Treatment

ABOUT RADIATION AND CHEMO

• Cancer cells exhibit high metabolic activity - they're constantly multiplying which is why people end up with a lump somewhere. Chemotherapy attacks areas of high metabolic activity - which means cancer cells, hair follicles, the whole digestive tract, and bone marrow. All side effects are traced to the latter three. It sounds like these days side effects can mostly be controlled fairly well, except maybe fatigue. 
• One of the oncologists I talked to told me that they have found radiation and chemo to be much more effective than surgery with this type of cancer. Surgery also tends to remove several body parts I would like to keep (look up 'pelvic exenteration' - yikes!)

MY TREATMENT

• 23 sessions of external beam radiation - 5 days a week takes about 30 minutes (South San Francisco). 
• 6 weekly chemotherapy sessions, each of which take about 4 hours (this will be in San Francisco.) Lab work two days prior to this, each week. 
• On Feb 8, I start internal or 'high dose' radiation - half a day once a week for 3 weeks (in Santa Clara.) On days I'm having this kind of radiation I won't have the other. Last one is Feb 28.
• I'm also going to fit 2 acupuncture appointments per week in here somewhere. 

In short, a lot of appointments. 1-2 per weekday!

RECOMMENDATIONS DURING CHEMO

• Fight infection - 1. Wash hands frequently (most important); 2. Avoid sick people; 3. Food - cook meat/eggs well, pay attn to hygiene in kitchen 
• Highly recommended: 10 minute walk 3x/day.
• Don't lose weight, make sure you're getting enough calories. Shouldn't lose more than 10% of body weight. 
• Small frequent meals. Suggestion was to freeze food so it's available when needed. 
• Hydration super important; 64 oz/day of liquid from various sources (soup, popsicles, smoothies, sports drinks.) Just drinking water can strain kidneys. Need electrolytes. Found this recipe on http://lowcarbdiets.about.com - Mix together: 1 cup (8 oz) water (not carbonated), 2 Tablespoons lemon juice, small pinch of salt, flavoring and sweetener to taste.
• Need to keep a thermometer on hand. If temperature is > 100.4 for 2 hours, OR if 101 even once, need to go to emergency room.
• My hair will fall out after a couple of weeks. I will cut it very short before I start. 
• Take Tylenol, not Advil or Alleve or aspirin which contain blood thinners. 
• Only take multivitamins and calcium; if taking anything other vitamins or herbs, make sure oncologist knows. 
• Recommended products: Nioxin for hair, Biotene restorative mouthwash, thermometer, sunscreen, mild toothpaste like baking soda, soft toothbrush, imodium-AD/loperamide, senna. Hypoallergenic moisturizer.
• Different doctors have told me that during chemo it's important to avoid any herbs or vitamins with high doses/content of anti oxidants such as Vit E and Vit C (a once a day vitamin is okay). Also, anything that thins the blood. 
• I probably won't be able do much during this time. I will be in bed a lot of the time, no doubt watching bad sitcoms on my laptop or perhaps listening to books on CD.

ACUPUNCTURE
Will be working with my acupuncturist to address side effects.