Good Morning John,
So, my hospital, strangely enough, has a secret special entrance
at the bottom of the parking garage just for cancer patients.
The first time I arrived at this door,
I read this little sign and was like, “Oh, shoot, we have to find some way
into the hospital” so yeah,
it takes a while to absorb the whole “cancer patient” thing.
Doesn’t really seem like that’s you at first.
But they do, once you're in there hit you with a lot of signage
at every opportunity to drive home the situation.
Also, I just feel like most hospital
waiting rooms don’t have THIS MANY TISSUES.
Like, I feel bad for NOT CRYING when I'm in here.
John, today was my very first radiation therapy appointment.
Which was weird and I wanna tell you about it.
So just a quick recap.
I started this all with chemotherapy which killed so much of my cancer
that they can no longer find it inside of me.
Which is great!
But, they do think that it is likely that
I still have microscopic disease and it’s probably entered in the area
of my body where my lymph nodes were previously very swollen.
We have a high resolution picture of that from when I was first diagnosed.
And so, the idea is to aim a beam of radiation at just that area
of my body where my lymph nodes used to be swollen,
and that’s to jus like explode whatever cancer cells are still in
there because cancer cells are more susceptible to radiation
than regular cells.
Now that doesn’t mean that this isn’t going to screw up
some of my regular cells, it will just hurt the cancer cells worse.
Now I gotta say radiation therapy is a little weird.
The whole idea is that you’re gonna go lay down in front
of a particle accelerator that’s
gonna shoot high energy photons into you at like a rate that is
somewhat comparable to what people who worked
on the Fukushima plant after it melted down received.
It’s enough radiation that if you got it to your
whole body all at once rather than light spread out
over several weeks the way that they do it, you would die.
Like, you would die immediately and terribly. But they don’t give it to you all at once.
And they don’t give it to you in your whole body,
so you don't die, which is awesome.
As I always say, not dying from radiation poisoning
is amazing.
So yeah, it seems like it’d be a pretty intense experience, but it’s not.
It's entirely silent and you feel nothing.
You lay there for 8 minutes and then you go get McDonalds.
Now, the thing itself is very cool.
It moves around and it shoots from several different angles.
And the idea is that it can hit the diseased area like from this angle
and then from this angle and then from this angle
and the place that all those things are intersecting is getting a super high dose.
Like the cross gets the high dose, but the finger parts get like half doses.
And you do that five times. And where all the beams are meeting
get five times the dose and all the other places
get one fifth the dose of the middle.
But also, in order to shape the beam so that it’s the exact size
of where my lymph node inflammation used to be.
There’s this adaptive shutter thing that like changes shape and it almost looks alive.
It’s very cool to see in person, but unlike the animation
I just showed you the radiation is invisible. So it doesn't look or feel like anything.
It’s super bizarre because you know it’s this big thing,
but unlike chemotherapy that has a feeling. This is like nothing.
Which doesn’t mean it’s not a big deal and it’s not dangerous.
It turns out I’m a good candidate for radiation therapy.
One, because where my cancer was means they can hit it with
a bunch of beams without hitting my heart.
They’re going to hit a little bit of my lung,
but not with as big of a dose, and so that’s not as much of a concern.
And also, it's because I’m kinda old. Like, if I was seven years old,
I’d have 80 years to potentially
get a secondary cancer from my radiation therapy.
But I’m 43 so I have like half that time
to develop a secondary cancer are lower. Like, this is the math they have to do,
because treating cancer isn’t really about getting the chances of cure as high as possible,
it’s getting the chances of cure as high of possible while also getting the chances
of severe side effects from treatment as low as possible.
And those side effects could be really significant.
They could be like heart failure.
Like straight heart failure where you have to either get a heart transplant die.
They could be secondary cancers that could be more dangerous
than the one that I currently have.
You can get a pulmonary embolism, you could get a stroke.
These aren’t side effects that aren't annoying, these are things that can kill you.
So cancer treatment, like a lot of things,
is not so much about decisions as much as it’s about trade offs.
Now do I love the fact that we could be
doing more to prevent relapse but we aren’t because
there are all these other things to consider? No, but like, that’s the situation we are in.
So I laid there for eight minutes and then I went and got McDonalds
and then I was on the wrong side of town, so I DoorDashed boba to my house
and then judging from the receipt that I received, I got Dakota’s sushi.
And I assume that Dakota got my boba. So Dakota, I hope you enjoyed my boba,
because I am enjoying your sushi.
Cause look! You gotta take what life gives you
and life gave me cancer and Dakota’s sushi.
John, I’ll see you on Tuesday.