Marks of Distinction – Radiation Tattoos

I got my first tattoos. Two tiny little black dots, about the size of a pin head. Doesn’t seem like much. But, as life-changing tattoos go, these two little marks are the motherlode of significance.

These two tiny little dots act as anchoring calibration points for the radiation machine that needs to align on exactly the same plane every time when it shoots life-saving beams through my breast and former tumour site. The process to get those tattoos is fascinating.

Every radiation treatment program is very carefully planned out. Based on your tumour type and pathology reports, the radiation oncologist determines the type, intensity and length of your radiation plan. Together with physicists and radiation therapists, the oncologist carefully calibrates the beam angles to minimize risk to other organs – like your heart and lungs.

For my course of treatment (20 zaps, of which 4 are ‘boosts’ focused only on the former tumour site and the other 16 cover the entire breast), I lay on my back, with my left arm stretched above my head, holding on to a fixed handle to stabilize my arm. My position is carefully planned with the aid of a CT scan. You “assume the position” and they scan you breathing normally and also one holding your breath. For the 16 zaps that cover your entire breast, you hold your breath for 20 seconds. Inflating the lungs raises the chest wall and suppresses the heart, minimizing exposing the heart to harmful radiation rays.

Using the CT scans, the team carefully checks the angles to make sure that the plan matches the position your body is in. Once the plan and your body position match, they put the two little tattoos on the exact spots the radiation machine needs to align with. That way you start from exactly the same spot each and every time.

The tattoos hurt. Not very much – more stinging for a couple of minutes. They are permanent. That part I’m not so happy about. But they are tiny. It is cool, though, how they are going to be used.

The team also put a clear sheet of transparent plastic over my scar and breast and drew a ‘map’ of where they put all the marks, plus where the scar was. A non-digital back-up.

All in all, this ‘simulation’ (that’s what it’s called – they simulate, or practice, your radiation treatment) is a good warm up for the real thing. It’s very reassuring that they go to great lengths to plan every detail to minimize your risks.

I also got a list of approved lotions and soaps. The list of possible side effects from radiation includes extreme skin sensitivity within the area being treated. Your breast will feel – and look – like it’s sunburned. Skin will turn pink, and (like a sunburn) can become very dry and cracked. They encourage you to liberally apply lotion to keep it moisturized – but only those from the approved list. And, you are reminded to not rub your skin – just pat it dry after showers.

The dry run is a success. Tattoos are in place. Lotions from the approved list are purchased. I guess I’m ready. Let the zapping begin.

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