Back at home again

My visit to Linköping did not last as long as I thought. I went there yesterday morning. My appointment at the doctors was at 14.20. I did the “simulator thing” where they mark my body exactly where they are going to stream the radiation.
At 16.15 I was sat in a taxi on the way home again.
The reason was that the “radiotherapy machine” was broken. There is a piece missing that they need to order from another country and they don’t know when it can be fixed. Therefor I got to reschedule my visits. I have to come back on Monday at 10.50am to start the treatment finally.

Here is some information about radiotherapy and what the doctors and nurses have done to me at the hospital in Linköping so far:

So does radiation work:
The radiation typically used in radiation therapy is similar to sunlight but with much higher energy. Thanks to the high energy radiation produces electrically charged particles in the area of the body being treated. Particles called ions, and therefore called radiation ionizing radiation.
The radiation also leads to the formation of free radicals in tissue and those causing damage to genetic material, DNA. It is precisely these DNA damage we want to achieve. Damage to tumor cells genome is the basis of radiation therapy effect.
Cells whose DNA is damaged, lose their ability to divide and eventually die. The damage in DNA is repaired often, but tumor cells have less repair capacity than healthy cells. Therefore, the tumor cells die while most healthy cells survive. In addition, shielded radiation so that the healthy tissue is spared as much as possible. In this way the tumor can be shrunk or completely eliminated, while the healthy tissue will be fine.

Preparation before treatment
Before the actual radiation treatment can begin you have to do some preparation. How much preparation needed depends on the type of tumor it is, how urgent it is to start treatment, whether it is curative or palliative treatment, and so on.
Fixation
It is very important to exactly the same area is irradiated from time to time. To facilitate this often produces different types of so-called fixation devices. For tumors in head and neck area makes it a face of a plastic net which is shaped just for the face, neck and shoulder shape. During treatment helps mask the patient to keep your head still on the treatment table so that staff can set the radiation exactly right.
Sitting tumor elsewhere in the body can instead use a so-called vacuum pillow, a kind of mattress where the body makes an impression, which then means that you are in the same way at each treatment.
Anchors are usually made so that you can easily get out of them if needed. Usually it is not concerned about any devices which are clamped.

Computed tomography
Another preparatory step is to do a CT scan. It is a kind of X-ray which can take detailed cross-sectional images of the body. The survey also known as CT, Computerized Tomography. CT Scans prefer the previous fixation. The survey takes about 15 minutes and then it can take up to two weeks before the actual radiation treatment begins. Sometimes also used contrast in this study to better distinguish the various organs and tumor changes. The contrast medium can either be administered intravenously through a vein or by drinking it.
The images from CT scan shows the tumor extent and location. Using this information, since doctors determine the range of radiation need to cover and which areas should be avoided to spare the sensitive organs.

Treatment planning
Then treatment planning. With the help of computers and staff knowledge is determined from which direction the radiation is directed, and the type of radiation to be used.

Simulation
Today it is becoming increasingly common for treatment is started directly in the radiation therapy apparatus, without a previous simulation. But when the treatment is simulated by the use of a simulator, an X-ray with the same opportunities for settings such as radiotherapy equipment. Everything is done in the same way as in the upcoming reading, because you use the tethers that you made.
When the patient arrived in the correct position, check with the aid of fluoroscopy the radiation field with the individual treatment plans. Since the marked boundaries of the area to be irradiated with a permanent marker, or with little tattoo dots on the patient's skin.
The markings are then used throughout the treatment period to verify that the radiation is placed in the right place. They must remain in place during the entire treatment period that may extend over several weeks. It is okay to shower the field with markings, but do not rub with soap. Avoid strongly perfumed soaps and deodorants in the radiotherapy field. Pat dry the skin. Disappears marks must be set on.
The visit at the simulator or the setting directly in the radiation therapy device can take about an hour, thus much longer than the next reading. It depends on many factors should be checked, the radiation fields are highlighted, radiographs should be taken and so on. Sometimes, this visit also include information about the treatment from the responsible oncologist. After a few more days so treatment can begin.

Simulatorn looked like this and I was in it for about 30 minutes. I got tattooed with 3 small dots.