It’s said a picture is worth a thousand words, but I suppose that depends on the picture. This one requires some explanation and I can’t guarantee I’ll do it well. But I’ll try.
This is a cross section of a scan of my chest. (Actually, it’s a photo of a very small printout of the computer screen I was looking at this afternoon, hence the poor quality.) Left and right are reversed because the view is from below, looking up.
Long story short, the colored contour lines mark areas to be radiated. (Remember, this is IMRT*, or intensity-modulated radiation therapy.) Note the lines skim around my heart, the gray blob right in the middle. Hurray! That’s the big story here. The doctor said they had to run a lot of calculations to come up with this, and I am deeply appreciative.
I was unlucky enough to get a tumor practically in the middle of my chest, where it didn’t show on a mammogram and, once discovered, has been difficult to treat. But I’m lucky to have a heart that’s located almost exactly in the center of my chest, which allowed the radiologists to work around it. Had it been farther to the left (right in this image), as it is in most people, it would have been difficult, if not impossible, to treat me without damaging it. As it is, you can see the radiation does clip a part of the left lung. Unavoidable, since the lungs fill the entire chest cavity. At this point I’m not sure what the long term effect on the lung will be. Today it was enough for me to see that my heart is in the clear.
The center of all the contouring is a pinkish area within a yellow contour. That’s where the tumor was. The tiny blue circle under (behind) the left end of that area is the vertical chain of internal mammary nodes, several of which appeared cancerous on early scans.
The total area being radiated extends all the way from the side of my ribs over to the right side of the sternum. And up to above my collarbone (there are lymph nodes there, too). Big area. Trying not to think too much about it.
I found this diagram on the internet, and with the exception of the arc/corner over the arm, it shows where I’m being zapped. With at least two applications of lotion a day, it looks like I’ll be going through gallons between now and mid-November.
By the way, you’re excused if you didn’t read this far. This stuff is definitely an acquired taste.
* “IMRT allows for the radiation dose to conform more precisely to the three-dimensional (3-D) shape of the tumor by modulating—or controlling—the intensity of the radiation beam in multiple small volumes. IMRT also allows higher radiation doses to be focused to regions within the tumor while minimizing the dose to surrounding normal critical structures. Treatment is carefully planned by using 3-D computed tomography (CT) or magnetic resonance (MRI) images of the patient in conjunction with computerized dose calculations to determine the dose intensity pattern that will best conform to the tumor shape.” — From the Radiological Society of North America