Tiredness and fatigue caused by radiotherapy are amongst several side effects mentioned in the info put out by Macmillan Cancer Support and Prostate Cancer UK. Their booklets and websites are well worth a look but there’s nothing like personal experience for learning. I’ve read that some people suffer no side effects. I’ve also read the effects are more likely to occur, if at all, towards the end of the treatment but, here I am, three days in, and I’m knackered. I can’t remember reading anywhere how quickly you can be affected and I hadn’t thought it might be this fast. I suppose my tiredness might not be down to the actual treatment, per se, but could be down to the change of routine (combined with the lack of routine, if that makes sense) – my three appointments so far have been at different times of the day – or it could be anxiety, the travelling to and fro, the change of diet or, for all I know, it could be the weather but, whatever the reason, things are already becoming an effort.
By the time the first day of the radiotherapy dawned I’d been on my low fibre / low residue diet for a week. It came as a surprise, then, that I was awoken at 5am by the urgent churning of my stomach, signalling that I’d better get to the toilet, and pronto. I have no idea what caused me to fall victim to the trots, but I’d hazard a guess and say it was stress at the prospect of having photon particles aimed at my torso. For some reason I keep on thinking of the Starship Voyager’s photon torpedoes. If you’re not a Star Trek fan that won’t mean anything, but I reckon you’d still appreciate that having any sort of a torpedo aimed at you would make you crap your pants.
So, it was with some trepidation that me and my partner set off several hours later, with him driving, for the 30 mile journey to Reading. We weren’t so much worried about the impending treatment as much as whether or not we’d make it without me needing clean trousers en route or, worse, a new passenger seat.
We got to the Berkshire Cancer Centre about an hour later and it felt like my first day at school. I didn’t know where to go or what to do and all the older kids who’d been there last term were no help at all. Then one of the teachers, I mean staff, came to my rescue. Yes, she said, you put your card in here, you can sit in there. Someone will come and find you wherever you are. The water fountain is over there. Oh, there are no cups, I’ll get some for you. Then, within minutes someone else came to get me to go through everything again and to see if I was OK and offering to help carry the three lots of water that I’m required to drink before every radiotherapy session starts. The welcome on my first treatment day reflected my first visit there for my planning session – nothing was too much trouble. My whole experience of this place to date has been good – our NHS at its best. So what if it doesn’t have carpet and “free” tea. I heard some of the people in the waiting room talking about the centre’s other site in Bracknell and saying that was even better. I’m transferring there from session 9 onwards as it’s a bit closer to home so I’ll find out for myself.
About half an hour after finishing the water on the first day, a student radiographer came to get me. The half hour wait is part of the process so your bladder has time to fill up. I was shown to a changing room where it was into a hospital gown, then a short walk to one of several treatment rooms. I always feel a plonker in a hospital gown. Wearing slippers or flip-flops with one is bad enough but the whole plonker-look effect is enhanced by the addition of shoes and socks. I got some startled looks when I held my iPhone out and asked if someone could please take some photos. The student who’d come to get me said she would take them and looked even more startled than before when I asked if she knew how to use an iPhone. Her startled expression changed to that “doesn’t everybody know?” look that old farts like me get from anyone under the age of 25. I get them more and more these days. I can’t think why. I found out her look was justified as she took loads of very good photos, all part of the service, and none of them showed gown, shoes and socks together!
A lot of time in the treatment room was spent getting me in the right position on the slab. I was told not to try and help but to let the radiographers shift me the millimetres they needed to. There’s a support for your neck and head, another to go behind your knees and a third that your feet rest in. As hard as the slab is, it wasn’t uncomfortable, despite laying on it for almost three quarters of an hour on the first day. I was told the first treatment appointment is the longest but every treatment has to be aimed precisely in order to make sure the beams hit the right place and nowhere else. If they hit the bladder or the bowel, for instance, that could possibly cause different cancers to form in those places in the future, as well as causing other problems. That’s why, before they started my treatment, I had an ever increasing number of radiographers pouring over me going through every hair with a fine tooth comb and a torch looking for one of the tattoos they’d done a couple of weeks before, the elusive one hidden in the dense undergrowth just north of my dangly bits. They finally traced it and were able to carry on. After the first treatment finished the elusive tattoo was done again by the same friendly young guy who had done it a couple of weeks before. I’m pleased to report his hands were much warmer this time. I still can’t see the dot, but he must have sorted it as on Days 2 and 3 it didn’t take long to find.
I was told a CT scan is done as standard before my first three treatments and then randomly throughout the course. Amongst other things it shows them whether or not my bowel and bladder are both where they should be. Despite my churning guts it confirmed that my bowel was empty, my bladder full and both were indeed in the right position. The only problem highlighted was that I was arching my back slightly and my pelvis was not in the same position as it had been during my original planning session. Still within tolerance, but not the same. Most people of my age have acquired a dodgy back and I found out when I had a bone scan 6 months ago that I’d got myself two slipped discs. I don’t like to do things by halves. It could be those that are causing me to arch on the radiotherapy table even though I take painkillers a couple of hours before each treatment to help but I’ve now been told I might want to try relaxation exercises as well.
When the radiotherapy treatment started on the first day I thought I could feel it. It was not a painful feeling but like very dull pin pricks inside in different places. I thought there was some sort of sensation on the second day but on the third I didn’t notice anything. The treatment itself doesn’t last that long – less than 10 minutes, but it feels longer, especially the first one.
I’ve found the professionalism of the radiographers and their attention to detail very reassuring. Most people only ever see a radiographer if they need an X-ray and probably think that’s all they do. I’ve found out different and it’s been a revelation to me.
It’s early days yet and I know lots can happen between now and the final daily session sometime towards the end of July but so far, so good.
I wasn’t forced to have radiotherapy but I’ve had surgery and the cancer’s still there and the PSA blood level is still going up, so I didn’t feel I had a choice about going ahead with it. If this doesn’t get rid of the cancer I’m told it then ceases to be curable but remains controllable. In that case the next treatment to try would probably be hormone therapy but, hopefully, it won’t come to that.
Whatever happens in the future, a few days ago I had a reality check for right now when I went to see the GP. I explained about the pressure I’d been getting from work and the total lack of understanding that was fuelling it. The GP said stress was no good for me and I had to put all that aside. She went on to say that whatever was going on was nothing compared to the cancer and that “you are fighting for your life”. Fighting for my life! That stopped me short. This is serious stuff. I think I might just have finally grasped that it’s a lot more serious than any job.
More info: Prostate Cancer UK – http://prostatecanceruk.org
Macmillan information: Side effects of pelvic radiotherapy in men http://www.macmillan.org.uk/Cancerinformation/Cancertreatment/Treatmenttypes/Radiotherapy/Sideeffects/Pelvicsideeffects_men.aspx
Macmillan booklet: Pelvic radiotherapy in men – managing side effects during treatment http://be.macmillan.org.uk/be/p-20578-pelvic-radiotherapy-in-men-managing-side-effects-during-treatment.aspx
Macmillan information: Managing the late effects of pelvic radiotherapy in men http://www.macmillan.org.uk/Cancerinformation/Cancertreatment/Treatmenttypes/Radiotherapy/Long-termeffects/Lateeffectsofpelvicradiotherapyinmen/Pelvicradiotherapyinmen.aspx
Starship Voyager Photon Torpedoes: http://youtu.be/PIGxMENwq1k