The Radiation Rotation

Thank goodness I'm getting 30 treatments.  Any fewer and I wouldn't have enough to go 'round.  25 of my friends want to accompany me to an appointment, which means only five will have to pull double duty.  The calendar is still taking shape, but week one will feature:

• Trailblazer
• The Groom
• Showgirl
• Marathon Girl

Next week's schedule already includes:

• Hollywood
• Bella Cucina
• The Bride 

And more are being confirmed all the time.  How'd I get so stupid lucky?

Tats for Tits

I can add another variety of scan to my repertoire.  This morning, I underwent a CT scan, in preparation for my radiation treatment.  No claustophobia, this time;  it's like being fed head first into a doughnut, rather than a toilet roll.

The whole experience was mostly about positioning -- and being able to replicate that position exactly thirty more times in the next few weeks.  Lying on my back on a bed like a seesaw with my head higher than my feet, a bolster beneath my hips (so I didn't slide), my left arm at my side, and my right arm raised above my head, I'd have felt like a pin-up, if it wasn't for the hospital gown and the fluorescent lighting.  Once in place, the tape measures and the Sharpies came out.  Numbers were read out and keyed into the computer, and Xes marked the spots.

With everything confirmed, out came the blue ink and needles.  I always thought my first tattoo would come courtesy of a leather-clad guy with a shaved head and piercings.  Who knew it'd be a student therapist in hospital greens that'd do the job?  So now, where there used to be temporary black pen marks, there are permanent blue freckles.  But no anchors or hearts with "Mom" in the centre.

In the next few days, The Burn, a physicist and a radiation therapist will use the images from my scan to target the beams for the most effective treatment for me.  And starting June 1, we play connect the dots.

Tamoxifen Tuesday

I took the first of 1,826 Tamoxifen tablets, this morning.  Then I stood in the kitchen for a moment waiting for my first hot flash to begin.  Of course, it doesn't work like that.  Hot flashes are more like terrorism than war.  Ambushes by little hormonal insurgents, not an organized assault by ranks of uniformed warriors.  Let the Tamoxifen Taliban do its worst:  I'm ready.

No "Shit"

After so many meetings with The Dutchman, suddenly we've reached the end of the road.  I was checking in at YYZ when his assistant reached me.  The Tumour Board must be in league with the lingerie industry:  I can keep the knockers.  So, I was airborne about an hour earlier than scheduled.

Now the Tuesday CT scan and the June 1 date with the tanning bed are in pen, rather than pencil.  Not that my BlackBerry can tell the difference.

Collateral Damage

The downside of having kept my equilibrium through all the procedures thus far appears to be that the people to whom I report at work have completely forgotten what I told them before my first surgery in January:  "I will be away during treatment."  By behaving normally, I might have lulled them into a false sense of security.  Today, I dropped the bomb:  I'll be out of the office from June 1 to Labour Day.

Can I get a "shit"?  I thought I could.

Radiation: Hold, Please

The wait to see her was longer than my time with The Burn, this morning.  Though I had expected the full-on planning experience, it turns out that won't move ahead until The Dutchman reports back post-chat with the Tumor Board, next week.

So, we reviewed the potential side-effects and risks of treatment.   The big side-effects I already knew:  fatigue and reddening, dryness and itching of the skin in the treated area.  I didn't know that most patients experience dull aches or sharp shooting pains in the breast (kinda like lightning strikes, according to The Burn);  apparently, they're nothing to worry about... just part of the rich and colourful tapestry of cancer treatment.

The major risks are radiation pneumonitis (a lung reaction characterized by a dry cough, shortness of breath and fever three to nine months after completing treatment) and -- wait for it -- an increased risk of cancer (of the skin, muscle bone or lung in the radiated area) five or more years after treatment.  Ironic that a major treatment for cancer puts the patient at risk for more of the same, huh?

Good news, though;  I'm provisionally booked for the CT scan on May 18.  With that behind me, my first treatment day will be June 1, and I'll be off work for about three months.  Could make for an interesting version of "What I Did On My Summer Vacation".

When You've Gone as Far as You Can Go, You're Halfway There

The Dutchman told me today that I'm his second patient ever to undergo three lumpectomies;  less sweater meat and I would have had a mastectomy on round two.  I'm suspicious that he's simply warm for my form, but I'll give him the benefit of the clinical doubt.

Today's consult is brought to you by the letter E and the number 4.  E is for equivocal.  I might be finished surgery, or I might be back for a fourth round.  Not "shit" exactly, but certainly "crap".  The latest pathology report showed that the third excision uncovered more DCIS:  two focal areas a centimetre apart in the tissue adjacent to the last surgery site.  But in the section between that location and my chest wall, there were only normal cells.  So, the question is whether to move me along to radiation, or perform a lopatitoffame.

With the information I have -- an MRI that shows no further invasive cancer, a clean section behind the latest DCIS discovery, still only stage one cancer, and the knowledge that a regular screening mammogram is a solid early warning device -- and without professional advice to the contrary, I'll roll the dice and keep my rack a while longer.  But The Dutchman's by-the-book (just one of the many things I love about him), so it's back to the Tumor Board we go.  If his peers don't feel strongly that there are benefits to the mastectomy option, then I'm done with the knife;  if they do, the decision is ultimately mine to make.  Either way, I'll hear from the man after their May 13 meeting.

In the meantime, with The Dutchman's approval, I've confirmed my next appointment with The Burn.  On May 7, I'll undergo a CT scan and meet with her and the radiation team to map out my plan.  If I need to detour for another surgery before we get started on treatment, so be it.  But if not, I'll be more than ready to bust out the sun cream.  I'm sure I saw SPF 400 at Shoppers...