Getting Ready for the Heavy Weapons of Radiotherapy

This entry is part 25 in the series Victory in the Valley

Start at the beginning of the story

Now read on . . .

The time had come to commence radiotherapy. The one-hour drive into the Rand Clinic, a private hospital in the center of the notorious Hillbrow suburb of Johannesburg, went too fast. Rob and I prayed aloud in the car. Then we tried to keep up positive conversation. How much positive conversation can you think of on the way to the gallows? I wondered.

The streets of Hillbrow

It was almost a relief to spot the grey building of the hospital towering ahead of us. We drove through the litter-strewn streets and past the street vendors with their wares laid out on the pavement. We shook our heads negatively at the shifty-eyed hawkers who plied their goods at the traffic lights. Two outrageously dressed girls, who looked as if they should still be young, faces plastered with make-up, cheap jewelry hanging over black plastic jackets, seductively sauntered up and down the pavement. Their high-heeled black boots covered their knees and almost reached the hems of their diminutive skirts.

“Are those what I think they are?” I glanced at Rob’s silhouette as he concentrated on the heavy traffic.

“Yes.” 

When Rob and I had first married, we lived in a flat near here.

“How the area has degenerated through the years,” I remarked sadly. My gaze was drawn back to the building ahead, as Rob maneuvered the car into the parking lot across the street from the main entrance.

Advice of a friend

Raeleen, a friend who had been through radiotherapy a year ago, had warned me of certain things, for which I became extremely grateful. She told me that I’d be left alone in a room full of gigantic machines. “There is a heavy metal door which will clang shut as the technicians leave. “When the machines start to work, they make a hideous row.” She explained how no one had warned her, and the first time she received treatment, she got such a fright that when the machines started to work, she leaped off the treatment table in terror, causing total panic to the staff! “There’s absolutely no pain,” she reassured me. “You won’t feel a thing.”

Be prepared! This is not only relevant to scouts. It applies to cancer treatment. The more you know, the better you'll cope. Click To Tweet

“Just be prepared for being left alone, for the clanging door, for the noise,” she assured me. “You’ll be fine.”  

As we walked through the hospital entrance, I drew a deep breath, and held my head high. I can do this! Then—O Lord, help me through the next couple of hours!

A new game?

“Please could you direct us to the radiotherapy Unit?” As Rob asked the officious looking woman at the Inquiry Desk, I noticed her disinterested gaze moving from him to me. Guess the cancer patient, I thought wryly. What a fun game!

We entered the lift, and pressed 6 on the lift panel. I felt if everyone was gazing at me, instead of watching the lighted numbers ticking off our ascent. One by one the passengers got out. Everyone, except Rob and me.

I reminded myself that I was unique. They had never given radiotherapy to Shirley Corder, so I resolved to stay positive. 

Cultivate a scornful disregard for statistics. You are unique! There are no statistics about your life! Click To Tweet

Ping! The lift shuddered to a stop, the doors opened, and we caught our first sight of the room where we were going to spend a good deal of time.  Rows of identical, upright, comfortable looking seats lined the walls of a long, cheerful room painted in pastel colors. Several tables stood under untidy piles of old magazines. To my left was a smallish reception area, with a number of busy ladies ignoring the lift and the newcomers. Hesitantly we approached them.

Reception Committee at Radiotherapy

Eventually a lady glanced my way and handed me a clipboard. “Please fill in your details.” With Rob’s help I filled it in, including all sorts of apparently irrelevant information, and took it back to the counter. I gave the lady a bright smile, hoping to receive one in return. From her expression I realized she didn’t consider this to be a smiling matter. She wasn’t the only one.

Soberly I answered some further questions, and retreated with Rob to “sit over there and wait until you are called.”

In the corner stood a vending machine offering free coffee, tea, and drinking chocolate. How I longed for a cup of coffee. Surely, the fact that it stood in this room indicated I could help myself. Yet, I didn’t know what to expect. Could I drink just before the treatment? I didn’t want to do anything wrong. I looked at the frosty-eyed lady, and decided it couldn’t do any harm to ask.

A smile goes a long way

“Excuse me. Is it all right for me to drink coffee?” 

“I don’t know what you are allowed, it depends on your diet. You’ll have to ask your doctor.”

I looked in astonishment at the steely eyes, looking out through the empty window of the top half of her glasses. I realized she had misunderstood me, but I didn’t have the courage to try again.

A young clerk smiled up at me from the other end of the desk. “You’re welcome to help yourself. It won’t make any difference to your treatment if that’s what’s worrying you.”

“Thank you!” What a relief to see a smiling face. I walked over to the vending machine and poured us both some much-needed coffee. 

 

I couldn’t concentrate on a magazine, so I stared at my shoes and allowed my mind to drift over the illustration of my war with cancer. In the next room there were machines that I’d never seen before. These were the artillery, and they were preparing for my arrival. I pictured those cowardly cells hiding in the scar tissue of my breast and resolved to tell the machines where to look for them. 

How about you?

If you are facing radiotherapy (or radiation as it’s called in some countries) try not to be afraid of them, but to see them as part of the weaponry in your fight against cancer. They are not the enemy! They are there to help route out the enemy and restore you to health once again. 

How do you deal with suffocating fear? It doesn’t need to be a fight against cancer. We all have to deal with this  terrifying emotion at one point of another.  Please share your coping mechanism with me and with other readers.

 

Decisions about Chemotherapy and Radiotherapy

This entry is part 19 in the series Victory in the Valley

Start at the beginning of the story

Now read on . . .

When my youngest, David, came home, he came straight to the point, with the impulsiveness of youth.

“He’s a Christian. You like him. Dad thinks he’s the right guy. This is the right man!”

His elder brother Stephen responded gently. “Mum it’s your decision. We only want what is best for you. But he sounds good to me.”

Why am I not convinced? I was still uneasy. His practice is so small – why? I like the man. Lord, he’s one of your children; and yet …?”

Eventually after much agonizing, I concluded that I would probably not be happy with any other Oncologist either. I was launching into a totally unknown area. I didn’t know enough about the subject to make an informed decision. My husband was sure. I decided to be guided by my family, and nervously agreed to return to Dr. Meiring the next day.

Drive to Johannesburg

The following morning, we made the one-hour trip through heavy city traffic, to the smart new private hospital in the center of Johannesburg. As we walked into Dr. Meiring’s other consulting rooms on the third floor of the impressive new hospital, I felt much more at ease. In some strange way, this felt more like a “proper doctor.” Little did I know that within two months he would close these rooms, and move exclusively to working from home.

“I have spoken to three colleagues,” he eventually said, having spent the past half hour talking “Church” with my husband. Why do I resent this? I wanted to get on with the matter at hand. After all—I was the patient. The sooner he dealt with me, the sooner we could get out of this room. 

He meticulously wrote out for me, in a beautiful script, the three options of chemotherapy that the other oncologists had suggested. As I was to learn, no two oncologists ever seem to see things quite the same way. Dr. Meiring presented me with three possible chemotherapy regimes. Well really, it was four. He took some things from each suggestion, altered one of the drugs completely, and then doubled the recommended period of chemotherapy.

“This is not the traditional treatment.” I can see that! “But I believe it is the best possible treatment for you.” He explained that he believed I needed an entire year’s chemotherapy, divided into two full courses of six months each.

More than I wanted to know

The one course of chemotherapy comprised of the drugs Carboplatin and Navelbine, both drugs not normally given for primary breast cancer. The second  would be made up of CMF – a combination of Cycloblastin, Methotrexate. and 5 Fluorouracil.  He elected to give me Methotrexate in place of the more usual because of my history of Rheumatic Fever, as he said it could aggravate my heart damage.

When I indignantly told him my heart was just fine, he retorted, “No it’s not. You take medication for arrhythmia. There is something there. The medical profession just hasn’t found it. But I don’t want us to find it during chemotherapy.”

I couldn’t think of a suitable answer so wisely kept quiet.

“The Carboplatin regime will definitely cause your hair to fall out,” he continued cheerfully. “But not to worry—it will grow back better than ever. Sometimes it even comes back another color.” 

The choice I didn’t want

All my life I had complained about my deep auburn hair. I had never appreciated being a ‘red-head’. Suddenly I liked my hair very much, and I really didn’t want to lose it.

“The CMF might not take your hair out,” he continued, “but it will make you very nauseous. We will obviously give you something to counteract this, but you could still have some unpleasant effects to cope with.”

He leaned back in his chair. “First we need to get the radiotherapy behind us, then we will decide which formula we will use first. You can think about this.”

Whoopee! What a choice. Do you want to lose your hair first, then get sick? Or would you prefer to get sick first—then lose your hair? It didn’t seem like much of an option to me.

Tamoxifen

In addition to the radiotherapy and chemotherapy he also prescribed Tamoxifen tablets daily. Initially he said this would be for twenty years. Later he changed it to “at least five.”

Tamoxifen is an anti-estrogen, which is normally prescribed to people whose tumor have a positive estrogen receptor. In other words, starve the cancer cells of estrogen and they will die.

Goliath however had been estrogen and progesterone negative, meaning that removing estrogen would not have any effect on it. However this was the one thing which all the consulted Oncologists agreed upon. I should take Tamoxifen, as a prophylactic measure, to discourage the growth of an estrogen positive tumor in the other breast.

I found it unnerving, to say the least, to read in the tablet’s insert that under no circumstances should this be used in the case of an estrogen negative tumor. Many times during my treatment I queried this with the ever-patient Dr. Meiring. Each time, he would reach for his big blue Oncology text book and make me read for myself what the latest research said.

Next on the agenda was radiotherapy which absolutely terrified me. As a student nurse I had cared for patients with horrific burns from this practice. Even though Dr. Meiring assured me this should not happen in my case, I remained unconvinced. Meantime, I faced an impossible decision. Really, which chemotherapy regime did I want first? Did I want to lose my hair first? Or did I want to get sick? How about I didn’t have it at all?

Have you ever faced an Impossible Choice?

Which of the two would you choose to have first?

Please leave a comment, and if you leave a live URL in your comment, I’ll get back to you.

NOTE:
These events occurred between 17 and 20 years ago. I have tried to recreate events and locations as accurately as possible, but in order to maintain their anonymity, in some instances I have changed the names and identifying characteristics of individuals and places.