My four weeks of radiotherapy finished today and I have been almost completely free of any side effects. My biggest problem has been tiredness. This was already a side effect of the monthly Prostap injections (which continue) before it was increased by the radiotherapy. It was also a consequence of reduced and disturbed sleep caused by the need to get up several times each night to visit the bathroom. Fortunately I am able to cope by having a nap from time to time during the daylight hours.
As you may have gathered, from earlier parts of this series of posts, I have been fascinated by all aspects of my treatment and especially by the amazing technology that has been brought to bear. Well, Velindre Cancer Centre in Cardiff (the proud capital of Wales, UK, for the benefit of overseas readers who may not know) kept the biggest treat until last. Its brand name is Elekta Synergy and it is a linear accelerator, usually abbreviated to Linac.
The picture below, taken with the kind permission of the radiographers at Velindre, shows “Linac 3” on which I received my treatment. In simple layman’s terms the basic function of a Linac is to fire high-powered and very accurately focussed X-ray beams at cancer cells within the patient’s body, thus damaging those cells irreparably while minimising damage to healthy cells nearby which, unlike cancer cells, are capable of recovering from such damage.
The “bed” is capable of multiple adjustments, up, down and sideways (among others) and to achieve the essential accuracy the patient is moved by the radiographers to exactly the same position on the bed for each treatment, with feet touching and remaining in contact with the red footrest and the blue headrest adjusted to suit. Positioning is aided by tiny permanent marks made on the patient at the planning meeting which can then be used in conjunction with green “gridlines” projected by lights in the cross-shaped apertures in the ceiling and side walls of the treatment room.
With the bed raised and the patient in position, and remaining perfectly still for the few minutes of the treatment, the radiographers depart to their workstation outside the radiation-proof treatment room, where the treatment procedure is controlled on monitors and keyboards. From the patient’s point of view it is painless and relatively quiet. The Linac hums as it revolves (note the circular “mounting” on the wall) around the bed, hisses slightly as it focusses and then buzzes as the treatment is being applied. To get an idea of how the Elekta Synergy LINAC can be moved in relation to the patient on the bed, have a look at this YouTube video, which lasts about 4 minutes 50seconds. It provides a summary of the whole external beam radiotherapy treatment but the part showing the LINAC in action starts at about 3 minutes 16 seconds. For a more detailed explanation of the internal workings of the LINAC try this video. Do have a look at these videos as they will help you to make sense of my brief explanation.
Radiotherapy usually lasts between four and seven weeks and takes place daily except on weekends and Bank Holidays. I had twenty treatments (four weeks), each consisting of several beams from above and both sides and also a scan (also on the Linac) every few days, presumably so that the radiographers could assess progress.
I must give enormous credit to the radiographers. They worked in pairs and I don’t think I saw the same pair two days in succession but it didn’t matter. They were all brilliant without exception. They couldn’t have done more to make me feel at ease.
It is extraordinary how lucky I have been. First, my prostate cancer was discovered only because Granny-Anne prompted me to go and get the general check-up that I had been merely thinking about for some time. Secondly it was discovered before it was sufficiently advanced to cause very much alarm. Thirdly, we had moved only just over three years earlier to Cardiff, the home of a major centre of excellence where cancer research and treatment are concerned, namely Velindre Cancer Centre. We had lived around 90 miles away previously but now we are about 20 minutes drive from the hospital. Finally, the various procedures involved in my treatment would have cost a fortune had I been required to pay for them, not to mention the advanced nature of many of those procedures and of the equipment used. The cost of a Linac alone, together with its ancillary equipment and special accomodation wouldn’t leave a great deal of change out of two-and-a-half to three million pounds. Yet it was all used on me for free, thanks to our great National Health Service. What a shame that both the present and previous governments have set in motion the destruction of the NHS as we have known it these past 60+ years.
There will be nothing to report now until I see my doctor at Velindre in mid June to find out how successful the treatment has been and for how much longer I will be having the Prostap injections.