Radiation Planning

Monday, June 28, 2010.


Today was a set up appointment for my radiation therapy. Everything was done very efficiently. I was placed on a simulator table which is actually a CT scanner and some images obtained. They use a mask which goes over your head which is not unlike fencers mask. It is warmed up and softened and then placed over your head, pressed into position, and then cooled so that it retains its shape. This allows them to keep you in the proper position during radiation treatments.
Treatments will start on Thursday, July 8 and continue for six weeks, ending, ironically, on my birthday, August 18, 2010. I will celebrate my 70th birthday by ending radiation treatment. We reviewed all the complications which are possible and the precautions to take. The most annoying probably will be the need to gargle and rinse my mouth about five times a day with a mixture of salt and baking soda and water.
Treatments will only take about 15 minutes and I should be in and out within half an hour. Every Monday, there is what they call a stat session which will involve reviewing my progress with the radiation oncologist. On the first Monday after treatment begins, we will also meet with the dietitian. Dietary restrictions expected will be as follows. I'll not be allowed to have anything which is too acidic, nor foods which are crunchy and which might tear the mucosa of the mouth. I will not be allowed to have hot coffee or anything too cold. I'll have to restrict processed sugars because of the risk of dental caries.


I'm still feeling cautiously optimistic, but I have to say that reading the case histories on the Merkel website is quite terrifying. Right now I am essentially asymptomatic, except for some discomfort at the surgical site. However I am aware that this is a potentially devastating malignancy which could rapidly appear in the liver, brain, bone amongst other sites. I hope that I am not spoiling my last good months by taking the radiation treatments. However I have no choice but to follow with my physicians recommendations as they are the top experts in the field.

Some interesting literature has come to light linking the virus which is involved with Merkel cell carcinoma and the Salk vaccine which was used to immunize me against polio. Apparently many early batches of this vaccine were contaminated with the polyamovirus. Who could have known?

I plan to spend some my time in the future writing a separate blog which will basically be my memoirs. In the meantime, I feel that I am coping very well with my current circumstances.