28 Mornings in the Basement: A Patient’s View of Cancer Radiation

Radiation therapy is a process often discussed in medical settings, but rarely experienced and described from the patient’s perspective. One individual, with decades of professional experience in medical radiation, shares a personal account of undergoing radiation therapy after a prostate cancer diagnosis.

A Routine Test, An Unexpected Result

The journey began shortly before the COVID pandemic with a routine blood test. The patient’s PSA (prostate-specific antigen) level was found to be elevated. This test was prompted by the patient’s approaching 60th birthday and his doctor’s recent prostate cancer diagnosis, leading to a proactive check. Subsequent tests, scans, and biopsies ultimately led to a decision to pursue radiation therapy.

Initial findings revealed traces of cancer and two nodules on an MRI. While most prostate cancers are slow-growing, the patient opted for “watchful waiting” – a strategy of close monitoring through regular PSA tests, MRIs, and biopsies. A genetic sequencing of a biopsy sample indicated a 28% chance of cancer growth, a 10% chance of metastasizing within five years, and a 5% chance of being fatal within a decade. Despite these concerns, continued monitoring seemed reasonable until a later biopsy revealed a change.

From Watchful Waiting to Active Treatment

The results of a biopsy received on a Friday prompted a swift shift in strategy. The patient found the terminology in the report concerning, and a subsequent call from his urologist confirmed it was time to move beyond observation. Discussions followed with both a surgeon and a radiation oncologist to explore treatment options.

Did You Know? The patient underwent 28 radiation treatments, each occurring on a working day around 7:30 in the morning.

Weighing the Options

Both surgery and radiation therapy offered a five-year survival rate of 95%, but carried different potential complications. Surgery presented risks of incontinence and impotence, with a recovery period. Radiation therapy, while potentially leading to recurrence, aimed to preserve more of the prostate and minimize nerve damage.

The patient ultimately chose radiation therapy for several reasons: his extensive 40-year experience working with radiation, a lower risk of nerve damage, and a friend’s experience with prolonged side effects following surgery. This decision was further solidified by a diagnosis of blood clots, a common complication of prostate cancer, which made surgery inadvisable due to the need for blood thinners.

The Radiation Process

The radiation was delivered using a linear accelerator (LINAC), a machine that generates X-rays by accelerating electrons into a metal target. The LINAC utilizes a multi-leaf collimator – strips of dense metal – to precisely shape the radiation beam to target the tumor while sparing surrounding healthy tissue. Dynamic collimators reposition these leaves throughout the exposure to treat the tumor from multiple angles.

A Typical Treatment Day

Each treatment day began at 5:00 AM with preparation – ensuring a full bladder and empty bowels to optimize radiation delivery and minimize exposure to surrounding organs. This was followed by a commute involving multiple subway trains, arriving at the hospital around 7:00 AM. The process itself, from changing into a gown to the actual radiation exposure, took approximately 50 minutes. The radiation delivery involved 13 short bursts from different angles, felt as nothing by the patient. By 8:30 AM, the patient was back at work.

Expert Insight: The patient’s decision to prioritize minimizing nerve damage reflects a common concern among men facing prostate cancer treatment. The trade-off between potential recurrence with radiation versus the immediate risks of surgery is a complex one, often requiring careful consideration of individual circumstances and preferences.

Recovery and Looking Ahead

Following the final treatment, the patient experienced fatigue, inflammation, and urinary and bowel discomfort. These side effects, along with a urinary tract infection, were managed with antibiotics and anti-inflammatories. While recovery took several weeks, the patient was able to return to work by mid-November and travel for Thanksgiving. A recent PSA test yielded outstanding results.

Frequently Asked Questions

What prompted the initial PSA test?

The PSA test was prompted by the patient’s approaching 60th birthday and his doctor’s recent prostate cancer diagnosis, leading to a proactive check.

What were the primary reasons for choosing radiation therapy over surgery?

The patient chose radiation therapy due to his 40 years of experience working with radiation, a lower risk of nerve damage, and a friend’s experience with prolonged side effects following surgery. A subsequent diagnosis of blood clots further solidified this decision.

What did a typical day of radiation treatment involve?

A typical day involved waking up early to prepare the bladder and bowels, a lengthy commute to the hospital, a brief preparation period in a changing room, precise alignment on the treatment table, and approximately three minutes of radiation exposure.

What aspects of navigating a cancer diagnosis and treatment resonate most with you?