Wednesday 27 March 2013

Does Sitting in the Sun Count Towards Radiation?

I sure wish it did!  It has been so sunny in Vancouver and I have spent lots of time enjoying it.  Especially since radiation was delayed.
I was scheduled to start radiation Friday afternoon.  At 0830 I got a call saying radiation had to be delayed until Tuesday because there was a problem with my plan so my radiation oncologist did not sign it off and changes were required.

Friday afternoon while sitting out in the sun after my Herceptin treatment I received another call from the radiation department.  Would it be possible for me to come in Monday morning for a clearance check?  They didn't want to cut my arm off.
Hmmmm, I didn't think I had signed up for losing my arm during treatment so Monday morning I trundled off to the radiation department for my clearance check.

Everyone was ecstatic............5 mm of clearance.

As long as I don't gain any weight I get to keep my arm.

And I gained some interesting body art on the radiation area to help with future setting up of the machine.

To interrupt all of this radiation fun.  My darling dog was sick, again.  It has been off and on for the last 2 - 3 weeks.  We finally decided it was time to take him to the vet and find out what was going on.  I went out for a walk while Ian took Jasper to the vet.  this is what I found when I got home:


Ah, yes.  The Cone of Shame.  Gotta love it.

Turns out my darling dog managed to pick up Giardia.  Probably from eating one of his favourite seawall snacks, goose poo or mussel shells.  Yippee.
The cone is required so that he does reinfect himself by licking his butt before his treatment is done.  Truly, a Cone of Shame.

So, once that  excitement was done it was over it was back to dealing with radiation.

Tuesday afternoon I met the same radiation techs I had the day before so we all sort of knew what was going on.  I got some more body art in green this time instead of black.  The whole process took about half an hour.
And for part of the treatment I have this jelly like sheet stuck to me.  The jelly is supposed to replicate skin so that the radiation is brought closer to the actual surface of my skin.

The radiation machine itself kind of reminds me of the bone scan machine.  There is a machine with a bed sticking out from it.  And there are these plate like things that also stick out and can rotate around the bed.
When the radiation happens I can hear a buzzing sound but I don't feel anything.

Afterwards the area felt a little warm, and by the end of the day I felt like I had spent the day in the sun.  I did go out for a walk, visit Costco, and do some grocery shopping so I did spend part of the day in  the sun but I felt a little more tired than that.

To protect my skin I am supposed to put on a water based lotion twice a day.  I picked up one of the recommended brands on my way home and slathered it on.  When I went to bed most of my body art had disappeared.  Oops.  I don't think my techs are going to be very happy with me today.
Actually, I'm not really happy with me either.  During radiation I have to lie without moving with my hands holding a couple of handles behind my head.  By the end of the day yesterday my left arm was totally numb.  With no body art, today will take at least as long as yesterday if not longer.

Oh well, I'm a radiation newbie.  Now I know to be more careful.  And maybe I should have read the information sheet more closely that said to be careful of the art work.  But I did test the lotion on the ink and it seemed to be okay.  But, I guess not.
Maybe that means I shouldn't follow the directions.  It is so confusing.

At least radiation has begun.  My completion day is April 18th and I can't wait.

Thursday 14 March 2013

Path Report

Now that chemo brain is gone it has been really difficult to stay inside and do nothing so I have been out and about lots and totally avoiding my computer.  As a result I am totally behind in the adventures in cancerland.

I did have a fun day in Whistler

And an uneventful trip up and down the Sea to Sky

(Wow, I really need to clean my phone camera lens.)

I saw my surgeon.........I think, a week ago?  Maybe longer.  No, it must have been a week, last Thursday the 8th.  How ever long ago that was.  What day is today?   Wednesday? No, Thursday, the Canuckleheads play today.  Thank goodness they finally won last game, I thought the band wagon was going to crash.

Anyway, I saw my surgeon last week, the 8th.  Great.  Now I'm getting so loopy I'm repeating myself, I really need to go back to work.  All of the pathology is back.  I have cancer.

Oh wait, we already knew that.

There were 23 lymph nodes removed (no wonder my armpit feels so funny!!!) and one node had isolated tumour cells.  That is as close to being negative for cancer cells as you can get without actually being negative.  My radiation oncologist classifies it as negative.  That is fine with me.

The most important thing regarding the tumour - all margins clear.  Yay!!
The only downside is that there was only a 1 mm margin at the chest wall and 2mm is preferred, but radiation will cover that.
All in all, my surgeon did an excellent job of hacking the cancer out of me.

With the pathology report now available, the next step was the radiation planning session.  That started with a meeting with a radiation resident who asked me if I knew the results of my pathology report and understood what it had said.  Then we covered the basics around what happens during the planning session and then he answered my questions.
My most important question was whether a person can have radiation multiple times at the same site.  This is a potential issue for metastatic cancer patients as radiation is used to control pain of bone metastases.
It turns out that one area can be irradiated more than once but it depends on how much radiation that area has already received and when it was done.  If a lot of radiation was given to a spot, a repeat could not be done within a year or two.  If, however, that spot needed to be done 5 years later, that would probably be okay.

So, now that you have all this new radiation knowledge plus the path results, I tell you that I will be getting 16 treatments, which is a pretty standard course of treatment, instead of the originally planned 10 treatments.  Can anyone guess what that means, remember at the same time about those other keys phrases, "due to my age" and "how well the tumour responded to treatment"?
Pretty much that means we are back to the "we're gonna try and cure you even though we can't really cure you" method of thinking.  The original plan of 10 treatments was apparently decided based on the thought that in the not to distant future the tumour would be involved in my chest wall and then I would have to be hammered with radiation to get it under control.  Now the path report combined with my PET scan makes me a perfect candidate for radiation and they are going to treat me like a plain old breast cancer patient with cure in mind rather than the metastatic patient I really am.
I think that falls in the good news category.

The remainder of the planning session involved getting a CT scan done, once breathing normally and once holding my breath.  I hold my breath for one scan so that my lungs are full of air (obviously) which causes my heart to be pushed down and thus further from the radiation.  Not all patients actually have to hold their breath during the radiation treatments but sometimes it is necessary to protect the heart. Fortunately each radiation zap would be for 30 seconds or less so the chances of me passing out are relatively slim.

My radiation oncologist reviews that scans and decides exactly how the radiation machine has to be angled to hit all of the required area with hitting things like my heart.  Once that plan is made I will get a call from the Cancer Agency telling me when radiation starts.
I hope that call comes soon.  I really want to get  on with the rest of my life.