(G)Rad School

Booby school was three months ago, and now that I'm about to graduate from surgery to treatment, I feel as though I'm beginning my advanced degree in all things cancer.

It turns out ionizing -- or high energy -- radiation can be delivered alone or in combination with surgery or chemotherapy, and internal or external to the body.  I'll take the surgical/external combo platter, hold the chemo, please.  With a side of Tamoxifen (and a Diet Coke, natch).

Radiation damages a cell's chromosomes, preventing division and growth -- which is great for cancer cells, but not so sexy for normal ones.  So, the idea is to focus on the tumor, or tumor bed, if the tumor's been removed (...the tumors were nestled all snug in their beds...), and steer clear of the surrounding tissue.  The total dose is divided into fractions -- small daily doses -- in order to allow the healthy cells to recover and repair themselves during the course of treatment.  (My geeky heart was happy to learn that a unit of radiation is a "Gray", named for Louis Harold Gray, who invented the field of radiobiology.  100 units are a centiGray.  But I digress.)

Before my radiation plan can be finalized, I'll undergo a CT scan, which will allow the radiation team to see 'slices' of my body in the treatment area -- including my internal organs, as well as the boob in question.  The plan design is more complex than simply the number of treatments and the dates and duration over which they'll occur.  The radiation oncologist, therapist, nurse and physicist powwow about the number of beams they'll use, and the angles at which they'll direct them at my breast, in order to hit what they want to without also targetting my lungs, heart and spinal cord.  Only once they've sorted out the details will my 30 dates be confirmed.

The day I have my scan, I'll also be tattooed, so the technicians can position the beams in the same place each time I'm on the table.  Apparently, the tats are freckle-sized dots, applied by someone in a white coat.  So, the leather-clad, ponytailed biker inking in the kanji for "lopsided" turns out to be a pigment of my imagination.