In my ten-year battle with brain cancer, I've been through just about everything, including three surgeries, more tests and labs than you can imagine, literally hundreds of MRIs, and 22 rounds of chemotherapy. However, I've been able to avoid one thing: radiation. This time around, I'm not so lucky. Having removed the tumor mass, the doctors are almost certain that some invisible tumor cells remain, and the only way to get rid of them is to treat them with radiation. So, here we go -- five days a week for six weeks, a total of 30 treatments. As I mentioned in a previous blog, the docs at NIH are also using chemotherapy drugs as a radiosensitizer, making the malignant cells more receptive to radiation than the healthy brain cells (trust me, I need every one of them). So, after starting chemotherapy on Sunday night, I showed up bright an early on Monday morning...
The radiation machine itself looks pretty timid. It's like an open MRI, or a half-CT, something like that...here's a photo of the room where my treatments are done:
The machine isn't the hard part. That white thing at the head of the bed is a radiation mask, and that's really the intimidating part. It conforms precisely to your face, and holds your head perfectly still. This process takes pretty serious mental control and concentration -- imagine, if you will, a scene from one of those slasher movies. It's pitch dark. A man lies on a bed, as if asleep. Slowly, a man approaches, holding something that looks like a plastic bag or plastic wrap, moving it closer and closer to his face... Anyway, you get the idea. When the mask is first placed on your face, it feels exactly like someone has put a plastic bag over your head. It is incredibly tight -- my face looks like I'm staring into 100-mph winds -- and breathing becomes quite a challenge. Your first instinct is to panic, but as you try to maintain your composure you realize that you can breathe through small holes under your nose, and if you strain enough to part your lips by a centimeter or so, you can get some air through your mouth as well. As you fight to control the panic, the mask is bolted onto the table, and the technician leaves you to yourself for about 20 minutes as the radiation machine does its work. According to the technicians at NIH, about 80 percent of patients must be sedated prior to treatment in order to avoid panic attacks. Now, four treatments in, I'm getting better at it...but it's still pretty intimidating. Here's how I look with the mask in place:
The little "plus" signs on the mask align with lasers mounted on the wall (you can barely see one behind the tech) and on the ceiling, which ensure that my head is precisely positioned, and positioned exactly the same way for each treatment. So, once I'm in the mask, bolted down, and properly aligned and positioned, the tech leaves the room and the radiation machine rotates around my head, occasionally emitting loud buzzes and beeps that I can only assume are wreaking havoc on the rogue tumor cells camped out somewhere in my head. 
The treatment itself only lasts about 15 minutes, after which I'm "unbolted" and on my way. If there's any question about how tight the mask is, I retain the battle scars from each radiation treatment for about 30 minutes after leaving the hospital. Like the pattern? It prompts some interesting questions on the subway...
The main side effect from radiation is fatigue, which is slowly setting in. I'm also battling the standard gastro-intestinal effects of chemotherapy...the combination will make the next six weeks very interesting! I'll also develop some surface skin burns (like a sunburn), and will almost certainly lose my hair (which is happening anyway). Most of the other side-effects from radiation are long term (like 10+ years from now), and can include everything from short-term memory loss, balance issues, cataracts, and more serious things like necrosis and secondary cancers. With those pleasant thoughts in mind, that's radiation! Now, on to training...
I'm not sure why I planned it this way, but somehow I started marathon training on the first day of radiation treatment. I may regret it later, but for now I'm managing fairly well. I've gotten two runs in this week, just 3 - 4 miles -- and I feel fairly good. My run on Sunday was the first run I've had since the marathon on November 30th, and I certainly felt it...I haven't gone eight weeks without running since I started this whole running obsession a number of years ago. Four miles today felt quite a bit better, but I'm in absolutely terrible shape. Regardless, I should easily be ready for Seattle, with a couple of tune-up races in between -- the George Washington 10-Miler in April and the Marine Corps Half-Marathon in May. Trust me, I'll be there!
In closing, I have to wish Momo a happy birthday...and my usual shout out to all the bloggers who have checked in on my recovery during the past six months! You guys (and girls) rock! Over and out, with a final farewell from The Monkey...
Run, daddy, run!
