Radiation

My cancer treatment plan includes four stages: surgery, chemotherapy, radiation, and hormone therapy. I had two surgeries in July which now seems like a lifetime ago and in October I completed my chemotherapy regimen.  

This post is actually out of chronological order because I found it too difficult to write about my chemotherapy experience while undergoing treatment. This was for two reasons: 1) for a week following each treatment I experienced side effects that required me to conserve my energy for work and other aspects of life and 2) during the week preceding the next treatment the last thing I wanted to think about while I was feeling somewhat back to “normal” was chemo. In fact, even now, just typing the word makes me feel sick to my stomach. I’ll eventually write about my chemo treatments because I want to fully capture this cancer journey, but for now, it's on to radiation.  

I first met with the radiation oncologist shortly after my diagnosis in May. The initial visit was more an introduction, and the doctor explained that his role was “clean-up crew” and he would be focused on a localized treatment. Chemotherapy is considered a systemic treatment which means the drugs travel throughout the bloodstream to attack cancer cells throughout the entire body. Surgery and radiation on the other hand are considered local treatments because they target a specific region or tumor.  

A week after completing chemo I met with the radiology oncologist, this time to receive my treatment plan and to complete the simulation and planning for the treatment. At my first appointment back in May, he said 2-4 weeks of radiation was likely. Much like the surprise I felt when my oncologist recommended chemo as part of my treatment plan, I had the same reaction (which included lots of tears) when the radiology oncologist shared his updated treatment plan...33 treatments over 6.5 weeks taking place five days a week, Monday through Friday.  

Throughout my diagnosis I’ve been told that the cancer was caught early, that I was stage one in the left breast and stage two in the right breast, that there was no detectable lymph node involvement, and yet even under these favorable circumstances, the treatments are intense.  

My doctor explained that because of the type of chemotherapy I received (Adriamycin and Cyclophosphamide—otherwise known as AC or the “Red Devil”) the radiation dosage would be less and therefore would be spread out over a longer period of time in order to minimize the overall toxicity risk to my healthy tissues, particularly the lungs and heart.  

After receiving my treatment plan, the second half of the appointment involved a CT scan in order to establish the precise positioning for treatment. For about 15 minutes I laid on an elevated table with my hands above my head and was moved into and out of the CT machine as the doctor and radiology technician observed from the control room located behind a glass window. For some of the scans I had to hold my breath for 20-30 seconds so they could identify where my heart and lungs were to ensure these organs were not impacted by the treatment. The doctor drew landmarks on my chest with a marker, and the technician applied three permanent pinpoint tattoos to serve as reference points to ensure the radiation is delivered to the exact same spot every time.  

During this appointment, side effects from radiation were also reviewed with me. The side effects include fatigue as the body is using energy to fight cancer cells and to repair normal cells. The other primary side effect is changes to the skin which can range from a mild sunburn to blisters. 

This journey has been long and is not over yet. While I’m not looking forward to six weeks of daily radiation treatments, I am grateful that chemo is over and that I have providers who are doing their best to ensure my cancer is curable and that it does not recur.