Words You Might Hear on a Cancer Journey

Let it be noted that oncologists and their friends often use words in unusual, unfamiliar, mysterious ways unknown to the general population. “Words you might hear” will stand in as an etymological broadening of such words.

Installment 1: Radiation

Simulation

Before radiation begins, there is a planning session called a simulation. No actual radiation is delivered at this time. In fact, the patient isn’t even in the actual room where radiation will be delivered. During the simulation, a cradle is created and tattoo markings are placed (see below), and the patient gets a tour of the facility. In my case, I also received a swag bag to bring every day containing a white robe (see pictorial tour) that I embellished subsequently.

First day of treatment

It isn’t really! They bring you in for another run-through (like a simulation in normal people language) to verify the setup from the simulation. I quickly re-named it the “dress rehearsal.” The bummer about this word use is that the course of treatment is specific, in my case, 30 treatments total. So the first day of treatment doesn’t count! Rude!

Cradle

A cradle is used during radiation. Sounds soft and cuddly, and that would be wrong. This cradle is custom molded to the patient’s body to bolster arms and maintain the posture/position required to deliver the appropriate dose of radiation to the desired body part. They are reusable and fairly nifty. You can see an example in the photo from the pictorial tour of radiation. Mine would be at the head of the treatment table nearest the stand mixer. The cradle has markings on the outside edges used to align it with the radiation machine.

Tattoos

These are not beautiful artwork tattoos, but rather registration marks. No choice of colors, they’re all black. They are placed by a radiology tech after determining latitude, longitude, and flatish, stable spots that are unlikely to change from day to day. Three freckle-like tattoos go on, one on each rib cage and one dead center sternum. For the record, these remain the only tattoos I have, and were acquired under protest. They are placed with a pre-filled ink reservoir with a needle. Disposable. These three dots line up with the marks on the cradle and the lasers in the walls and ceiling of the actual treatment room (very sci-fi).  All of that ensures that the radiation beam targets exactly the same bits each day, because bodies are mushy and weird.

Bolus

I thought I knew this word, but it has more meanings than I previously understood. In context, this bolus is a bit of material used to mimic skin during radiation treatment sessions. The bolus could be a gelatinous mat, similar to a reusable ice pack, room temperature. Or, as in my case, another custom-made, form-fitting bit of plastic, not reusable. Think: breastplate of righteousness and you’re on the right track. My dosimetrist preferred it because the soft one was not adhering to the skin as reliably as she wanted. Those pockets of air can burn the skin more and affect the ultimate dose. Either way, in the radiation suite, a bolus is neither swallowed nor pushed, let alone passed.

Dosimetrist

The most bizarre word, made of Greek parts with who-knows-what combining form! This word does not appear in etymology online. Help me out, Scripps Spelling Bee kids! A dosimetrist is in charge of monitoring the dose of radiation and its delivery. Like a pharmacist. She’s wicked smart because physics.  In any case, the word stuck out so I thought I’d share.

Photons

I know this word from my one and only physics class in college, which I enjoyed a good deal. Also from The Great Courses on the Higgs-Boson. My take away is as follows: particle, particle, photon, particle, field, wave, particle particle. At Lemmen Holton, radiation is delivered in a few ways. My dose came from photon radiation. Not electron, not proton. And now we have arrived at the end of my comprehension.

Less Shallow

A synonym for “less shallow” would be …. About half of my radiation treatments were less shallow. They want to radiate some skin, as cancer can recur in skin. Gotta burn that, Baby! Some lung tissue is also at risk. In pursuit of the less shallow dose, the radiation does not penetrate deeper, as the phrase suggests, but the shallower bits are not. Clearly there is wizardly magic that continues to elude me.

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