I completed radiation treatment (radiotherapy) for lung cancer (adenocarcinoma) last Monday.

This is treatment room A (above) in the radiation oncology department (called Bighorn) at the Lucy Curci Cancer Center in Rancho Mirage, California.  I underwent a two-week course of Stereotactic Body Radiotherapy, or SBRT, delivered daily with one day off to rest between doses.  SBRT delivers very high doses of radiation in a few sessions using precise image guidance.  By using advanced imaging technology to track the movement of lung tumors in real time, the radiation oncologist can keep the radiation tightly concentrated around a patient’s tumor while steering clear of healthy tissue.

Because lung tumors move when the patient breathes, radiation previously had to be applied to a large area of the lung so doctors could make sure they weren’t missing the tumor.  Radiating large areas meant that the radiation doses had to be decreased to protect the normal surrounding lung tissue; these doses were largely ineffective at killing the cancerous cells.  Prior to the innovation of SBRT and the equipment used to deliver it, daily radiation for seven weeks was the norm for lung cancer, and it was largely ineffective, meaning the tumor would often recur.

SBRT is much more targeted, and it allows very high doses of radiation to be given over a shorter period of time – in my case, two weeks.  Evidence has shown that SBRT can be just as effective as surgery for treating some early-stage lung cancers:  a randomized trial of patients with Stage I lung cancer (like me) that compared surgery to SBRT found that SBRT provided equivalent tumor control rates as surgery with minimal side effects.

My final day of treatment was last Monday.  It was a very emotional day.  After my radiation treatment in Rebecca the Radiator (the name I gave the machine) they told me to wait out by the nurses’ station.  The entire staff, in addition to my radiation team, suddenly appeared, applauding.  I was presented with my graduation certificate (above), and asked to ring a large brass bell three times hanging on the wall.  I burst into tears.  The gravity of this whole experience from my diagnosis last July hit me all at once, and then evaporated and vanished with the applause of the doctors and nurses and therapists smiling and shouting “you did it.” It was a very powerful, very human moment, one I will not soon forget.

Now we enter the monitoring phase.  Initially, this will involve CT imaging of my chest every three months with associated bloodwork done by the lab.  Radiation therapy usually does not have an immediate effect, and it could take days, weeks, or months to see any change in the cancer.  The cancer cells may keep dying for weeks or months after the end of treatment, and it will be some time before I know whether the radiation therapy has controlled the cancer.

So in meeting with my oncology team at Lucy Curci yesterday, they counselled me on mitigating the ongoing side-effects – like fatigue, skin irritation, and cough – by focusing on self-care.  They practice a kind of holistic health care there that is so patient-focused, uplifting, and energizing.  I asked Dr. Burkeen to write me a scrip for mint chocolate chip ice cream from Cold Stone Creamery to be delivered to me by my assisted living facility daily (which is how I define “self-care”) and he said only if they bring him some too. 🙂

Finally, let me just say a word about Bighorn and the Lucy Curci Cancer Center.

Everything about my time at Bighorn/Lucy Curci was outstanding in a way that the word ‘outstanding’ does not do it justice.  This cancer diagnosis was the scariest thing I’ve been through in my life (and I’ve had brain surgery!), and they made it, if not okay than at least a little less scary.  You see their commitment to caring for the whole person in the smiles and eye contact you get from every member of staff, even those you pass in the hall and have nothing to do with.  From the picture they take of you at your first visit so they recognize you and call you by your name on subsequent visits, to my radiation therapy team (who sometimes seemed a little more interested in how Gordon was holding up with all this than me, but that’s okay – I’m used to living in the shadow of a Chihuahua), to the state-of-the-art equipment (like Rebecca the Radiator) which gives you this visceral sense that you’re in good hands…  I could go on.

“Monitoring” does not mean this is over, I’m just entering a new phase.  But I will tell you that with Bighorn Radiation Oncology, and the Lucy Curci Cancer Center just down the road and on the other end of a phone call, I feel today that I not only have a new lease on life but I’ve got a “pit crew” ready to spring into action if I pull off the track for any reason.

Fall has returned to the desert and there’s a pleasant chill in the air.  At 59 years-old, on the cusp of 60, I’m ready to begin the next chapter of my life.  Here we go…