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84<br />
Esophagus Radiation <strong>with</strong> Chemotherapy<br />
Enhancement<br />
Thursday, July 14, 2011<br />
This phase of my treatment has begun.<br />
On Tuesday, I went for the first radiation treatment to the mediastinum. New markings<br />
covered <strong>with</strong> tape were placed on my chest. The actual treatments consisted of six short<br />
bursts of radiation, <strong>with</strong> the machine repositioned for each burst so the tumor is shot from<br />
many different angles. This is done to reduce the radiation dose to structures near the<br />
treatment site. These include my heart, lungs, spine and spinal cord, vagus nerve and<br />
liver.<br />
<strong>My</strong> appointment was for 8:00 AM, but there is a new regulation from Medicare which<br />
requires the Radiation Oncologist to be on site during the treatment so it was delayed<br />
until after 8:30. The schedule has now been changed so treatments will be at 8:30.<br />
Yesterday, I went for my radiation treatment followed by chemotherapy.<br />
After the treatment, I went to Dr. Flam's office in the same complex, and the waiting room<br />
was as crowded as the Los Angeles Freeways will be this weekend. I had my blood<br />
drawn. The results are good. Platelets normal at 137,000, White count normal at 4,900,<br />
and hemoglobin low but stable at 10.9 g/l.<br />
After a brief visit <strong>with</strong> Dr. Flam, my treatment began. Through the port, I was first given 32<br />
mg of Zofran over 30 minutes to prevent nausea. then, over the next 2 hours, I received<br />
57 mg of Taxotere. Because this was the first dose, they gave it slowly to make sure I did<br />
not have an adverse reaction. The only reaction was some flushing and a slight burning<br />
sensation around my ears. I did not get sick but was tired afterwards and was mildly<br />
nauseated.<br />
I drove myself home, and rested in the afternoon.<br />
Brian is visiting from Vancouver. Gary and Dana invited us for dinner and I was able to go<br />
and eat some BBQ chicken and a hot dog, <strong>with</strong> a small amount of strawberry pie for<br />
dessert, so the nausea was not a factor. I drove there and, being tired, drove myself<br />
home before Judy and Brian left.<br />
Today was treatment #3 of 25. There was also a status check <strong>with</strong> Dr. John. There is<br />
nothing much to report about this, but I did ask him if I should show up on time for my<br />
8:30 appointments, because if he was going to be late, so was I. He did admit to having a<br />
conference on Thursdays which do not end until 8:45, so I will not rush to be on time on<br />
Thursdays.<br />
It looks like the main side effect to be aware of is esophagitis, <strong>with</strong> possible development<br />
of a stricture. (An area of narrowing from scar tissue which can obstruct the movement of<br />
food)<br />
As a precaution against this, Dr. Flam wants me to take 20 mg. of Prilosec twice daily and<br />
Carafate Suspension, 1 tablespoon after meals and at bedtime. Somehow, my dead taste<br />
buds still think it tastes terrible.<br />
Today, I am feeling well, mildly constipated, <strong>with</strong> no nausea.<br />
I don't expect significant symptoms for the next 2-3 weeks.<br />
Posted by David Shuster at 11:17AM (-07:00)<br />
<strong>My</strong> <strong>Battle</strong> <strong>with</strong> <strong>Merkel</strong> <strong>Cell</strong> <strong>Cancer</strong>
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