FIRST STOP - UCSF, FOR CONFORMAL XRAY THERAPY.
My first good fortune was finding a place to stay within walking distance of the
UCSF Medical Center. A friend of a friend owns a house less than a mile away, and agreed
to put me up for the duration. Here is the street, and my room, where I am also
telecommuting.
Out in back, a garden! A few blocks away, UCSF Medical Center:
UCSF has one of the world's most advanced radiation therapy centers for cancer
treatment. The treatment is performed using highly automated linear accellerators, which
are controlled by computers. Before treatment, the patient undergoes several types of
planning procedures, such as CT scans, urethragram, and simulation Xrays. Then this
information is input into the computer, and a customized treatment plan, including exact
dosage profiles ("isodose plots") is generated. Where many treatment facilities
use simple rectangular arrangements of lead baffles to control the pattern of radiation,
UCSF has computer controlled "conformal" templates which create complex patterns
of radiation in four (or more) planes to give the most radiation where it is needed and
the least where it could damage healthy tissues.
My treatment at UCSF began on November 11th and was scheduled to be completed
shortly before the Christmas holidays. Then it's on to Loma Linda. Here is a picture of
the treatment room, accelerator, and Bob and Franklin, my radiation therapy technicians,
and me on the hotseat!
TREATMENT AT UCSF - "A PIECE OF CAKE" (NOT!)
Things went well the first couple of weeks, but because of a change in my medication, little did I know, a time bomb was ticking away. The reason was that my doctors and I decided to change one of the medications used in the Hormone Blockade, from bicalutamide to flutamide. This is considered to be more effective in suppressing tumor growth, and switching to it seemed like a good idea. However, one of the side effects of flutamide is diarrhea. In some cases the diarrhea can be severe, and can start suddenly, without warning. In my case, the change was a bad idea, especially while going through radiation therapy, which tends to irritate the colon and bowels.
After about two weeks of the new medication, and the radiation, a friend came up to San Francisco to visit. We went out to a Japanese restaurant and had a lot of spicy sushi and yakitori. I really enjoyed the company and good food, but by the end of the evening, I was suddenly doubled up with stomach cramps, and when I got back to my apartment, I had the "mother of all cases" of diarrhea. It just didn't go away, and for a week, I spent every spare moment sitting in the smallest room in the house. Unfortunately, I also didn't realize that drinking water was NOT the right thing to do in this case. After a week, I became seriously dehydrated. I woke up one night and almost passed out on the way to the bathroom. Finally I realized I was in serious trouble and asked the owner of the house where I was staying to drive me to the emergency room. The doctors took one look at me and hooked up an IV. They proceeded to pump 4 liters of saline and electrolytes into me over a period of 8 hours! At this point I decided that maybe the switch to flutamide was not such a good idea, and started taking bicalutamide again. The diarrhea soon subsided, and is now only an unpleasant memory.
The last two weeks of my treatment at UCSF was fairly uneventful, although I was pretty tired, both from the radiation as well as recovering from the dehydration. I finally got my "Happiness is the last day of treatment" button on Tuesday, December 23, just in time to go home for Christmas.