Adventures with Breast Cancer

I am currently on week four of radiation with minimal side effects. There is a little redness and tenderness across the radiation site, and fatigue so far feels somewhat manageable, as long as I’m in bed at the same time as my children. It is supposed to get worse before it gets better, but I would still take this over chemotherapy any day of the week.

I have naturally befriended the therapists/technicians and they are all sweet, fun, and super efficient. All four of them (three gals and a guy) are at least ten years younger than me. And, all have great hair.

The only mirror in my house is perched over my bathroom sink. I can easily see from my waist to the top of my head from a distance of 22 inches (the depth of our sink). It’s close enough for making sure I don’t walk out the door with toothpaste on my face, but far enough away that I don’t obsess over crow’s feet. I don’t spend much time in the mirror. Never really have….until one surprising day last week.

I was changing out of my very glamorous hospital gown (standard issue for radiation treatment) in the dressing room and decided to check out the surgical scar under my right arm to see how radiation was effecting it. Low and behold there was a hair. I immediately raised my other arm and saw several more hairs. I actually felt joy. Over arm pit hair.

I stepped even closer to the mirror and inspected my trademark eyebrows. Every spot where hair was sparse had tiny black stubble moving back in. It was this point that I started crying.

Finally, I surveyed my scalp. And, I saw tiny black (and, I’ll be honest, white) hairs all over my once smooth and shiny scalp. It was beautiful! For the first time in almost six months I could see that my body was actually bouncing back. That there would really be an end to this.

My (our) body’s ability to heal itself is miraculous. It fights with all its might to protect me from a minor cold and heal severe infections. It regenerates healthy cells and can restart suppressed bodily functions. I’m reminded that my body is strong, despite my feeling weak. And, it is continuously working to function at its optimal rate. That is truly amazing.

Once upon a time, I would have seen an armpit hair and cursed the dark, coarse, evil nemesis of tank tops. Today, however, I will appreciate this symbolic reminder that I am getting better every day. And, I will feel good again. With a head (and body) full of hair.

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Today marks three weeks post-chemotherapy. And, today was also my second radiation treatment. This makes my total treatment end-date in the middle of December. Merry Christmas to me!

My latest-and-greatest doctor, Dr. William Small, is a Radiation Oncologist. He is also a hoot! I’m a sucker for anyone who makes me laugh. When I first met him, he talked to me as if he had to sell me on the idea of radiation. He gave me all the pros and cons of radiation therapy including percentages of recurrence (much lower with radiation) and side effects (skin irritation and fatigue). I agreed that his treatment plan was my best option, considering my age and the overall success rate. So we scheduled a date for a CT scan.

At my CT appointment, I sat very still on the table while the therapist adjusted the angle of my body (I lay/sat up at about a 30-45 degree angle on an inclining board) while they took images of my surgical site. The doctor then double checked that he had the spots where he would target the radiation – where the the tumor and the lymph nodes under my right arm were removed, as well as the remaining lymph nodes under my right clavicle (the latest studies show that this will decreases my odds of a recurrence even more). Once the location(s) were established, the therapist proceeded to give me tiny permanent tattoos (dots the size of a period at the end of a sentence) in between my breasts (center of my sternum) as well as one dot on each side of my body underneath the arm pits. All three dots line up on the same  longitude. These dots will be there forever, but are small enough that they will probably never be noticed.

At the end of my appointment, I watched a 7 minute video and visited with a nurse, who gave me the do’s and don’ts and answered all my questions. 1.) Radiation kills healthy cells AND cancer cells, but the healthy ones regenerate – the loss of the healthy cells is what can cause fatigue. 2.) I can not take a multi-vitamin with more than 100% of the daily recommended allowances (this can reduce the effectiveness of radiation) 3.) I’m not allowed to swim or use a hot tub as the chlorine will irritate/dry out my skin. 4.) I must use a moisturizing bath gel and a special Rx lotion to keep my skin soft and less irritated (which would be similar to a sunburn). 5.) I should continue to use a supportive bra to prevent pulling on breast tissue/skin – perhaps even while I sleep. 4.) Breast swelling (edema) may occur on my treated side and chances of lymphedema (swelling in the arm where lymph nodes were removed) is increased and I should avoid heavy lifting with that arm. 5.) I can not wear regular deodorant – only the natural kind without aluminum – and may not apply it before treatment. 6.) I can not shave my underarms for the duration of treatment, again, because of skin irritation.

My very first radiation treatment appointment lasted about an hour. The radiation equipment also took my x-rays. Supported like an offset patio umbrella, the radiation/x-ray device hangs over the table on which I lay. I remained very still while the therapists proceeded to use protractor-like-laser-lights (with my tattoos as a reference point)  for each angle that Dr. Small wanted to send the radiation. Once Dr. Small approved each angle (using the x-rays to be sure they were targeting the right spots), we proceeded with the actual radiation. The first treatment took the longest since they had to determine the angles that they will use every day.

The machine basically sends radiation (very similar to getting an x-ray) into the coordinated spots from several pre-determined angles for 8-15 seconds each. It’s like an invisible laser that shoots into my breast (from multiple sides/angles), under my arm (where lymph nodes were), and near my right clavicle from the front and back (where there are existing lymph nodes that could contain stray cancer cells), killing everything in its path. The actual process takes no more than 15 minutes total. In fact, I was in-and-out of the office today in 20 minutes. That allowed me time to what for my nurse to arrive, change into my hospital gown before my treatment, AND get dressed again afterwards. The actual radiation doesn’t hurt while it is happening – again, it is very much like an x-ray. But, since I will be treated 5 days a week for 6-7 weeks, the accumulation in the skin/body create the unpleasant side-effects. In fact, radiation works best with no more that 3 days off in between individual treatments, so the accumulation makes all the difference in fighting any rogue cancer cells.

So, I am on my last (god-willing) leg of my cancer treatment journey. I round out my series of treatments with 5 years of taking an estrogen-receptor-suppressant Tamoxifen. But, after 6 months of surgery, chemo and radiation, popping a pill will be easy-peasy. I’m in the home stretch!

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One accomplishment I admire tremendously (although I have never had the desire to achieve it myself) is the completion of a marathon. The amount of strength and endurance it would take to run and/or walk 26.2 miles in a matter of hours boggles my mind. I have several friends/family members that have completed one (remarkable) and know a select few who have completed more than one (utterly amazing….or they’re gluttons for punishment).

I kind of see this cancer journey as my marathon. A stretch of time. Unexpected physical and emotional hills and valleys. My training an accumulation of previous life experiences which have required endurance and strength. This marathon spans testing/diagnosis, surgery, chemotherapy and radiation.

One week post-last-chemo I began the tapering off of my steroids. It is at this point that I hit the wall of my cancer marathon.

With the last of the chemotherapy still pumping through my veins, but without the same effectiveness of my pain medicine, I was physically hurting. Every joint ached with an overall soreness similar to the flu. I had trouble sleeping at night with a wake-up at anywhere between 3AM and 5AM without being able to return to sleep because of the discomfort. Regular hot flashes dripping sweat off my naked head and neck. My neuropathy created a nearly constant numbness in my hands, feet, lower back, butt, tongue and lips. Stairs and even just walking felt unnatural. I was miserable 24/7. Even picking up my kids from school felt like a monumental chore. One which I fortunately received assistance from some very kind friends on more than one occasion.

On a particularly tough day last week, I called my loving and wise friend, Beth (who has run 2 marathons), from the lobby of the hospital before I entered the consultation meeting with my new Radiation Oncologist. I was feeling ready to quit all the ‘stupid cancer treatment’. (Funny how I resemble my children when I’m exhausted and feel shitty.) I knew I couldn’t stop without the radiation, but yet another stage of treatment, when I was still feeling horrible from the previous stage felt truly overwhelming.

Beth gently reminded me that I was on mile 23 of my marathon. The mile where the desire to stop is overwhelming and an emotional response is inevitable because of the physical demands on my body. I would just have to put one foot in front of the other to keep in motion. Focus on that and I would be at the finish line before I knew it. So I did that. For a whole week….one foot in front of the other. Do what I can, ask for help when I can’t, and just keep going. She got me through a whole week with that imagery. Like I said, wise lady.

So now I am two weeks past the last of my chemo. And, I am only now starting to feel some minor relief. I still ache and I’m still constantly fatigued. But, ibuprofen worked for the first time today and I was even able to go for a walk. So, I am starting to see the light at the end of the tunnel. However faint.

I begin my radiation treatments next Tuesday, November 1. I went in for a CT scan and ‘mapping’ today so they know just where to position the radiation when I come in every morning. I will pop in five days a week for almost 7 weeks, after which I will be at my cancer mile 26.2.  And, I will have earned my ‘medal’ for crossing the cancer treatment finish line by simply putting one foot in front of the other.

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