[Verse 1] Picture dose measured out in units called the gray, Not dumped at once — we dole it day by day, One-point-eight to two, a modest little bite, Small enough that healthy cells can set the damage right, Between each visit, tissue stitches what it can, That's fractionation — the surgeon's patient plan. [Chorus] Repair the break, reoxygenate the core, Redistribute the cycle, repopulate once more, Four R's spinning like a cellular wheel, Add sensitivity — now you've got the deal, Gray by gray, we're chipping at the wall, Learn the four R's and you'll remember it all. [Verse 2] Cells caught resting, sheltered in a phase, Redistribution shuffles them through radiation's maze, Repopulation means the tumor breeds between the doses — that's the race, Reoxygenation: as the bulk cells die, Starved cores finally get some air and open up their eye, The hideout's gone, the hypoxic cells can't hide. [Verse 3] Oxygen's the secret ingredient in the fight, Breathing tissue burns up two, three times as bright, But tumor cores packed tight and starved of air Shrug off the beam like they haven't got a care, That's why we wait, let the blood flow back in, Reoxygenate the core before we strike again. [Verse 4] External beam swings round on a steady metal arm, IMRT sculpts the dose to spare you further harm, SBRT strikes precise — a handful of sessions, sharp and steep, Brachytherapy tucks a tiny seed in close to sleep, Four ways to deliver, one goal set the same: Hit the tumor harder than the tissue near the flame. [Chorus] Repair the break, reoxygenate the core, Redistribute the cycle, repopulate once more, Four R's spinning like a cellular wheel, Add sensitivity — now you've got the deal, Gray by gray, we're chipping at the wall, Learn the four R's and you'll remember it all. [Verse 5] But radiation lingers long after the beam is gone, Small vessels thicken, quiet scarring carries on, Endarteritis obliterans — the vessels choke and close, Wounds forget to heal the way a healthy body knows, Years from now the bowel turns inflamed and tight, Fibrosis, enteritis, sarcoma out of sight. [Verse 6] For rectal cancer, chemo and the beam arrive together, Shrinking down the tumor, softening the tether, Surgeons wait it out, eight to twelve weeks clear, Letting the angry tissue settle before the blade comes near, Patience pays in margins, patience pays in healing too, Timing is a weapon just as sharp as what you do. [Bridge] Fibrosis in the field, a scar that won't forget, Count the weeks before you cut — the body isn't finished yet, Four R's, the oxygen, the waiting and the beam, Stack them all together — that's the surgeon's radiation scheme. [Chorus] Repair the break, reoxygenate the core, Redistribute the cycle, repopulate once more, Four R's spinning like a cellular wheel, Add sensitivity — now you've got the deal, Gray by gray, we're chipping at the wall, Learn the four R's and you'll remember it all.
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