6th Update: Radiation Consultation

March 5, 2018

After my dad's bone scan and PET scan last week the doctors noticed his cancer has spread further in and through his bones, so last week the doctors added a once a month bisphosphonate bone medication to his chemotherapy which tells the bone cells to create more bone to fill in the holes to harden it, so the cancer cells can't spread to fill in.

Today we had a long consultation with a very patient radiation oncologist to begin my dad's radiation treatment for his sacrum, L3, L4, and scapula, but not his 2 ribs because the main priority treatment of chemotherapy will take care of it. The radiation is only to treat pain and to prevent tumors causing issues near the spinal cord where it's compressing. The iliac and lumbar spine is where the bone marrow is created, so if radiation hits there too much it could prevent the blood cell count from coming back up and prevent or slow the main chemotherapy treatment.

The goal of radiation therapy in my dad's case is to kill his tumor load in the singled out specific sites. It will not stop the spread of cancer. 2/3rds of patients have a complete response in getting rid of the tumor. 6-8 weeks after radiation he will have new images taken to measure response and know if the radiation worked.

Next Monday my dad will be getting a high dose of radiation for 5 days in a row. He's doing it on his off week, so the radiation doesn't affect the chemotherapy symptoms. Today he did a CBCT which they will use with laser guides for his future radiation treatment placements to compare the daily images to the planning images to ensure everything gets lined up correctly, so they're hit the precise spots accurately.

Radiation might cause swelling and a bit of pain in the 1st 24hrs. Improvement from pain can come anywhere from the last day of treatment to 20 days after. Skin can get red and itchy, but lotion or aloe without alcohol or perfume will take care of it. Little cramping and more frequent bowel issues in the week to follow. And fatigue might start to become an issue on the last day. Other than staying out of the sun to not get extra solar radiation he won't have to change his eating, drinking, exercise, nor work habits. Some side effects might last up to 6 months after treatments, for example the part of the lung that's exposed might have scar tissue showing as a white patch in scans and he might have some skin tanning at those particular locations.

Apart from the new changes my dad is hanging in there. He's half way through his 1st cycle of chemotherapy. Some side effects kicked in this last week, diarrhea and not being able to handle cold things due to Oxaliplatin, plus now his jaw bone is starting to hurt. His esophagus tumor is shrinking, but we're not sure if it's working on the bones yet. Time will tell. He's able to eat solid soft foods again and is now about where he was about 6 weeks ago. I think he's progressing slowly. He naps a lot the 1st 3 days after chemo and as long as he avoids car rides, he's doing OK.