And I’m thinking that mesh mask is going to make a killer costume on the playa some year soon.

  3. Paul Mallon says:

    Hey Sean,
    Sorry I don’t have a website….I barely can handle my flip phone. I appreciate your candor and dry humor about this trying ordeal. I think it helps to share information…its empowering. We are going through a cancer issue with my wife’s father, Larry. Easter egg-sized tumor in the right frontal lobe. Operable and the surgeon has confidence that it will be excised and the follow on treatment will be effective. Slow-growing and explains a lot of strange changes in personality, responsiveness, implusiveness, etc at 82 yrs old. Case in point….he just went out and bought a new Buick Regal on a whim. Now we have some context on what was going on “up there”…..
    Our prayers are with you and the family. Keep the high spirits and motivation. I am convinced that 90% of the battle is mental. Keep us updated, please.

    Paul & Linda Mallon (Evans GA)

  4. Andrea says:

    Thanks for posting a picture of the mask–not quite what I had envisioned. Yeah, you know I would’ve been sweatin it big time not being able to move under it–good for you!

  5. Mom & Dad says:

    Good to talk after your first radiation and chemo specialist visit. May all days seem as uneventful as today! We bless you from afar!

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