October 2, 2008

Oh yeah.

I forgot to update on the cancer treatment progress.

We met with the radiation oncologist on the 22nd, and she wanted to have 4 weeks of healing between the last surgery and the start of radiation.  I wanted to shake her – do you know how big any microscopic cells could grow in a month?  It only took 10 months to grow 1.3cm *while* I was in treatment – in one month, while I’m *waiting* for treatment it could grow *more* than 0.13cm!  They told me before that I was clear, and look what happened…

But…she knows her job, so I just listened, and we scheduled the appointment to have a mold made.  Because they have to hit the target exactly in order to avoid irradiating the heart and lungs, or other important things like the unaffected breast, I will have to lie in exactly the same position for every single one of the 33 appointments I will have.  Hence the mold, which will hold my left arm over my head and (I think) slightly arch my back so that my chest is rounded up (get along little . . ., well, OK, not quite like that).  After the mold is made, they will take a CTscan with me in the mold to figure out where all the internal organs are, so they can plot angles and place tattoos, etc.  I get the mold done on the 6th, and I think the tattoos, also.

Then I will start radiation on the 13th.

5-1/2 weeks later, they’ll change from the general bombardment of my left chest (from the bottom of the ribs to the clavicle), over to a 1 week specific bombardment of the area around my latest scar, where the surgeon placed clips so they can locate the correct spot.

My last treatment should be the day before Thanksgiving – I think that’s taking things a little far, trying to make sure I have something to be thankful for.  As far as I’m concerned, I already do – Brian, Robin, April, and Jeremy; family and friends; a house; a job; my health – well, 4 out of 5 ain’t bad. And by the time Thanksgiving rolls around, I suspect that I will be grateful for not having to go through any more radiation treatments.

As far as side-effects of the radiation treatment, the two worst things I will experience are fatigue and skin problems. The doctor said that if you consider the fatigue from chemo a 10 on a scale of 1 – 10, then most people report the fatigue from radiation around a 3 on the same scale. Also, it won’t start right away – it’ll probably take a couple weeks before I start feeling any, and it will slowly build as the treatment progresses. And it will continue for a couple-three weeks afterwards. As far as skin issues, most people get a “sunburn” effect, to the extent that it turns red, becomes dry, and peels – sometimes it will become swollen and puffy.

Other than that, some of the long term effects can be heart damage, brittle ribs, lymphedema, and cancer. Huh? I thought that’s what we were treating! Yeah, well, that’s down the road – wouldn’t you rather be cancer-free now, and get to go through all this again later? Geez…

Then I have an appointment with the pulmonary specialist in November, about the sarcoidosis – he’ll do a chest x-ray to see if it’s the same, gone away, or if it has spread. I still have symptoms, but typically very mild, and he doesn’t think that the radiation should affect it.

And I meet with the oncologist in mid-November to plan out the chemo treatment. His nurse says that he prefers to leave 4 weeks (what is it with 4 weeks! If they were medieval doctors, it would be 3 weeks, or 5 weeks, or some other mystical number – when did 4 become the talismanic number for doctors?) between radiation and chemo, which means I’d be starting the last week in December.  I figure if he thinks it can wait that long, it can wait another week, and I will start after the New Year. Yeah, this is the same person who was just railing about how big those theoretical microscopic cancer cells could be growing while waiting for radiation treatment to start. But look at it this way – if it grows 0.13cm in the 4 weeks between radiation and chemo, one more week will only add 0. 03cm to it. Hardly the tipping point, eh?

So anyway, there’s the plan. I hope to be able to work through the radiation – I may do more work from home if the fatigue gets bad. As for the rest of it, I’ll think about that tomorrow. After all, tomorrow is another day.

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