At school I was always absolutely rubbish at maths and physics. My brain was always wired more to creative subjects and it struggles to compute numbers and scientific concepts. Radiotherapy was always going to be the most difficult bit of cancer treatment for me to get my head around and after 15 sessions, I have to admit, I still don’t fully understand what was going on!
Here are the basics and my radiotherapy survivors guide. Radiotherapy is a localised treatment – focused only on the immediate area around the primary breast cancer (as opposed to chemo which is systemic – treating the whole body). High energy x-rays are used to zap (that’s the technical term!) the area, killing off cells. Healthy cells can repair themselves but the cancer cells cannot. It’s used to mop up any stray little nasties that may still be lurking about after surgery. There are different types of machines used depending on the type of radiotherapy being administered – my treatment was external beam radiotherapy and was given on a LINAC machine – short for linear accelerator.
Depending on the post-surgery pathology different areas may be treated. For me, as I had a mastectomy, it was the chest wall and the area above the collar bone, it’s called the supraclavicular fossa and turns out to the one of those words (a bit like anaesthetic) that I really struggle to say! Ironic for someone who reads out loud for a living.
Radiotherapy is a pretty precise business, as the medics don’t want the rays to damage areas they don’t need to and you have quite a lot of important organs knocking around in your chest. A week or so before starting you have a radiotherapy planning appointment which is used to work out exactly how the bed should be set up to get you in the right position for maximum effectiveness and minimum damage. This involves a CT scanner but as with most of radiotherapy you don’t feel a thing and just need to be manhandled around the bed a bit by the very friendly radiographers until they are happy with the setup. Then comes the only painful bit – the tattoos. I always thought if I got a tattoo it would be of something cool but no. It was 3 small black dots, one in the middle of my chest, one under my arm and one up near my collarbone. They are no bigger than a freckle but the pain of their delivery is inversely proportional to their size, believe me!
Then you are ready to start the exciting part of getting zapped! If you want to see what it looks like here’s my video blog for BBC North West:
Top Ten Tips
Here are my Top Ten Tips from what I learned while laying on that uncomfortable looking bed:
- Get used to going to the hospital every day
I was given 15 sessions of radiotherapy which is pretty standard for breast cancer. They were delivered daily, Monday to Friday with weekends off. That’s three weeks of travelling to the hospital every day which is the most annoying part. One of the main side effects of radiotherapy is tiredness and much of this can be put down to the daily commute. Prepare to be bankrupted by paying for parking every day though I discovered you can park on the road outside the Christie Hospital in Manchester for 2 hours for free!
- Appointment times are not set in stone
One of my main worries before starting radiotherapy was how the daily appointments would affect my work and childcare. This may differ from hospital to hospital but at the Christie you are given your appointments a day at a time and a bit of horse trading on timings is possible. You can ask for a particular time of day – I chose late afternoon/early evening – but if you do need to change this they try to be flexible. My advice is to give them plenty of warning if you have something coming up that means you need to tweak timings. Sometimes it’s just not possible to change and you have to just turn up when you’re told.
- It doesn’t hurt
This really is the least invasive of all the breast cancer treatments. You can’t feel the radiotherapy as it’s being given. So much so that for about the first week I wasn’t even really sure when the treatment was actually happening. Then one of the radiographers told me it’s when the machine makes a buzzing sound. I counted the seconds one time and I’d guesstimate it was barely a minute in total when the rays are doing their thing.
- It doesn’t take long
With the actual active treatment part being so quick you’ll probably have gathered that the process of having radiotherapy doesn’t take too long which makes the daily nature of it more bearable. The most time-consuming part is the set-up process as the radiographers need to line you up on the bed so lasers bisect your tattoos in just the right spot. Expect to hear a lot of numbers and technical jargon being bandied about between the radiographers here as they check and double check placement. It is a VERY exact science! Overall though the whole process from going in to the radiotherapy suite to leaving again took about 15-20 minutes.
- Be prepared for delays
While the treatment itself doesn’t take too long be prepared for delays. You are generally treated in the same room on the same machine each time – I was on suite 6. Most of the time it ran to time but some days I’d arrive and a sign on reception would inform me there was anything from a 30 min to 2-hour delay! If you’re pushed for time or trying to squeeze it in on your lunch break it’s always worth ringing ahead to see if they’re running late. Sometime delays are unavoidable – so, grab a coffee and take a good book if things are running behind!
- Look after your skin
I have always been very lax in my beauty routines, I can usually manage to moisturise my face twice daily but there’s just too few hours in the day to be bothering with moisturising top to toe. But when it comes to having radiotherapy you need to be on it with the moisturiser over the area being treated. Whilst getting nasty burns and cracks in the skin is less common these days you need to do all you can to ensure that doesn’t happen. I did a bit of half-hearted research into the best creams to use and saw a lot of good things about Aloe-Vera gel. I chucked that on liberally morning and night alternated with some of Freddie’s Oilatum Junior cream that I found at the back of the cupboard! This combination worked a treat and my scar and skin were looking pretty good by the end of it. Expect some skin discolouration though. I ended up with some pretty odd looking radiotherapy ‘tan-lines’!
- Make sure you keep your shoulder mobile
You have to spend a fair bit of time with your arm in a rest above your head while set up on the radiotherapy bed so if you’ve had surgery on your lymph nodes then you need to make sure you keep your shoulder mobility. Do all the stretches they give you to make sure your shoulder doesn’t seize up. It will make the process a whole lot easier!
- You will feel like you’re in a sci-fi movie at times
The green lasers that beam across the room to help the radiographers line up you tattoos will have you feeling like you’re in a scene from Star Wars or Star Trek. Or if you have very poor taste in films like me you may spend the whole time with quotes from Austin Powers Dr Evil going around in your head!
- Think about your schedule
They say to rest as much as possible and listen to your body. My advice would be to NOT offer yourself for a load of nightshifts at work whilst at the same time moving your son from his cot into a toddler bed resulting in him running into your room every 2 hours in the night JUST BECAUSE HE CAN!! Nobody would be that stupid though would they??
The mini sleep-thief at work
- Sit back, relax and enjoy
Remember there is nothing to be scared of. It’s really very easy having radiotherapy so just lay back, relax and enjoy the thought of any last little cancer cells being blasted to smithereens!