by Hugh Gilmore

As I explained previously in this series, I’ve been undergoing five-days-a-week radiation therapy since early March. If I’m lucky, this treatment will rid my body of the residual prostate cancer that last year’s robotic prostatectomy didn’t quite remove.

The procedure got setup like this: In February I watched in a small casting room as a technician took a blue plastic bag the size and shape of a pillow case and set it open-mouthed on the table. He mixed two containers of liquid chemicals into a big plastic jar and then poured the gunk into the bag. After flattening the bag he began running his hands over the plastic to spread the contents evenly.  “Do it like you’re petting a cat,” he said to his assistant as he expertly smoothed out the form, which by now had begun expanding as the chemicals interacted. “”Okay, lie down on this,” he told me, “before it cools too much.”

The sack felt warm, an almost pleasant feeling if I weren’t so alert at the strangeness of it. As I lay there, the case began to thicken and they pushed it into form against the sides of my hips and upper legs, inside and out. After a short while I was helped up and out and viola! My restraining cast looked like a baby’s car seat that had been bent flat.

Shortly after the cast was made, it was sent over to the imaging room. There the planning team would gather some information about me that even my dearest friends or closest family members don’t know: what I’m like on the inside. My radiation oncologist needed to see what my prostate fossa (where the prostate used to be) looked like and where it resided in relation to my other organs. His educated guess was that the cancer cells that had triggered my bad PSA results were located there. (We all hope he’s right.)

After seeing images of my innards, he and his team would program the external radiation machine to beam rays at that target. Exactitude is impossible in my case since the rays pass through healthy skin, fat, muscle, blood vessels, organs and bone on their way to the cancer. The radiation dosimetrist’s objective here is to minimize the collateral damage to my body.

Even held in place with external restraints such as casts, the body’s organs move about quite a bit. The organs involved with digestion and elimination are especially active, bobbing and writhing as they work to remind us we are living mortals. At some point (I remember only the sting) the radiation technicians needled a tattoo the size of a Sharpie pen mark on each of my hip points and poked two more on my lower abdominal midline, about two inches apart north/south. Those are the polestars that helped set up the baseline the navigating gunners will aim for. After that, and with the help of a pair of crisscrossing red laser beams, I was ready for some cat scans and a 20-minute MRI (the clanging kind).

The subsequent information they obtained was then fed into several databases and thus the program for curing Patient Gilmore of his unseen, unfelt, but quite scary, disease was generated. This work and planning was done at the Fox Chase Cancer Center, where I am a happy and quite willing participant. Current thinking as regards a case like mine is to treat the cancer cells to a certain dosage of radiation spread over about seven weeks. I’ve met fellow patients in the waiting room who’ve had many variations of this protocol.

Now, each weekday morning I check in to the main station of Radiation Oncology, get my daily wristband, and head to the waiting room. Usually, only minutes later, I am called to Room 6. The team greets me warmly. I give one of them the card on which I’ve written the name of the music I’d like played that day. I remove my wallet and cellphone and keys and shoes and lie down on the table on my back, fascinated as always by the red laser beams that cross my tummy. “Lift up,” I’m asked. I do, while also pulling my elastic-waist sweat pants and boxer shorts down nearly to the tipping point. As I arch like that, they slide my smoothed-like-a-petted-cat mold under my hips – rounding my round belly even rounder. They tug and pull at the sheet under me until my tattoos line up with the laser lines.

When done they leave the room, starting my musical choice as they exit. The imaging machines begin taking fresh pictures of the den of iniquity that is my prostate bed, as, meanwhile, the computer back in Oz lines up those pictures with the old ones and readjusts the radiation program. From the intercom someone says, “Treatment starting” and leaves me there to wonder at it all as I listen to the music and watch the giant machines dance across the arc of my body.

I am scheduled for 34 treatments. On March 21 it snowed heavily enough I could not get to the treatment center. A day was added to my finish date. On April 3, their machine was down. Another day was added. As I write this, I have six sessions left. As you read it, I’ll probably have just three.

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