Absolutely radiant

For those of you who've never had the pleasure, I'll describe what it's like to have radiation treatment. A typical course for breast cancer is 25 treatments, every weekday for five weeks (statutory holidays excluded). Sometime before the treatments begin, you have a planning session including a CT scan during which they position you on a table and take a bunch of measurements so that they can aim their radiotherapy beams at the right spots. Each treatment has to exactly duplicate the position in the plan.

When I had radiation five years ago, the positioning bit was time-consuming and even painful because my back problems got in the way; they wanted to radiate my breast without catching my armpit, but I'm so inflexible it was hard to do. Not only do they not want to radiate tissue that doesn't need it, but they don't want to preclude the opportunity to radiate it sometime in the future if it becomes necessary. I believe that's because they aren't supposed to radiate the same spot twice in one lifetime. This time around, it's going much more smoothly; when I mentioned this to my radiation oncologist and attributed it to the fact that this time they're radiating my armpit and not my breast, she said no, it was because they are better at it than they were five years ago. She told me with some excitement that my plan had been presented to a board or a committee or something, presumably as an example of something tricky.

They're not just radiating my armpit; they're also doing something called the supraclavicular area, which is between my breast and my neck, as well as a spot on my back. There are lymph nodes there that can develop cancer, which would not be good.

The setup at Princess Margaret Hospital is pretty smooth. I received a little card with a UPC label unique to me, and when I arrive in the department, I stick the card under a scanner until it beeps, which lets the technicians know I'm there -- I never have to speak to a receptionist. A computer screen tells me if my treatment unit is on time or running behind. The modern-looking reception area is equipped with comfy chairs (though they're arranged like an obstacle course), jigsaw puzzles in progress on coffee tables, as well as bins full of partly knitted scarves that knitters can pick up and continue. But the wait is never very long; I'm usually called in within five minutes, by a young technician proffering a robe that's large enough to fit three of me.

After I change, I enter the large radiation room when the "Beam Off" sign is lit up. A huge photo of a tropical beach hangs backlit on the wall. My plan states that I don't use the neck support, so they remove it from the table before I lie down, positioning my tailbone on a ridge in the table, almost the only uncomfortable part of the procedure. Every single day they ask me for my date of birth.

There's a CD player in the room, with a pile of CDs; most often they play some horrendous Muzak-y piano renditions of tunes such as "Babe" by Styx or Whitney Houston's "I Will Always Love You." Once in a while I complain and ask for something better and they put on a Motown CD, but I think some of the technicians prefer instrumental stuff so they can concentrate on what they're doing without distracting lyrics.

Two young and friendly technicians spend about five minutes getting me in the right position, measured down to the millimetre, literally. I remove my left arm from my robe and raise it so that it lies in an arm support and my breast is exposed. During my first appointment, I was tattooed with minuscule black dots on my chest -- so minuscule I had assumed the ones I got five years ago were gone, but apparently they could still see them. They make some more spots on my skin with a Magic Marker. One technician reads out measurements in centimetres and millimetres and the other adjusts me, the table, and other doodads. "Eighty-nine point five," says one; "I agree," says the other. In the dim room, narrow beams of green light crisscross my body -- I don't know what they are. But there's a sign on the wall that warns against looking at the sources of the beams, so I mostly keep my eyes shut. So that the radiation doesn't hit my chin, I have to keep it tilted up, which is the other mildly uncomfortable part.

When they're assured I'm in the right position, the technicians cover me up with my robe or a piece of paper, and say brightly, "Here we go." They leave the room to go to their posts at the computers that direct the beams, where they can see me on a monitor. There's a big round machine above me, and it starts to make whirring noises, moving around me in a circle. A high-pitched whine sounds when the radiation pierces my body, but I feel nothing at all. It takes about five minutes, and then the technicians re-enter the room and help me off the table. That's it. It's about as simple as a normal X-ray, though it's really a kind of particle accelerator, with much, much more power than an X-ray.

There's an easy-to-follow explanation of all this at a U.K. website called Cancerbackup, which I find amusing because in one spot, where they explain that certain types of cancer require the insertion of an internal probe, they use the term "back passage" presumably to mean "anus." Yikes. Anyway, luckily none of my passages, back or front, are being invaded.

Yesterday I was hit with serious fatigue, but it might just be the heat. My skin is starting to get a little rough and sore, but it's not too bad so far. I have 10 treatments left.

Pollyanna moments:

• It's like an oven outside, but I've been able to keep my non-air-conditioned house relatively cool by keeping all the doors and windows shut and judiciously using fans.
• I had a birthday cake at my brother Paul's last weekend.
• I was able to spend a long while with my dad on Saturday, and we bopped around his room to Oliver Schroer's fiddle and a bunch of tunes by the Mamas and the Papas.