In my TNBC Facebook group, radiation is often referred to as "rads," and since I've already used "radiate" as a post title, I decided to go with "rads" today. I don't think that I will often call radiation "rads," but now you'll know what it means.
I met with the radiation oncologist today and liked her very much. She spent at least 45 minutes giving me her undivided attention and explaining what a radiation program for me could/would look like. I really appreciate her time and thorough explanation. Her perspective on TNBC was interesting in that she said that she recommends radiation for people with TNBC no matter what surgical option they choose because TNBC is aggressive and has a high grade, meaning that it is fast-growing. She put her surgical thoughts quite simply "you'll be a great candidate for a lumpectomy so that is what I think you should do. If you find that you can't sleep at night because you wish that you had a bilateral mastectomy, you can always do that later." I had not really thought of it that way. She's right, of course.
So it looks like I'll have radiation no matter what surgical option I choose, and the surgical decision is still ultimately mine. I am about 90% sure that I will choose to do a lumpectomy. There is no real reason to do a bilateral mastectomy at this point so why put myself through major surgery and months of reconstruction if I don't have to. I think that part of me worries that we're missing something on my right side, but 2 ultrasounds, a mammogram, and an MRI all tell me otherwise so I should probably relax a little bit on that.
Radiation is not without risks, though. My particular radiation will be very near my heart and left lung so there is a risk of damage to both. The lung is more at risk than the heart. There is a sliver of lung behind the chest wall that will be in the line of fire, and there is just nothing that can be done about that. The doctor said that the damage, if any, will be minimal. With radiation, you also run the risk of developing a secondary radiation-induced cancer. It is, again, rare but possible. That possibility exists with chemo as well. Most likely, I will experience some fatigue and skin changes that can range from a slight "sunburn" to blistering and cracking in the skin. Unlike chemo, the side effects from radiation are delayed, so we won't really know how I will react until we are about 2-3 weeks into treatment.
The benefits of radiation far outweigh the potential drawbacks so it looks like "rads" are on the docket for me sometime this summer. I recently saw an analogy related to cancer treatment that resonated with me. You drop a glass in your kitchen - surgery picks up the big pieces, radiation tackles the small pieces that you can't pick up, and chemo sweeps up the tiny shards that flew all the way across the room. I want to make sure that ALL of the pieces of that broken glass get picked up.
I am likely to have 28 standard radiation treatments and 5-6 boots. The boosts will focus exclusively on the pocket where the cancer was removed to make sure that the surgical site is 100% sanitized. The final plan there will depend on the pathology report from my surgery, but the above is what will probably happen.
I talked to the doctor about my goal of attending my company's October 27-28 event in LA, and she seemed to think that goal is achievable. If we start radiation in mid-August or even the beginning of September, I should be free and clear! The doctor also commented on how she was pleased with how well I look after a brief exam. She said that some patients who are on chemo really look sick but I do not. It was nice to hear that because some days, I don't feel like I look so great.
In non-radiation news, I had a nice evening out with some members of the Young Survival Coalition's Charleston Face to Face peer group. They get together for dinner once a month, and I am glad that I was able to join them. It was a pretty small group, but it was good to meet some others in my age bracket who can relate to my experience. I'm not much of a "joiner" and a moderate, at best, networker, but this is different. I am pretty eager to meet others my age who are either going through or have been through breast cancer treatment. The group was really nice, and I look forward to the next time we get together. I'll definitely keep going.
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