The Treatment


The most important thing to say is that the treatment doesn't hurt at all, in fact you can't feel a thing, when the radiotherapy is being given you have absolutely no idea when the beams are being fired.

Two weeks prior to the treatment commencing, you are given aqueous cream to wash with, in my case from my head down to my armpits. You also apply the aqueous cream as a moisturiser twice a day. You are advised to avoid perfumed soaps or cleansers and not to use deoderant which has any metal content (many contain aluminium).

Every day the treatment is exactly the same for me. I strip down to my waist in a changing room and get into my gown, lie on the scanner table with my head in the cradle and a support under my legs. The mask is then fitted and clamped to the table. First lasers are lined up and checked then everyone leaves the room. You are constantly being monitored on cameras so if you have a problem you raise your hand and someone will come to your assistance as fast as they can.

linac machine
Radiotherapy machine

When everyone has left the room the door to the treatment room is closed electronically; this door must be about a foot thick and an alarm sounds to warn of its closing. Then the treatment begins. Although background music is played you can hear various clunks and whirring noises and before you know it you are being released again from your mask.

My treatment seem to take the length of time for me to listen to four songs, so probably about 15-20 mins.

Throughout the treatment you also here the door alarm going off frequently as radiographers come in and out of the room, constantly checking the lasers are lining up with your markers and the room light gets frequently switched on and off making it easier for them to see the lasers.

At St Barts the radiotherapy rooms/machines are named after planets, mine is Saturn and was kindly donated by the Mark Master Masons in 2011.

presentation plaque waiting room
Presentation plaque Radiotherapy waiting area

Week 1

I really didn't know what to expect, but after a week of treatment I didn't seem to have any symptoms. I still didn't feel any more tired than normal, I didn't have any pain although I could tell that I had received treatment as my muscles in my neck seemed a little bit tight and even though it was winter and around 0 degrees I didn't like the feeling of a scarf around my neck.

On day 4 and 5, I did have some slight reddening to my neck and chest a couple of hours after treatment, this was not sore and was gone again by the following morning. I think this may have been down to the fact that I didn't apply the aqueous cream the usual 2 hours before treatment and had therefore not had enough time to sink in and take effect. Also over the weekend, before the start of my second week of treatment, I didn't seem to be able to swallow as big a mouthful of food as I normally did, but it wasn't painful. I also noticed a slighty more mucus texture to my saliva.

Week 2

Week 2 started well, the slight redness disappeared and I felt fine, but following Fridays treatment my throat felt like it had swollen inside, making eating very difficult, and even swallowing water was troublesome and painful. One of the side effects of this treatment is damage to the mucosal membranes in your throat and mouth. This means they are very sensitive to abrasion from foods which has a major impact on what you can tolerate to eat or drink. I also found it caused my mouth to go into mucus overdrive. This is probably related to a reduction in saliva production as your saliva glands get caught in the crossfire.

And so the diet of soup begins.........

linac machine
Radiotherapy machine in motion

Week 3

My sore throat continued and following my weekly appointment with the dietician, I moved to a 'soft diet'. As the name suggests, I was advised to eat soft, easy to swallow foods such as pasta, jacket or mashed potato, eggs etc; things that wouldn't scrape my throat when trying to swallow. I was also advised to avoid anything acidic, which includes mosts fruits, not to eat/drink anything too hot or fizzy nor anything spicy for obvious reasons. Milk, as it is alkali, is apparently good to drink to soothe the throat.

I found if I took 2 paracetamol about 20 minutes before eating, I was able to manage soft foods. I was however told not to use any throat pastilles or sprays, just the paracetamol, which I could take in either tablet or dissolvable form; or just gargle with dissolvable paracetamol if I wanted.

The mucus situation also got much worse this week. I was constantly finding myself trying to clear my throat which was difficult as everything was so sore. It also affected my sleep as I kept feeling as though my throat was being blocked by goop. I couldn't swallow this as it was too stringy so I ended up sleeping with a towel which I would use to collect the 'surplus'.

Some people find that toothpaste 'burns' their throat when used, so I was given the pink dissolvable tablets that dentists use, to swill my mouth with and keep bacteria at bay. This would be all the more important if I found I couldn't continue with toothpaste. It is seemingly important to maintain a healthy mouth to discourage infections as your inflamed throat and mouth are now far more susceptible.

As the week continued, my throat became more painful and the effect of the paracetamol lessened, but I was still able to eat and drink each day, although not as much as I would normally eat. As far as I can tell, keeping hydrated assists the healing process and reduces the inflamation of the mucosal membranes in your mouth and throat - so constant sips of water were the order of the day. The dietician recommended drinking at least 2 litres per day which is quite a challenge when swallowing hurts.

Overall, it is important that you maintain, as much as possible, your starting weight so that the mask maintains a tight fit and your body is also best placed to heal itself after all this treatment. As you don't consume as much as normal you are encouraged to eat high calorie foods, such as by adding jam or sugar to your food or eating chocolate (I knew there had to be an upside somewhere).

As well as my throat becoming sore, this week saw the redness becoming quite noticeable to my neck and chest. The gallery photos below are taken at one week intervals and show the quick onset of redness.

Week 4

Predictably my throat felt worse and the mucus continued, but thanks to the web I found my new secret weapon.......honey.

I found if I dissolved a couple of teaspoons of honey in a small amount of boiling water and drank and gargled with it, it gave me some relief, albeit short lived. It seemed to soothe my throat and soften the mucus. I suppose the warm thick liquid coated my throat as it went down, and with honey's antibacterial properties helping to ward off infections, it must be better for my body than taking medication continuously. It turns out that Manuka honey has been proven to have antibacterial properties and is available in differing qualities from health stores and supermarkets. My jar cost £25, but I feel that is a small price to pay for a harmless natural remedy with no side effects.

This weeks visit to the nurse, dietician and doctor saw me coming away with some protein drinks of the juice and milkshake variety (yuck - I decided the pain of eating was better than the taste of these drinks), and some medication in the form of Mucilage (dissolve aspirin into water and add a raspberry flavoured syrup) which you either just gargle with, or gargle and swallow; and some oral morphine solution, which I wanted to only use as a last resort.

This week also saw my neck reddening more and I was given Diprobase cream to use instead of the Aqueous cream (although I was still to wash with the Aqueous cream). By the end of week 4, the skin on my neck and chest started to get a red/brown colour and it started to get rough. With me being a sun worshiper I know this only means one thing, I'm going to peel! To add to this, tiredness is starting to kick in, which is to be expected.

Week 5 - the final week of treatment

Having gone through 4 weeks of radiotherapy and not faired too badly, I wasn't expecting my final week to be as tough as it was.

The skin on my neck suddenly turned to a deeper red and I was given Aquaform Hydrogel Wound Dressing to use instead of the Aqueous or Diprobase cream. This felt lovely and cooling on my skin at first until it dried a little and I found its major drawback. It became sticky as honey. This was not a major problem until I tried to sleep whereupon my neck would end up sticking to my pillow and covers. This lead to an extremely uncomfortable nights sleep and I'm sure I made my skin more tender when I regularly had to debond my pillow from my neck!

For the last couple of treatments the radiographer covered my sore and sticky neck with clingfilm before putting the mask over me; both to prevent the mask chaffing as I breathed and swallowed and also so the mask didn't stick to my sore skin. Having lost about a stone in weight due to my reduced diet, I found I could now move very slightly in my mask.

Friday! With the final zap done all I had to do was get the okay from the doctor to go home and then pay a visit to the nurse to stock up on supplies, to ensure I'd have everything I would need to help me recover.

Nurse Fin gently demonstrated how to clean my neck with gauze and saline solution and how to apply cream and dressings to aid my skin's recovery. At this pont I was given yet another cream in the form of Flamazine. Now that I wasn't having radiotherapy, it is safe to use creams with a metallic content. Flamazine is often used for skin burns as it has a silver content which gives it antibacterial properties - the last thing you need at this stage is an infection.

Fully stocked up with nutrition drinks, creams, dressings, bandages and the like, I felt I was ready to open a Chemist.

The final advice I was given was to keep an eye out for signs of infection and to get antibiotics if anything flared up. Hopefully that won't be required!

Recovery, Post Radiotherapy Treatment

Recovery on the outside was, for me, fairly quick. I was advised that it would get worse before it got better and that was true. The redness of my neck deepened and it looked like it was going to crack, although thankfully it didnít; then almost overnight 10 days after my last dose of radiotherapy it looked much better. I decided that I would apply the bandages at night to prevent the Flamazine cream going over my bedding and if I went outside, but when I was in the house I left it exposed to the air. Once the redness faded, about 2 weeks after my last dose of radiotherapy, I was left with a darker brown area in its place, like a suntanned zone. I am still waiting for that to disappear a few months later.

The inside understandably took much longer to heal. During the last couple of weeks of treatment my voice came and went, but a few days following the last dose of radiotherapy I almost completely lost my voice. My throat wasnít sore in such a way as when you are ill and have a sore throat, instead it was just very difficult to swallow any food or even to swallow water. This croakiness and difficulty in eating lasted for a few weeks and I had to really chew my food well. Think of it as accidently swallowing a too big a mouthful of food and it grates as it goes down, that is the only way I can describe it, and dry foods like bread or chocolate I found were the worst.

Iím now a couple of months into my recovery and I still have my radiation tan, that is obviously going to take a while yet before it fades, I am still much more tired than I was before treatment and my saliva glands still arenít back to normal, making my saliva still quite thick which is most noticeable after brushing my teeth when it becomes quite stringy.

I am now awaiting my follow up Radioiodine scan, where hopefully I will be told that I am now cancer free!

Gallery - during treatment

Week 1 Week 2 Week 3 Week 4 Week 5
End of week 1 End of week 2 End of week 3 End of week 4 End of week 5

Gallery - post treatment

1 day after 4 days after 5 days after 6 days after 7 days after
Recovery day 1 Recovery day 4 Recovery day 5 Recovery day 6 Recovery day 7

8 days after 9 days after 10 days after 11 days after
Recovery day 8 Recovery day 9 Recovery day 10 Recovery day 11

If you have any positive comments to make about this blog please write to...