The Mask (Radiation 101)

I left class a few minutes early today (sorry, Cinda!) so that I could be with Tony for his appointment with the radiation oncologist at the Cancer Center. I particularly wanted to be there for this one because we'd be discussing all the radiation stuff, which is still new to us.

In the next week and a half or so, Tony will be starting daily radiation treatments (Monday - Friday) and weekly chemo (yes, that again - luckily he doesn't have to wear the pump home for this stuff). This will go on for 7 and 1/2 weeks. When he goes in for the treatments, he'll also be getting a daily injection of a drug called amifostine (Ethyol). This will be given subcutaneously (under the skin), and it is designed to preserve the function of his salivary glands during the radiation. This is important because radiation is pretty vicious, and tends to lead to dry mouth, swallowing difficulties, increased risk for cavities/dental problems, etc. So while it will really stink to get a shot every day, we hope in the end the drug does what it's intended to do. Amifostine also can cause nausea/vomiting and a drop in blood pressure, so they'll be monitoring his BP frequently and he'll pop a good ol' Zofran (anti-nausea med) before going each day.

The radiation treatments themselves are called IMRT or "intensity modulated radiation therapy." Basically the idea is to use a CT Scan to place the radiation more closely to the affected tissues while preserving as much normal tissue as possible. Here's a good link I found with some more info: http://www.radiologyinfo.org/en/info.cfm?pg=imrt

So after the question and answer session, Tony went back into the CT area to have his mask made. This involved him lying on the CT table for about 45 minutes while the technicians did what they needed to do. He said the worst of it was that he had to place a contraption under his feet to pull his shoulders down into the proper alignment for the mask to be made, and this was really uncomfortable to hold for 45 minutes.

The mask itself was a plastic mesh material, which was warmed and then placed on his face and conformed to him. Some people get anxious when this is done, as it can induce claustrophobia because you're fastened to the table. Tony, however, enjoyed it and said it was the closest to a spa treatment he'd ever had. Go figure.

He also had a bite guard in place during this process, which is designed to move the healthy tissues away from the planned field of radiation (he'll be wearing this during treatments too). Oh, and the best part of the whole day? Tony got a tattoo! It's not a very exciting one, mind you...it's a dot. Literally no bigger than the period at the end of this sentence. But it's in the middle of his chest and will help them align the mask properly. We may have to get a more exciting one when this is all done.

At any rate, it will take about 7-10 days for them to complete the computer modeling necessary to begin his treatments. When this is done, the Cancer Center will let us know, and then we'll know when the radiation will start. Please continue to keep us in your prayers, especially for Tony to have minimal side effects. We love and appreciate you all!