Radiation - Take Two . . .

I was told to make an appointment with the radiologist toward the end of my chemo treatments.  I made the appointment for November 14th telling the woman I might have to change it in case my husband decided to go deer hunting.  The annual trip where he drives 12 hours into the UP to stay in a cabin with no electricity, no running water but it has a sauna.  Then he sits in the wilderness for hours on end waiting for the prize buck which year after year eludes him.  Alas, this year he’s decided to forgo his trip to stay with me.  November 14th it is.

We get to our appointment, I know where to go having been here 6 years earlier.  This time when I check in, I receive a gray key card with my name and patient ID number.  It’s like the key card I had when getting my blood drawn every week.  I will use this every time I visit.  Scan and I’m good to go.

The first thing I notice when I walk into the office – no scale.  Six years ago, the scale was right next to the front door.  You walked in and weighed yourself, in front of God and the world.  Yep good times.  Pleasantly pleased about the move, Bob and I are taken into the examining room.  I get weighed (what is it with weight?!), blood pressure taken and as I’m finishing up the mountains of paperwork in walks the resident.  We discuss my past history, current history and treatment options.

He walks us through the process and what I can expect from treatment.  Because I’m stage 3, it is highly recommended that I have the radiation.  It will increase my odds.  Side effects are fatigue and possibly skin irritation.   Information given, he leaves and we wait for Dr. Chen. 

Dr. Chen is a kind soul who is extremely dedicated to his work.  Work he does extremely well.

We have a kinship, since his parents used to live four houses down from us.  He knows several of my neighbors.  He’s like an old friend.  He comes in and after the usual greetings, I ask, “What happened buddy?  I did your clinical trial and here I am 6 years later.  I don’t think it worked too well”.  I was actually joking thinking it was a great ice breaker.  Dr. Chen was very serious and said “The protocol used last time was the right treatment for your diagnosis – DCIS.”  I reminded him I had 1 millimeter of Invasive Lobular cancer also.  His response was that I had a different kind of cancer, not invasive lobular.  I stopped for a minute and thought, OMG I’ve gotten my diagnosis wrong all this time?!  Regaining my senses, I said to him check the records. I’m pretty sure it was Invasive Lobular.  Dr. Chen spends several minutes going through my records and finally locates it – I’m right!  It was Invasive Lobular.  He was amazed that my surgeon found it.  Now here comes the sad part, he goes on to explain:

1)      What probably happened was there was as stray cell, not in area that the margins were previously tested, that it had been growing for the last 6 years.

2)     He went on to say that Invasive Lobular cancer is not detectable by mammograms.  Let me repeat that:  Invasive Lobular cancer is not detected on mammograms.  My mammogram showed calcification and because of that, I had a biopsy.  The biopsy identified the Invasive Lobular cancer.

3)     In addition to the Invasive Lobular cancer, I had a tumor along with cancer in my skin.  Three places – it was in three places.  It was like my left breast was exploding with cancer.

Okay, looking for some good news here.  I finally get it.  He goes on to explain that since I did the clinical trial the first time and the treatment went directly to the affected cancerous area, I could have radiation this time.  In other words, if I had had traditional radiation the last time, my body would have already had radiation in my chest wall and I wouldn’t have been able to receive it this time.  I immediately think to myself, “Everything happens in it’s time”.  I’m lucky.

We discuss whether I will qualify for proton therapy.  It’s a relatively new therapy that is less invasive.  It actually administers the radiation to an exact pinpointed area instead of the entire breast being radiated.  My cancer was located close to my heart.  I tell Dr. Chen of my concerns of being radiated too close to my heart.  I want the proton therapy because of this.  We discuss how I’ll be evaluated when I’m being “fitted” for radiation.  Which lead me to my next question – “Fitted?”

He explains that I will lay on a warm form, my upper body, which will make a mold of my body.  This form will be what I lay in every treatment.  I will be tattooed (not happy!) at three different points on my body to help me align up every time.  I will have to hold my breath for 20 seconds while they look at where my heart sits in my chest wall.  Can’t wait for this to happen – not.

I will be seeing Dr. Chen once a week during treatment.  He walks us over to the appointment center, gives me a hug and says I’ll see you soon.  Appointment made -December 18th is when I’ll be fitted.

We leave the office and I’m quiet on the way home.  I’m thinking about my diagnosis.  You see, I usually ignore it.  Logically, I know I’ve had cancer and it was advanced.   But I don’t dwell on the details and today I figured out why.  Details drag me down. They can sound so dire. Doom and gloom.  If I dwell on it, it’s like I’m saying “Hey fear come on in”.   I stay in that place for a while, thinking about the severity of my diagnosis.  I eventually remind myself that I was estrogen positive, which is a good thing, that medical advances have come a long way and I’ve been given a great success rate.  It’s a struggle at times to get back to center, but I always get back there and for that I’m thankful.