Saturday, April 22, 2017

20 Days of Radiation

Back in December I was diagnosed with DCIS non-invasive breast cancer.  I blogged about the first portion of my diagnosis & treatment HERE.

The last phase of treatment is radiation.  I met with the radiation oncologist the same week I met with the medical oncologist.  I wasn't nearly as resistant to radiation therapy as I was the hormone therapy.  I met with the radiation oncologist on Thursday, March 16th.  Dr. Hayne, although nice, wasn't as open to discussion to radiation as an option like Dr. Ari was. Of course I could have declined treatment but it wasn't like the discussion Dr Ari & I had. It was more to the point, how many days, what to expect, what you can & can't do, etc and I was OK with that. When you look at the DCIS trial data below radiation therapy seems to be the big hammer when it comes to reoccurrence.  
B24 Trials
My treatment plan was 15 days of radiation plus an extra 5 days to the tumor bed. This was due to the inferior margin.  I was scheduled to come back the following Monday (March 20th) to get scanned so the planner can create the radiation profiles. They also marked me with body paint & stickers. On March 22nd, I went back for a dry run of sorts so the techs can make sure the profiles were accurate so we would be ready to start for real the following day.

Day 1 of radiation was on Thursday March 23rd.  I picked the end of the day since it worked better with my work schedule.  Plus afterwards I could just go home & rest which would be needed about 2 weeks into treatment. Below is the table & equipment.  Every Tuesday was a quick visit with the nurse & doctor to make sure all was OK.  Every 5 days the techs took an x-ray while on the table to make sure the position was still good.  The treatment takes about 5 minutes total of which about 1 minute is of actual radiation. Most of the time is spent aligning you on the table using the body markings.  Treatment is daily, Monday through Friday, for 20 days. 

Radiation Table
Day 1 Post Treatment Arbo Walk with Steve
I was told the main side affects would be fatigue & possible sun burn on the treated area.  It seemed crazy that only a minute of zapping would cause fatigue but about 10 days in I really started feeling it.  Especially as the week went on.

Quarter Horse Relay Marathon - 3 days after I started radiation
Another issue I had was a really tight, painful upper back.  I think it was partially from the surgery & partially from the treatment.  It was so sore that ibuprofen wouldn't touch it. When I got home after my last treatment of the second week I massaged some Tiger Balm into my upper back.  That actually took the edge off.  I used it all weekend & by Monday it was feeling much better. Unfortunately after Monday's treatment it was sore again. I didn't use the Tiger Balm on Monday since I didn't want it to interfere with the treatment.  On Tuesday I saw the doctor & explained what was going on.  She didn't have an issue using the Tiger Balm on my back but didn't want me using it on my armpit since that was part of the treatment area.  Apparently I wasn't the first patient that day to complain about a sore back. They discussed looking at the table ergonomics the next day to see if adjustments could be made.

One nice benefit is the massages at the Wellness Center next to the radiation treatment.  I had a massage scheduled for Wednesday after my 5th treatment.  Since they are in the hospital they are trained to work with cancer patients.  The prior weekend the masseuse had gone to a craniosacral training seminar.  It was unlike any 'massage' I have ever had.  It was amazing! My back felt so much better after I left and it never got really bad again after this session.

Around Day 7 you could start the notice the redness on the treatment site. The area was swollen & tender.  The doctor said this would be expected until after the treatment is over.

Baptist Health - Lexington, KY
About 10 days in I started to feel the fatigue.  It wasn't awful but it would hit me suddenly. I would take a 30 minute nap & feel OK after that.  As the treatments went on the fatigue got progressively worse.  Never so bad I couldn't get up but definitely more tired than normal.  Also, as the week went on the likelihood of needing a nap increased.

The first 15 days was treating the full breast, the final 5 days was called a tumor boost.  The radiation was focused at the tumor site.  On day 15 after my treatment they set me up for the last 5 days.  There was an attachment that was used & the angle was different.  The setup took about 15- 20 minutes but each actual treatment is only about 30 seconds.  Getting me lined up on the bed took more time than the actual treatment.

Tumor Boost
After day 16 & 19 treatment I got another massage.  Since the last session went so well we agreed to do the same treatment again for both sessions.  It was the correct call.  My upper back is feeling normal again after these sessions.  It is really amazing. It is the most relaxing massage I have ever had & I leave feeling so much better.  My upper back is no longer in any pain.  Yay!

My friend Ruth joined me for my last treatment.  She was also there for my first dry run day.  We followed up the last treatment with a walk around the Arboretum.

After my last treatment

Yes, they gave me a radiation diploma :-)

Post treatment & walk celebration beer!
Overall, the 20 sessions were not bad.  I do have some general soreness, fatigue & itchy skin but that will pass.  I am really grateful that the cancer was caught early & chemotherapy was not needed.

What's next?  

I have a follow up in 3 weeks with the radiation doctor then I go into monitoring stage.  My next screening MRI is in late summer.  Hopefully I can avoid the embarrassing passing out episode from my first MRI.

We head to Washington state for an overdue vacation in May.  Lots of hiking & exploring to be done!

I signed up for the LIVESTRONG program at our local Y to jumpstart the rebuilding process. It starts the first of June & goes for 12 weeks.

I am hoping I can build up enough endurance to bike the GAP trail this summer.

Cancer, even a stage 0, puts things in perspective. Life is short. Choose to be happy. Plan the vacation. Call that friend. Tell someone you love them. Don't dwell on the past. Plan for the future but live in the present.

Lastly, I am so appreciative of all the love & support I was given during this process. Thank you, thank you, thank you. You never know what someone is going through so sending them love, prayers & positive energy goes a long way, even when they seem to be AOK on the outside.

Love & peace to you all!

'Pink tulips for your last week of treatment - Jennifer'

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