Olá Bom dia to Jordan’s Global Support Network:

This week’s edition of the ESPN (Extra Special Paganelli Network) will continue to chart our course through the miraculous world of RADIATION. With Week 21 & 22 complete…….Jordan has passed the half-way mark on his 7-week epic journey with “high-energy particles”. So………let’s see what’s up!!

First, the HEADLINES:

• Segment 1: Jordan valiantly and voraciously chews through the 3^rd week of his 7-week Chemo/Radiation deluxe meal deal………and watches Mr. C-Cell get spit out of the mix.

• Segment 2: Summer is in full swing in Southern Maryland………. and Team JP is making the most of cruisin’ the neighborhood, goin’ to the pool, playin’ games, and just hangin’ out.

• Segment 3: Jordan’s Dad is back at it with “Cancer 101 for Dummies: Part 8—What’s this Radiation thing all about??”

Now, on to more detailed coverage of our stories:

• Segment 1: Weeks 21 & 22 are in the history books. No need for my usual long-winded and overly-detailed description of Jordan’s treatments. Simply put: Three UP ………and three DOWN!! And, no ill side-effects from either the Chemo or the Radiation. Jordan is handling the combo meal-deal the same way he handles everything else………like a true warrior. ‘Nuff said…….GIDDY UP!!

• Segment 2: School is OUT ………and Summer is IN!! Teenage Translation: Non-stop fun in the sun for Jordan and all his Buds. And………since this phase of treatment does NOT include any IN-patient stays at the hospital……..Team JP can keep the party crankin’ without interruption. Daily routine: crusin’ the neighborhood, crusin’ chicks, hittin’ the pool, playin’ games, goin’ to movies………all the usual stuff that makes Summer such and awesome time of the year. And, for us……….it is ESPECIALLY awesome because Jordan is lookin’ good, feelin’ good, and havin’ a good time. All smiles on this end.

• Segment 3: Now for our third and final segment of the evening: “Cancer 101 for Dummies: Part 8—What’s this Radiation thing all about??

• As we learned a few months back………..battling cancer often involves a 3-prong attack: Chemotherapy, Radiation Therapy, and Surgery. Each of these “Tools” in our “Toolbox” are highly specialized weapons against Mr C-Cell………..and, when used together (in the right combination) they provide a “synergistic” effect that makes the overall treatment much more effective. Up to this point, Jordan’s treatment regiment has called for Chemotherapy ONLY because Chemo is the quickest (and most efficient) way to initially target ALL the C-Cells throughout his body……....while determining if (and how) his body will respond to the Chemo medicines. As we have learned……….the Doctors have tracked the effectiveness of Jordan’s Chemo regiment by conducting periodic evaluation scans to see how things are progressing. These scans tell us which C-Cells have been killed-off (“chemo responsive”) and which C-Cells (if any) appear to be NON-responsive or “resistive” to the Chemo. In Jordan’s case…….the scans have revealed a progressive decrease in both the size and activity of the cancerous areas that we can SEE. However………since Mr C-Cell and his buddies are made-up of billons and billons of cells……..we have to be sure that EACH and EVERY one of those cowardly invaders (both the ones we see…….and the ones we can’t see) die a PERMANENT death. Enter Radiation.

• Now, just like most viruses and bacteria………Mr C-Cell often has the ability to “mutate” itself over time to become more resistive to Chemo medicines (I’m sure you’ve heard of term: “Survival of the Fittest”). Most organisms (including the bad ones) will “learn” and “adapt” to their environment in an attempt to survive and evolve their “species”. Unfortunately, that causes a lot of problems in the world of medicine. That is why doctors are continually forced to develop new Anti-virus and Anti-biotic medicines to combat the emergence of new “strains” of bad guys. For example: the Flu Shot we get every year is slightly different from the previous year’s vaccine………because it is formulated from predictions and analysis of how the existing Flu virus has evolved and adapted from year to year. These “adaptations” also occur with C-Cells. Statistics tell us that there is a possibility that some of Jordan’s C-Cells will be “lurking in the shadows”………learning and adapting……..hanging out waiting to reveal their “new form” at some later date. That, of course, is UNACCEPTABLE. So……..we bring out another “Tool” from our Toolbox and hit Mr C-Cell with a ONE-TWO punch. And……… not only is it a ONE-TWO punch…….but, it is also a “SNEAK ATTACK” because Mr. C-Cell doesn’t see it coming. Before it can adapt………the Radiation has deep-fried (Paganelli-Style) its DNA backbone and left it on the side of the road to die with the rest of the C-Cell losers!!

• In this segment, I’ll take my first “bite” out of Radiation……….and attempt to explain the “mechanics” of how Jordan gets his daily Radiation treatments. Then……..next time, I’ll take another bite and explain the “biology” of how the Radiation actually works to kill C-Cells. So…….strap-in…… and standby to put your thinking-cap on.

• As I mentioned in the last update, Jordan is currently receiving 7-weeks of daily Chemotherapy COMBINED with Radiation. We drive up to Walter Reed Hospital Monday through Friday so Jordan can receive his deluxe combo meal-deal. About a week prior to starting the Radiation, the doctors performed a procedure called a “Radiation Simulation” which is like a “dress rehearsal” for the real thing. During this “simulation”, the Radiation Oncology doctors re-scanned his body to confirm precisely where and how they wanted to use the radiation. Then, once that was confirmed……… they used those CT scans in conjunction with lasers to establish an exact position for Jordan to lie in so the machine can precisely deliver the Radiation to the pre-determined areas in his body. Why?? Because……in order to consistently and accurately deliver the radiation, Jordan’s body has to be “anchored” to a known fixed-point so that the machine can radiate the correct areas ……… and so that he doesn’t move during the treatment. To do this, they used 3 independent lasers to measure, determine, and show EXACTLY where they need Jordan to be on the radiation table. These 3 lasers intersect at a precise point on the table that is called an “ISO-CENTER”. After the ISO-CENTER was determined……..Jordan’s body was positioned relative to this spot and a machine “tattooed” (marked) his body where the 3 laser beams hit his skin. By doing this, the doctors can align and ensure his body is in the correct spot each and every time relative to this known fixed-point. Now……..to stabilize and anchor his body in that precise spot and orientation each time, they created a “body mold” for him to lie in that keeps him in the same spot each time. To do this…….the doctors initially had him lie in something that looks like a “bean-bag chair”. This “bean-bag chair” contained millions of plastic “beans” that were filled with a special type of foam that conformed to his body. Once they had him in the correct position…….a machine sucked the air and moisture out of the “bean-bag” which caused the “beans” to shrink and harden…….thereby forming an EXACT mold of the position/orientation that the doctors need him to be in for ALL of the radiation treatments. Once that was complete, they “tattooed” (marked) the “bean bag chair” the same way they marked Jordan’s skin. So…….each time he goes in for a Radiation treatment…..they simply align him in the “bean-bag chair” using his “tattoo” marks…….and then align both him AND the “bean-bag chair” relative to the Radiation machine using the ISO-CENTER of the lasers. Pretty simple Huh!! Now enter the big, bad-ass Radiation Machine.

• At the risk of sounding pretty GEEKY……..the Radiation Machine is a fascinating piece-of-gear. It’s comprised of 3 main components: the “Linear Accelerator”; the “Radiation Head”; and the “Gantry”. But don’t be scarred……….it’s not that complicated. Here’s the dumb Fighter-Pilot version of how is works: Inside the guts of the machine they have what they call an “Electron Gun”…….which is basically an energized filament (like a light bulb) that emits electrons that can be captured and then accelerated This acceleration is accomplish by generating a “electro-magnetic wave” that gradually strengthens as it travels down a “wave guide” in the accelerator. These Hawaiian-Style Electrons grab their surfboards, “hop on the wave”, and “Surf” it down the wave guide as it gets stronger and stronger……picking-up speed/energy along the way. Keep in mind that “Radiation” is nothing more than high-energy (read: accelerated) particles. Now…..by the time these dudes get to the end of the wave guide, they’ve had a good time cruisin’ the wave and are packin’ some serious energy ……..so….. it’s time to put ‘em to work. So……at the end of the wave guide we’ve got another magnet called a “bending magnet” that makes these speedy electron-boys bend towards the “Radiation Head” so that we can unleash this energy on Mr. C-Cell. However, we can’t have speedy electron-boy actually hit Jordan’s body directly because electrons are “negatively charged” particles that are too “heavy” and won’t be able to penetrate deep into his body where Mr C-Cell is hiding. Instead, we’d like to have a particle that is PERFECTLY SUITED to killing Mr C-Cell—the PHOTON. The Photon is perfect because it does NOT have an electrical charge and can penetrate very deep in the body without causing undue damage.

• So…….you are probably wondering……..where do we get high-energy Photons?? Answer: After we bend the high-energy electrons towards the “Radiation Head”, they hit a very dense substance on the head called Tungsten ……..and abruptly come to a STOP. As the electrons slam into the Tungsten and come to a stop, the Tungsten atoms are forced to absorb a tremendous amount of energy……..energy that’s got to go somewhere. Now……due to a law of physics called the “Conservation of Energy”……we know that energy can’t be created or destroyed ---it has to be converted/transformed into something else. This “something else” is PHOTONS (also known as “X-Rays”). As the Tungsten atoms absorb the energy from the electrons, they emit Photons (X-Rays) of the same energy---Photons that we can now use to kill Mr C-Cell by directing them through an opening in the Radiation Head and onto/into Jordan’s body. This process is the same as the one used in “traditional” X-Ray machines for determining broken bones, cavities, and other irregularities in the body. The big difference is in the energy state of the Photons emitted. Traditional X-Ray machines emit relatively low energy Photons that stop when they hit dense material(s) like bone and teeth………whereas the Radiation machines used for cancer treatments emit EXTREMELY high energy Photons (X-Rays) that penetrate through the entire human body and pulverize C-Cells. Hang in there……..we are almost done.

• One component left to talk about—the “Gantry”. The “Gantry” is simply the huge mechanical arm that moves/rotates the Radiation Head so it can direct/administer this high-energy Radiation anywhere it is needed. The Linear Accelerator and the Radiation Head are both housed in the Gantry Arm Mechanism. The Gantry Arm (and thus the Radiation Head) can rotate at different angles around the radiation table where Jordan is lying (stabilized) in his “bean-bag chair”. And…….since the radiation table can also be moved, the Radiation Head can supply a shaped-beam of Photon Radiation at an infinite number of spots and angles on Jordan’s body. It’s very much like the TV shows/commercials you see of an “assembly line” where a robot circles around a fixed object……..while welding, painting, or assembling something while the object is held in one position. In this case, the Gantry swings around Jordan so the Radiation Head can apply radiation to places he needs it.

• In Summary: Radiation is yet another weapon that we use to fight Mr. C-Cell. We use it in conjunction with Chemotherapy so as to ensure that we kill ALL the C-Cells……..even the ones that adapt and might become resistive to the chemo medicines. The Radiation Machine supplies high-energy PHOTON radiation to Jordan’s body by accelerating Electrons, converting the energy into Photons, and then directing these Photons onto/into his body through a mechanism that can rotate around the table where he is lying in a fixed position.

• Segment “Thank-YOU”: Thank-you, Thank-you, Thank-you………by now I probably sound like a “broken record”. However, this is one record that I’ll keep playing each and every week. Why? Because it is so very important for ALL of you to know how indescribably grateful we are of YOUR support. Each day we are given an opportunity to be with the ones we love. We are able to draw and harness YOUR collective strength in order to provide a foundation from which to fight. God bless you all.

Live Life – Make a Difference

ONE DAY AT A TIME!!

VR

Jordan’s Dad