After having had my zoladex at the GPs, I headed off to The Christie, ready to talk radiotherapy with Dr Misra, and whether I want to be entered into the CORE trial – I will be having radiotherapy either way, but it may be standard treatment, or stereotactic ablative radiotherapy (which seems to be used quite widely in the rest of the world, but the NHS doesn’t routinely fund it). I am eligible for the trial because I have less than three metastatic tumours (just one), of less than 3cm – in other words, I have oligometastatic tumours.


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Got a week to think about whether I want to join the CORE trial for #radiotherapy – 50% randomised allocation of standard or stereotactic radiotherapy on my spine. #busylivingwithmets

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I have another appointment with Dr Misra next Tuesday to sign up for the trial, assuming I say yes, once I’ve read the 18 page consent form. If I say yes, the form then heads off to London, and the randomisation determines which kind of radiotherapy I get, and then the process starts.

He asked why I sighed when he asked how I was doing – well, no one wants more cancer treatment do they?

Standard Radiotherapy

This could start within a couple of weeks, with a CT planning scan probably within a week of being assigned standard radiotherapy. Standard dose is 10-15 treatments, typically 10, and this would likely happen before any chemotherapy.

Side effects (which is the bit I really care about) are mostly local, including temporary stiffening and tenderness around the treatment area (which I think is T11, not T10 as had originally been mentioned); redness on the treated site, and nausea (which they would seek to keep on top of with medication). The fatigue which I am particularly nervous about (as that is still impacting), but the expectation is that it shouldn’t be as severe, because a smaller area is being treated.

Late effects can either weaken the bones and lead to a possibility of fracture, or (more commonly) harden the bones and reduce damage.

Stereotactic Radiotherapy

There may be a waiting list for this to start, in which case, Dr Chittalia (my oncologist) would likely start the chemotherapy, as we want to get going with the treatment (although as I’m still on exemastane and zoladex, which is what the tumour appears to have been reacting to, it’s not as urgent as it could be) and and the radiotherapy would be fitted in at an appropriate time in the midst of treatment. I’ll see Dr C next Monday.

The potential side effects for this are largely the same as standard radiotherapy, with an increased risk of fractures in the long term, because it has focused so tightly on one area. It’s often ‘sold’ as ‘without nausea’, but if the beam ends up being sent through the front of the body, it can still cause nausea (joy).

What does it mean for the gym?

I’ve been building up my time at the gym, but I’ve been a little confused about what’s OK to do, and what’s not OK. For now, they want me to be cautious, but not freaked out. Once treatment is over, can be reassessed, so is not necessarily for ever but:

Oh, and I thought this clip was excellent:

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