The Neutron Dance.

Whoa I’m just burning doin’ the neutron dance
I’m just burning doin’ the neutron dance

(OK. First thing, a physics lesson for technical accuracy. Despite my inability to resist the Pointer Sisters reference, I’m being treated with high-energy electrons, not neutrons. The University of Washington does happen to be one of three centers in the country that has a neutron therapy machine, and one of a dozen with a proton therapy machine, but I’m not using either. Please let’s keep our atomic particles straight.)

So, what is technically the electron dance goes like this: Monday through Friday, around 10am, I deliver myself to the Radiation Therapy department, which is deep in the basement of the UWMC. I check in with someone at the front desk. At this point, 14 sessions in, I no longer have to bother giving my name, and we just have a pleasant little chat while they enter me in the computer and hand me a little pager device, just like the ones you sometimes get at large restaurants. Then I go to sit in the cluster of chairs in the waiting area. Because we are in the basement, there is no cell signal in the waiting room, but there is usually enough time for me to connect to the patient wi-fi with my iPhone.

The pager goes off with a rather excessive combination of vibrating, beeping AND flashing red lights. That’s my signal to get up, deposit the pager back at the front desk, and begin the long walk back to the treatment area. The treatment machines are in rooms dug back into the hillside, at the end of a turning hallway. To keep patients from getting lost, they have artwork of salmon mounted on the walls along the way, and they tell you to ‘just keep following the fish’ until you get to the small waiting area right outside the treatment area.


IMG_0263At which point, just in case you had missed the subtext, you notice that the rooms with the machines in them are referred to as “vaults”.

And they are behind foot-thick doors. Yeah, this is serious stuff, boys and girls.

When it’s my turn, I’m walked past a bank of control monitors and into the space with the actual machine, which looks not much different from a modern CT machine. That resemblance makes sense, because this is actually “image-guided radiation therapy”; the machine does a scan of my head each time so that it can adjust for small movements of my tissues.

Before I lie down on the table, I take off my shirt, and then have to insert my dental mouthpiece, called a “stent”, which was custom shaped for me during a visit to the specialist dentist weeks ago. It holds my teeth in a fixed position, and has a flap that holds my tongue out of the main path of the beams. It’s quite awkward, and getting it in and out requires opening my jaw wide, which hurts a bit. I can already tell that this will get harder as my mouth gets more sore.

Then I lie back on the table, making sure that the back of my head rests on the plastic cradle. The technicians (Ashley and Keith, usually) drop hand-hold pegs into a set position on the table for me to grab, so that my shoulders are in a particular location. Then they slide my mask on, and bolt it down.

IMG_0215 Oh, yeah, the mask. During treatment, my head is held stationary by a form-fitted mask, custom shaped to my head during my preliminary appointments. A flat panel of a plastic mesh was heated to malleability, then pushed down and molded to my face. As it cooled, it became rigid again. The blue border visible in this picture allows it to be fastened to the table, holding it, and me, in place. (Since I took this photo, they’ve cut eye and mouth holes for me, for what that’s worth.) I did say there was a medieval quality to this process, right? Foot-thick doors, bolted-on masks? Right.

The technicians make some final adjustments to my body’s position, using laser levels and the small spot they’ve marked on my chest, and then leave the room. After the door swings shut, the machine’s armatures do the first scanning loop around my head. There is a pause of about 30 seconds. Then the machine begins a series of movements and noises as the beam head moves to different positions and fires from different angles at my tumor. I normally just keep my eyes shut and wait for it to be over. The zapping process takes about 5 minutes. The effect of the beam can’t be felt, so I’m mostly just trying to stay motionless and to not think about the high-energy particles moving at relativistic speeds through my flesh.

The techs come back in, move the table back to the base position, and remove my mask. Then I can take out my stent, stand up, and I’m done. I put my shirt back on and head back down the hallway past all the fish, and it’s time to go home.

Then, about 4:30 in the afternoon, I go back and do it all over again. In between, I eat, and sleep, and take the drugs that help me get through all of this.

The treatment plan is a total of 60 sessions. I’ve now done 14 sessions; 46 more to go.

And that’s how my current ‘day job’ works.

I don’t want to take it anymore
I’ll just stay here locked behind the door
Just no time to stop and get away
‘Cause I work so hard to make it everyday
Whoo oooh, whoo oooh

8 thoughts on “The Neutron Dance.

  1. You just made me think of “Make a Circuit with Me” by the Polecats, which I then had to find on YouTube. And then Gary Numan’s “Are Friends Electric?”

  2. Holy voltage, Batman. Who could make up this stuff?! Hang in there, Paul. Can’t wait to see you and Kimberly on Saturday.

  3. The song I thought of was the Gap Band’s “You Dropped a Bomb on Me,” although I guess this is somewhat more specifically targeted…

  4. Yikes.

    How do you breathe through the mask, and how do they confirm that the beam went where it should?

  5. And by the way I thought of Electric Avenue….

    Hope this week goes ok for you Paul.

  6. I got no song references, sorry. Thanks for the really fascinating and amazing description. What I think about (not surprisingly) is all of the people who did the incremental bits of research (on the researcher and the patient sides) to get the technology to this point. Truly astonishing to think of how these technologies continue to develop and improve. I feel very grateful to those who have helped to figure this out, and to our federal government that has funded the basic and translational research. Thanks US Taxpayers who have helped to heal Paul!!

  7. This all sounds as though it might trigger extreme claustrophobia but you’re already more than a quarter of the way through. I’m cheering for you, every day.

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