A blog about my journey and experiences with Adenoid Cystic Carcinoma

RADIATION / PRE TREATMENT


Before treatment starts you will have an appointment to get the mold of your head made and a scan done. This is actually a very quick and painless process that takes about 15min. They take a sheet of plastic with diamond cut opening in it and put it in hot water to make it flexible. The warm plastic is then quickly molded over your head while you lie flat on your back. You then wait about 5min with the mold on your head for it to cool down and harden. The mold is used to hold your head in exactly the same position and perfectly still during your radiation sessions. Some people documented that the mask made them feel a little claustrophobic but because you are able to open your eyes and the treatment is over so quickly it should not be a problem for most.

Before they started molding the mask I was asked to put a syringe (without the needle of course) in my mouth. This was done in order to protect my palate and upper jaw from the radiation. It just gives a bit of separation.

A small piece of wire was taped directly onto the scar in my neck where the lymph nodes were removed in order for the oncologist and radiologist to see on the scan exactly were it is in order for them to take this sensitive area into account while planning my sessions. After the mold is made you will then have the scan done with the mask on in order to provide the radiologist with a clear picture of your position and to enable him to plan how the radiation will be done. The angle of the beam will be planned in such a way that it will not cause damage to important areas such as your eardrum and eyes.

RADIATION / SESSIONS


After this session they provided me with a printout of the dates and times my sessions were scheduled. I had to have 30 sessions, which were spread out over a seven week period and a 10min appointment with the oncologist once a week.

Session 1 2014 / 02 / 11

I was asked to tie my hair up in a tight ponytail on top of my head, the same as when I had the mask made and this is how it must be for all of my sessions. Treatment took about 10 minutes. Felt absolutely nothing. The only minor issue I had was the saliva that gathered at the back of my throat that I was unable to swallow because of the syringe in my mouth.

The nursing staff asked that I be there 10min before each session in order for them to stay on schedule. It is clear that there sessions run like a well oiled machine. I had my first weigh in at 60kg. How strange it is to be weighed in order to check that you do not loose too much weight.

I also bought two scarves today to protect my face and neck from the sun. For the next seven weeks I am not allowed to wear any make up or apply anything to my skin other than aqueous cream for my face and blue label Vaseline on my lips.

Ate a pork chop and couscous for lunch, yum!

Session 22014 / 02 / 13

Still feel nothing and have no side effects.

Session 32014 / 02 / 14

The burning plastic smell during treatment made me feel a bit sick and kept lingering in my nostrils for most of the day. First time I noticed the smell. No redness or side effects yet. Had to stop just as my treatment started and be repositioned, the angle of my head was slightly off. Today was the first day since my surgery that I was able to open my mouth wide enough in order to see how it looks where the part of my jaw was removed.

The stitches holding my tongue to my cheek have now dissolved but there is no jaw area, just one piece of skin connecting my tongue to my cheek. Not sure how my surgeon plans to give me teeth in that area again seeing that there is no visible jaw area, but can't worry about this now.

Session 42014 / 02 / 17

My treatment was even quicker today, the staff informed me that this is because they stopped taking x-rays before they start the treatment (didn't even know they were doing that). Now they are only going to do it every ninth session.

Had a scratchy throat last night, hopefully it was nothing and just my paranoid brain acting up and not a real side effect starting. Had nice pasta with a medley of vegetables. My scratchy throat made it difficult to enjoy though.

Session 52014 / 02 / 18

Throat feeling a lot better today, must have been my paranoid brain. Ate a tasty toasted ham, cheese and tomato sandwich after treatment. Still feeling very good.

Session 62014 / 02 / 19

Drank a non alcoholic beer today which was gross, miss being able to drink real beer. Was told to not consume any alcohol during treatment because alcohol can worsen your dry mouth side effect caused by the radiation.

Ate spicy vegetarian Bobotie and beetroot salad at a friend's house. Delicious!

Session 72014 / 02 / 20

Started noticing some cracks in my tongue. Spoke to the oncologist today and he told me that it would get progressively worse from here. Got weighed again today, now 59kg. I am not experiencing any trouble eating but think it is the stress of it all that has caused the slight weight loss. The staff told me to try to eat as much as I can while I still can in order to build up some resources.

Session 82014 / 02 / 21

Blisters are forming inside my mouth, was shocked at how quickly they appeared. Really was expecting this to happen a lot later. These blisters are not only on the left side of my mouth were the tumor was removed and which receives the bulk of the radiation but also on the right.

Ate some boneless chicken wings at Hooters, luckily still able to enjoy it. However eating has now started to become painful but still manageable. Skin rash starting on the lower left side of my face, looks more like fine acne that sunburn at this point though. Nurses assured me that it is normal.

Session 92014 / 02 / 24

Told the staff about the blisters in my mouth, their advice was to start changing over to a soft diet. I am however not ready to give up solids yet. Ate lots of biltong (the South African version of Beef Jerky). I can still taste everything and not experiencing any trouble with dry mouth. The radiologist also told me that it is very important to eat loads of protein and suggested I eat more eggs. Blisters in my mouth are getting progressively worse.

Session 102014 / 02 / 25

I've made it a third of the way!!!

Entire mouth covered in blisters, but I am still eating everything. I have no difficulty swallowing and my throat feels fine. Starting to enjoy ice cold water more and more, does bring some pain relief. The power went out today just as I was about to start treatment. Luckily it came back on soon after. Spoke to another patient in the waiting room; she is being treated for breast cancer. It was nice hearing about someone else's cancer experience.

They took x-rays again today which meant that treatment took a bit longer that usual.

Session 11 2014 / 02 / 26

I am still eating solids but I am starting to prefer bland foods.

Session 12 2014 / 02 / 27

Told radiologist that my blisters are becoming increasingly painful and that I am starting to lose my ability to taste, was sent to the oncologist and he prescribed the 'cocktail'. The ingredients of which will be provided under the medication section. It burns like hell, but does numb the pain for a short while. It is very strong and also makes me quite tired.

Threw up this morning, not sure what caused it. Maybe it is the combination of pain and eating too early. Had ensure (meal replacement shake) and pawpaw. Not a winning combo. The 'cocktail' is too strong for me so I am urrently drinking ibupain forte which is still helping rather well.

Session 13 2014 / 02 / 28

In extreme pain. Mouth filled with very large yellow blisters that look more like a fungus. My tongue is extremely swollen and feels like it is on fire. My usual oncologist wasn't in today so saw another doctor who prescribed Temgesic 0.2mg (Buprenorphine Sublingual Tablets). Hope it brings some relief. It is my best friend's engagement party this weekend and I am supposed to host the event.

Session 14 2014 / 03 / 03

Had a disastrous weekend. The pain became absolutely unbearable and my tongue is now so swollen that I can hardly speak. I am also finding it impossible to eat; I am only drinking Ensure now. It was so stressful having to entertain people at my home and by Sunday I felt extremely depressed. I am seriously considering quitting treatment, if my symptoms become any worse I can not imagine going on, I am not even halfway yet!!

I showed the radiologist my tongue and was sent to the oncologist immediately. I told him that I was seriously considering quitting and he asked to give the new medication he prescribed a try before making my decision. He prescribed stronger morphine, steroids for the inflammation and drops for my swollen tongue.

He also said that perhaps instead of quitting I could rather just take a week off and recover a bit before continuing with treatment. He said that because Adenoid Cystic Carcinoma is such a slow growing cancer this was an option. I told him I would stick it out one more week because we already traveled to Pretoria and I didn't have the energy for the 3 hour trip home. The new morphine is bringing relieve but also making me feel very drugged.

Session 15 2014 / 03 / 04

Halfway... Swelling in tongue is down a bit and the pain is more manageable. Feeling very worried that as the week progress this will change. Eating soup and ensure. I now weigh 56kg. Trying to limit my speech as much as possible. Talking has become very painful. Blisters are now also forming on my lips. My face is extremely red and dry but luckily it isn't painful.

Session 16 2014 / 03 / 05

Definite signs of improvement. The large yellow blisters have now changed into less swollen white patches. My gums have started to bleed badly when I brush my teeth, despite the fact that I am using a super soft toothbrush. My teeth also feel like they are never really clean. It feels like I have a constant layer of plaque on them, maybe it is just the skin that is coming of in the inside of my mouth. The drops and steroids the doctor prescribed really does help. I can still taste some things but mostly everything just tastes like salty rotting meat.

Session 17 2014 / 03 / 06

Feels very strange to end of my fourth week feeling better than what I did at the start of the week. Went to a friend's house for a braai (barbeque) not expecting to try and eat anything.
(I have only had ensure the last week) but he managed to convince me to give it a try and I was very surprised when I managed to finish a medium rare lamb chop. The taste was absolutely revolting, really did taste rotten, but was happy to get real food in my stomach. The firm textures of the meat made it easy to eat because I could cut it in thin strips give it two chews and swallow. It didn't fall apart in my mouth and forced me to use my tongue too much. It stays a single bite unlike rice or salad that goes everywhere. The acidity in fruit makes it impossible to eat, burns too much.

Session 18 2014 / 03 / 10

Feeling tired and negative. I have no appetite and is really getting very sick of ensure. After I drink it I struggle with a slimy mouth for about an hour. It makes my saliva very thick which in turn make me very nauseous. The vanilla flavour ensure is also too frothy so I stick to chocolate flavour. The steroids that helped so much with the swelling and pain is now starting to make me feel sick. It burns my stomach and makes me feel bloated.

Session 19 2014 / 03 / 11

Feeling horrible. Tried my best to eat salmon and vegetables for lunch but just couldn't keep it in. My stomach is very sensitive. I am feeling dehydrated and emotional. I really can't even think about food. I couldn't drink my steroids today because I knew my body would reject them and I just couldn't bring myself to drink them knowing they would make me feel worse.

Session 20 2014 / 03 / 12

So tired of people telling me to eat and making smoothie suggestions. I promise I am doing my absolute best. I know that it is because I am not eating that I am feeling so emotionally spent but I just can't. Doctor prescribed pills for my nausea; they are usually prescribed to chemo patients but will hopefully bring some relief. They are extremely expensive, R100 a pill, so hoping I get my money's worth. Took one and it helped for about six hours, they are too expensive to take more than one a day so will try again tomorrow.

Session 21 2014 / 03 / 13

Drank another nausea pill (Zofer Rapitab) and it really helped a lot. Amazing how much better you can deal with life just by being able to think about something other than how crappy you are feeling. I am for the first time able to consume something other than ensure. Thank goodness!

Session 22 2014 / 03 / 14

Think the worst of the nausea have passed. Still feeling a bit drained and tired. Experiencing extreme constipation.

Session 23 2014 / 03 / 17

Had a horrible weekend. Had to get an enema which was very embarrassing but it did help and I am feeling less uncomfortable. Things are looking up and I feel much more stable emotionally. I even bought a flight ticket to Cape Town for my friend's wedding next weekend.

Session 24 2014 / 03 / 18

Feeling better still. I have fewer blisters in my mouth and even the rotting taste in my mouth is a bit better or maybe I am just getting used to it...

Session 25 2014 / 03 / 19

It is so strange that I continue to improve. The oncologist told me that my symptoms would reach a plateau but I am experiencing definite improvement. The fact that I can eat is helping with my emotional state of mind. I have completely lost my ability to taste sweet, really miss it. Went and saw a movie with my mom today, I was a very welcome distraction.

Session 26 2014 / 03 / 20

So happy that I am feeling this good for the wedding. The massive red mark on my face is not going to look good on the wedding photos, luckily the nurses told me about a make-up brand that I am allowed to use called Bio-Nike. It was specifically tested and found to be safe to use by patients undergoing radiation therapy. Instead of this wedding being another obstacle that I am going to have to endure, I actually feel like I might even be able to enjoy it.

Session 27 2014 / 03 / 25

I was supposed to have a session yesterday but there was something wrong with the machine so only had it today. I had a wonderful weekend in Cape Town and enjoyed the wedding a lot. Danced until 2am and had so much fun with all my friends. Must admit when I got to the guesthouse I sat and cried in the bathroom for a long while. I think they were more tears of joy than sadness though. I was just so relieved that I was able to attend the wedding and that I was almost at the end of my radiation therapy. I am so glad that I didn't quit in my third week when things felt unbearable. Only three more sessions to go.

My mouth is quite sore again. Think it is because I finished with my course of steroids. Blisters are popping up everywhere again and my left ear is constantly aching.

Session 28 2014 / 03 / 26

Saw the oncologist again and got a new prescription for steroids. I am so lucky that my symptoms are so mild in the end. I still have sufficient salivary production and only have a dry mouth when I wake up in the mornings. The first oncologist I saw told me that all of my salivary glands would be destroyed and that I would have permanent dry mouth. How incredibly happy I am that that is not the case. I can even eat very dry foods such as bread without needing a drink to wash it down with. I can still taste salty and bitter but sweet and sour is completely gone now. I have a constant salty rubbish taste in my mouth and because I can't taste sweet sucking on candy doesn't bring any relief.

Session 29 2014 / 03 / 27

My symptoms are still stable. My neck area is red but not painful. In my fourth week of therapy my skin became very dry and irritated but then I started using the Bio-Nike lotion. My skin is much softer and no longer itchy. The lotion specifically helps with the redness and my skin has changed from a very deep almost purple red to a much lighter shade.

Session 30 2014 / 03 / 28

My last session!!! Wow, I can't believe this nightmare is coming to an end. Bought a big container of chocolate cookies to say thank you to all the staff that helped me during this time. They asked if I wanted my mask, which of course I did. Not sure what I am going to do with it or where I am going to put it. Looks like a scary Halloween mask. So incredible grateful that I have finished this part of my cancer journey and can go home now.

/ GALLERY


RADIATION / FOOD


Foods that held their shape worked best for me. Something I didn't have to chew too much and could almost just swallow. Remember the blander the food, the less pain it will cause. Here is a list of specific things I was able to eat:

Foods that worked for me
  • Meat, especially red meat. Chicken can be a bit dry and stringy- you don't want something that gets stuck in your teeth.
  • Boiled carrots.
  • Vegetable juices – especially carrot, beetroot, watermelon
    & apple.
  • Al dente pasta (no sauce) short stout pasta like penne worked best for me.
  • Ensure – this however must be your last resort. Don't become to dependant on this too quickly. Believe me you are going to become so sick of this.

* Remember to keep pushing yourself to try new things.

The radiation is wreaking havoc on your taste buds so maybe something that was terrible last week becomes a new favourite this week.

Foods that didn't work for me
  • Dairy – Made my saliva slimy and thick.
  • Grains – It goes everywhere in your mouth and becomes a mission to wash out.
  • Potatoes – Burned like fire, even when mashed.
  • Salads – Too many components. It is easier to stick to food that are the same size and texture.
  • Ice cream – Because it just tasted like salty cold butter, gross!
  • Bread – It will soak up every last drop of saliva you have and become impossible to swallow.

* Please don't dismiss these foods just because they didn't work for me.

I spoke to another woman who said that ice cream was the only thing she enjoyed eating. Every person is different. I only add this list as a guide. If you struggle with the same food, know you are not alone.

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