Tuesday, May 23, 2006

Radiation Simulation # 2

Went for my second radiation simulation session, this time with radiation oncologist # 3. He said due to the fluid build-up in my chest, not a good idea to do 3D conformal radiation since the shape and size of the radiated field will change day to day. Better to do 2D, which will administer an even dose of radiation to the entire treatment field -- hence, variations in skin elevation won’t affect it. But it also means the dosage can’t be varied to make cancerous areas get higher dose and lungs and heart area get lower dose.

Not happy with this compromise and asked if I could have a drain put in to drain out the fluid and flatten out the radiated field. He said there’s too high a risk of infection with putting in a drain, so just settle for 2D. He got testy with me so I just let it go. Bad idea! But I’ve already seen all the other radiation oncologists in Singapore, so I’ve run out of options.

Simulation took only 15 minutes, compared to one hour for the previous one. And this room had arm rests and a different machine -- a CT scanner, I think. The markings were also MUCH smaller. I asked the radiation therapist to use tattoos instead of markers to ensure accuracy and consistency, so she used them for the main three marking points in the middle of the chest and on two side areas of my torso. They’re just tiny little dots the size of pin pricks. I’ve often thought about getting tattoos. This wasn’t quite what I had in mind though.

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