Day 19: Three Weeks In
I’ve had 15 treatments so far and I gotta say, this whole proton therapy thing isn’t growing on me. It’s uncomfortable. The complete surrender of control I’m giving to my radiation therapy team is unnerving. And, as far as I can tell, I haven’t developed any super powers…yet.
If you’re unfamiliar with proton therapy, don’t worry. It’s quite uncommon. There are only ten centers in the country, and Mass General’s is the oldest in the country. Back in the ’60s, scientists and doctors from Harvard and MCH decided to take a particle accelerator built for physics research and aim it at patients. For a long while, MGH had the only proton therapy center in the country, probably because most doctors were hesitant to aim devices normally used for bashing high-speed atoms together at their patients. Its benefits – the ability to deliver high doses of radiation while sparing healthy surrounding tissue – are becoming more and more evident, and more centers are popping up around the country, including seven since 2010. Fucking posers.
So how does it actually work? It all starts with hydrogen atoms, which are made of a happy little couple of one proton and one electron. Hydrogen gas is placed in a device called the cyclotron and, like alcoholism, the cyclotron splits the pair. The cyclotron is MASSIVE, like thousands and thousands of pounds massive. It has its own room. It uses magnetic fields to guide these lonely protons around a large loop, increasing their speed with each pass. When the appropriate speed for treatment is reached, the beam of protons is redirected to the patient’s room.
In the patient room (or gantry), the visible portion of the device is staggeringly big, but it’s only the tip of the iceberg. The rotating portion of the machine in the room is about one story tall, but surrounding that outside the room is a larger part that is about three times larger.
My radiation oncologist used my MRIs and CT scans to map out a “treatment plan.” They treat me from four different angles, usually two a day. Each angle has its own shape, which is carved into a brass cylinder. To control depth, they use a “compensator,” or fancy piece of plastic that keeps protons from going too deep and damaging my brain.
So what does it feel like? Well, nothing really. The mask is uncomfortable. They have Pandora hooked up to some pretty nice speakers, so I listen to a little Pinback radio everyday to mellow myself out. As I lie there, I can hear my team of techs mumbling to each other. Sometimes they laugh. The machine buzzes as they move my bed and spin my gantry, using X-rays to line everything up just right. Eventually one will walk over, slide the brass cylinder in and say something like, “Barrett RA-1A.” Someone else confirms. “We’ll be right back, Tom,” they announce before heading out. Then it’s quiet. After a few seconds, I’ll hear the machine doing something. It sounds like roller coaster brakes releasing. This happens a couple times. Then it beeps, like I’m in a microwave and I’m all done. They’ll walk in, and the whole process repeats one more time. Then, my favorite part, they take off my mask. I get up, lightheaded from lying there with too much blood trapped in my face. And that’s it. No pain. No nausea. Just the uneasy awareness that something very unnatural has just happened to my body.
Well, I’m three weeks in! I’ve got a couple friends here this weekend, so I’ll write again on Sunday hopefully.
Fifteen treatments down, twenty to go!