Home » Mark Arsenault » Part 4: Radiation and Chemo and Ultrasounds, Oh My!

Part 4: Radiation and Chemo and Ultrasounds, Oh My!

Originally published August 09, 2009


Last Monday, August 3rd, I had my consult with the radiation doctor. I got a run down of the treatment plan and was scheduled for a couple more tests. The following day (Tuesday) I went back in for the preliminary CT scan. For more details, read on.


Let it Glow, Let it Glow, Let it Glow

When I arrived at the South Sacramento Cancer Clinic for my consultation with the radiation doctor on Monday I went in, filled out some forms and waited for my name to be called. A short while later I was taken back and introduced to the newest addition to my “team” of physicians. She’s a nice older Jewish lady, with a grandma-esque quality about her. To round out the picture she also has a hint of an East Coast accent. I’m from Massachusetts originally so her overall presence was calming to me.

We talked about the radiation treatments, coupled with chemotherapy, and all of the possible side effects. The side possible effects range from fatigue to hair loss (all over the body, not just the head) and inflammation. The treatments will be five days a week (except holidays) for five weeks.

While the possible side effects are somewhat frightening, the reality is that I will be receiving a “pre-operative dose” of radiation, not a “curative dose.” Essentially, I’ll receive half the cumulative dose of radiation that someone with prostate cancer would receive. As a result, I’m told I will likely see few side effects and most of those will likely be only toward the end of the treatment program.

I asked about the possibility of gaining super powers from the radiation. She said with a smile, “I haven’t seen that with a patient yet.” I still haven’t given up hope that I may yet gain the ability to fly, cling to walls or turn invisible.

The goal of the treatments is to kill as many cancer cells as possible and reduce the size of the tumor prior to the surgery. My newest doctor (“grandma”) told me that this has been shown to be the most effective treatment for this kind of cancer. Different doctors have made encouraging comments about this treatment, including one who said “Radiation will dramatically reduce the size of the tumor. That’s good.” Damn straight, that’s good! So I remain optimistic.

The doctor gave us a new packet with information brochures and other papers, including a kit for completing a Living Will. I plan to get that done soon. If getting colorectal cancer at age 42 has taught me anything it’s that it’s not a bad thing to be prepared for the unexpected.


What’s One More CT Scan Between Friends?

The next day I went back to the Cancer Center to have a preliminary CT scan done. I went in, changed into the gown and laid down on the scanner bed. There the technician lined me up ever so precisely, using red laser beams that were projected onto the bed (and me) as a guide. As I lay there, face down, and the table started to move I couldn’t help but imagine myself sliding across the scanner at the grocery store and wondered what would show up on the register. A price? “Item not found?”

The technician marked three Xs on me with a Sharpie – one on each hip and one around the bottom of my tail bone. These he covered with small circles of surgical tape. Before my first treatment they will mark small “tattoo” dots on my skin where the Xs are, for use with aligning my body for the procedure. It’s strange to think of having permanent markers as a reminder of this period in my life. But not as strange as the thought of dying. Given the option, I’ll take the tattoo dots.

In regards to the procedure itself, they’ll be shooting three powerful “X-Rays” at the tumor, from three different angles (thus the three Xs). The beams will all go through the tumor, giving it the full, cumulative dose of all three beams. Any healthy tissue in the path of the individual beams will only have one third the total dose thus minimizing damage to healthy tissue.

Five days a week for five weeks.


Things to Come

My appointments will be in the afternoon, so I plan to keep going to work, like normal, just leaving a few minutes early each day for the appointment. The treatments will only last 10 minutes or less, I’m told, after which I’ll head home to rest up for the next day.

Barring any new found ability to fly or teleport I’ll be driving myself to and from work and the treatments. It may be that no one notices any changes in me. That would be great.

Whatever happens, I am ready to begin this stage. I have felt held in the grip of uncertainty and a little fear, and not a little anger, since the discovery of the tumor on July 17th. I am a fighter. I hate feeling helpless. Anyone who knows me knows that I would much prefer to confront an issue head on. That includes this issue. I’m ready to start the bombardment of this foreign invader.


Once More for Old Time’s Sake

Friday, August 7th, I headed over to the Morse Avenue hospital for yet another procedure. I was heading for another (partial) sigmoidoscopy with an ultrasound. The idea is to determine if the tumor had grown through the wall of the colon and, if so, how far.

This condition seems to bring out the need for all manner of digits and machinery to be inserted into one’s nether region. Why all these doctors can’t get together and take care of all these things during one procedure is beyond me. But I digress.

I found the people at this facility to be less friendly than at my regular facility. I likened the experience to moving cattle through wooden chutes and into pens and onto trucks.

The procedure itself was much like I had gone through before. It was painful, and there was much cramping and grunting. Frankly, if we could legally use this procedure to obtain suspect statements in law enforcement we would see a huge increase in confessions and conviction rates pushing 100%.

Did I mention that I hate these procedures? One was bad enough. Three in as many weeks is over kill.

Afterward the doctor said “I’m sorry for the discomfort.” All I could say was, “It’s necessary. I need to beat this. It’s one step on the way to killing it.” He looked at me for a moment and nodded.


All in All It’s Just Another Brick in the Wall

The ultrasound showed that the tumor has, indeed, grown through the wall of the colon and that “it may be impinging on the intestine.” The doctor could not confirm the latter. Perhaps the upcoming PET scan would shed more light on it. If not, then they will know once I’m in surgery.

It is what it is. One step at a time.


PET Scan

That brings us to today. This morning I went back to the Morse Avenue hospital for the PET scan. No eating or drinking for six hours prior to the procedure. No problemo. I’m a pro at the whole no eating, clear liquid diet, flush out your colon thing, so this was a snap.

After being dosed with radioactive glucose and “marinating” for a half hour, I went in for yet another CT scan (this makes three now) plus a comprehensive PET scan. The scan itself lasted about a half hour, during which I fell asleep (requiring the technician to come in and wake me up so I could hold my head straight).

After a few hours, everything was done and I headed home. I’ll find out the results of the PET scan from one of my army of doctors in the coming days, I’m sure.


The Days Ahead

My next – and final – appointment before my treatment begins is this Tuesday. I’ll be having a consultation with the Oncology folks about the chemotherapy. My radiation doctor tells me that I may be given a pump to wear (ick!) but that I will more likely be given the option of chemo pills to take.

Pills are good. I’m sick of getting poked.

The chemicals in the pills apparently go into your bloodstream and, upon reaching the liver, are converted to the “chemo” chemical that kills the cancer cells and makes them more susceptible to the radiation. Of course, the same stuff also can make your hair fall out, make you see sounds and smell colors, etc. But like I always say, one step at a time.

After that, the following week, I will begin my treatments.

After this flurry of consultations and procedures I am so ready to start zapping this cancer, I can hardly express it. All of my discomfort, lack of sleep, and emotional ups and downs I try to channel into a kind of aggression toward this tumor. I want it dead, though I’ll settle for shrunken down and excised.

I would be remiss if I didn’t recognize some of the people who have helped make this journey more bearable. Of course my wife and mother, who have always been stalwart supporters of mine and helped see me through all manner of B.S. through the years. I want to extend my appreciation, too, to my extended family, friends and co-workers, who have given me added strength from their words, thoughts and prayers.

I love you all.

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