NH cancer patient describes radiation therapy at Seacoast Cancer Center
As I walked into the treatment room to begin seven weeks of radiation, I saw a sign that read “Linear Accelerator.” What was that I wondered?
This was to be my second time receiving radiation after cancer surgery. The first time was in 1992 when New Hampshire had only a few places to receive the treatment, so my Brigham and Women’s surgeon set me up in Boston. I went from the New Hampshire Seacoast five days a week for five weeks. A high energy X-ray machine was used to beam radiation into my groin and a shield was placed to protect those parts of me that didn’t need treatment. I was to learn nearly 30 years later that the shield was not exactly protective, but that’s another story.
Wentworth-Douglass Hospital has three state-of-the-art linear accelerators, two in Dover and another at the Seacoast Cancer Center at Pease where I was to be treated after a tumor was removed from my right thigh.
The linear accelerator, often called linac, accelerates charged subatomic particles to a high speed along a linear beamline. Among other applications, linac generates X-rays and high energy electrons for radiation treatment.
I met first with radiation oncologist Dr. Andy Singh who explained the need for radiation and the process for delivering the treatment. Unlike some medical procedures, radiation is different because cancer cells are microscopic and can’t be seen. To determine the treatment area, the doctor looked at x-rays, CTs, and MRIs and consulted with surgeon Dr. Chan Raut at Brigham and Women’s Hospital in Boston. In my case, the surgeon removed a large liposarcoma tumor from my thigh. I already had a disabled leg from my earlier surgery, so Dr. Raut was concerned that removing too much tissue and risk cutting nerves that might disable the right leg, too. Ordinarily he would cut onto the margin area, beyond the visible edges of the tumor, to remove as much of the cancer as possible. The radiation would have to include the margin areas, too.
Preparing for treatment
Next, I was taken into a testing room where I had another CT, this one to prepare a three- dimensional picture of the exact treatment area and areas to avoid radiating. This information was fed into the linac along with details about the shape of the radiation beam and the angle/s at which the radiation would be delivered. I was to lay on a platform that moved under the linac. The machine’s head could and did move around the platform. I received three tiny tattoo dots that the machine would use to orient itself in the proper position for my treatment. The placement of the radiation beam is accurate to one millimeter, so my leg had to be in the exact position each time I was treated. Based on the CT, my leg was moved into a position atop a customized vacuum bag creating a form. It was placed under my leg for each treatment.
The final element was to determine the total amount of radiation I would receive and the amount I would have per treatment. This results in knowing how many treatments were needed. In my case, the plan was 35 or seven weeks.
Technicians made the process smooth
The linac room is reserved in 15-minute blocks. I was met by two or three radiation technicians who helped me to get into position. These women received two-and-a-half years of training, they are experienced and knowledgeable about all aspects of treatment. Each one was personable and helpful. While the radiation is not painful, there is some anxiety involved and the technicians made the process smooth and relaxing. The actual treatment lasted about two and a half minutes. I watched as linac moved into position and heard a slight buzzing sound as the radiation beam activated. The movement was exactly the same for each treatment and I could anticipate when it would begin and stop. The technicians monitored the procedure from an adjacent control room and arrived quickly once linac stopped. They helped me up, got me dressed and on my way immediately.
The Pease facility treats about 25 to 30 people per day and the Dover hospital does double that amount. I thought that was a lot of people getting treatment, but Dr. Singh suggested with people living longer there are more cancer cases, however more screening finds more cases earlier resulting in cures.
Radiation side effects
Radiation does have some side effects, the most common being fatigue, which might be experienced midway through treatment. Dealing with this and other issues is radiation oncology nurse Michelle Carr. A native of Kittery, she has worked at major cancer centers in Boston, New York and elsewhere. She recently returned to this area to share her expertise. She helped me with another common side effect. The treatment begins to create a sunburn condition with the skin becoming red and possibly peeling. Michelle checked my leg weekly and provided various lotions to apply and my leg recovered nicely.
The most common cancers treated at the facility are breast, prostate and lung. But as the technicians told me, “We treat everything from the top of the head to the tips of the toes!” The Seacoast is fortunate to have this state-of-the-art facility and such an experienced staff to treat us. And I was thrilled when Dr. Singh cut my treatments from 35 to 33!
Peter Randall is an author, editor, publisher, and a photographer. He has been working in Portsmouth since 1966 and lives with his wife Judith in Eliot.