This afternoon was Lisa's first radiation treatment, which went fine except that is was very difficult for Lisa to be flat on her back without severe coughing. Beforehand, we got called in early for a meeting with the primary oncologist to talk about the chemo side that supports the radiation, so in all, we were at the cancer center for almost six hours.
In a nutshell:
>> An injection of Ethyol will be given each day one hour before the radiation. Although mostly used for radiation to the head and neck, it is also useful for preventing damage to the lining of the esophagus, which is what Lisa needs associated with the location of her tumor and treatment. She has to stay lying down for 15 minutes following the shot. The first one of these is tomorrow. This drug commonly produces unpleasant side effects including nausea, so Lisa has to take a Benadryl as an antihistamine and Compazine as an anti-nausea pill one hour before the shot as a preventive.
>> The chemo will be done with Navelbine once a week. It's a 30-minute infusion and will be done following the Ethyol shot on Wednesdays. The first one is tomorrow.
>> There's now "no question" as to the number of weeks of radiation treatment. When the cardio-pulmonary surgeon talked to the radiation oncologist yesterday after Lisa's laser bronchoscopy, he told him that the tumor was already "almost unresectable", meaning that it's now almost too large and invasive to be surgically removed. The full seven weeks of radiation (the maximum medically allowable) has the best chance of shrinking the tumor adequately so it can be removed with at least the upper lobe of the right lung.
>> We got the results of the biopsies done from yesterday's laser bronchosopy, and they were identical to those done early in the process: "undifferentiated non-small cell lung cancer". That means, as before, that they can not sub-type the cancer further (such as to adenocarinoma or squamous cell carcinoma) or do genetic/dna "fingerprinting", and Lisa is being properly treated for what they are able to determine about her cancer.
>> The type and dose of radiation being given has a "logarithmic" effectiveness. For those of you who aren't math majors, that means that during the very first treatment (today), 90% of the cancer cells should have been killed. Tomorrow, 90% of the remaining 10% should be killed... and so on, and so on. There's about an 85% chance that this will be effective as predicted. The reason that it's only 85% is that some cancers are just more resistant than others and/or respond in an unpredictable way.
>> Lisa's Superior Vena Cava (SVC) Syndrome is going to be treated with short-term administration of steroids, which started today. The steroids should give her some relief from the swelling in her face and neck and difficulty swallowing.
So, tomorrow we'll be at the cancer center most of the afternoon again.
Michael
