I am getting close to being done with radiation. As a reminder, I am having radiation because I had a lumpectomy and that is the standard treatment if you have a lumpectomy. I was lucky enough that the cancer was not in my lymph nodes so I only have radiation in two positions (vs three if my nodes were involved).
The actual radiation treatment is about twenty one seconds in each position, so about 42 seconds total. Yep, that quick. I dont know the details behind it but I do know there is a physics department that reviewed my case prior to starting. And the seconds may be off a little cause that is just me counting once I hear the noise that the radiation has started. The technicians did say that they do not do individual treatments longer than a minute. I know some other people with different cancers get up to 7 positions but fewer seconds in each position.
I go through a lot to get those 42 seconds of treatment . . . the radiation oncology facility is an hour away from my home or work. That is a round trip of 2 hours. There is a shuttle going from my local Kaiser facility to the Kaiser in Ontario. The shuttle bus is more fun that I thought it would be. The people on there definitely make an unfortunate situation bearable and sometimes a lot of fun. Radiation is 5 days a week and there are people with all different types of cancer on the shuttle bus. I notice a difference in the number of radiation treatments and the type of cancer. So far on the shuttle people with Prostate cancer seem to have the most with 38 treatments (and 7 positions) and Lymphomas seem to have about 15-18. There is a wide range for Breast Cancer . . . some of us have 31, while others have about 15. I know I was given the choice of doing it in 31 or 20, and there seems to be a difference if you had a lumpectomy or a mastectomy. One thing I have learned through all of this is that the doctors develop a personalized treatment plan, which is why there is such a difference in the treatments.
I mentioned above that I had the choice of doing my treatment in 31 or 20 treatments. The 31 treatments are not all the same - 25 are whole breast radiation and 6 are boosts that are targeted at the scar area (or in my case area where the tumor was removed since I have scars in a different area since I had a reduction too). It is a similar case for the 20 treatments - 16 are whole breast radiation and 4 are boosts. In the 20 treatment plan, also called Hypofractionated, each radiation treatment has more radiation per treatment but less overall radiation. The 31 treatment plan, also called standard treatment plan, has a total of 50 Greys (Gy) of radiation at 2Gy/ whole breast treatment (not including the 6 boosts). The 20 radiation plan has a total of 42.5 Gy of radiation at 2.66Gy/ whole breast treatment (not including the 4 boosts). I asked the doctor if there were any studies done on this and he gave me the link to this study from the New England Journal of Medicine. I read the article carefully and debated a lot on which one to do and decided on the 31 treatment plan (25 whole breast + 6 boosts) because in the aforementioned study there was a significant difference in the local recurrence of people with a high grade tumor. My tumor was high grade (grade 3) and the difference in the study was about 10% higher local recurrence rate for those with a high grade tumor that had the Hypofractionated treatment (16 whole breast). I asked my doctor about this and he said the consensus was that this was not really a concern. I asked if there were further studies and he said there were not. I decided that an extra 11 days of going to Ontario was worth the chance of lowering my risk of local recurrence. It may be that the results were not really indicative of the true implications since the study sample size was small but I decided that peace of mind in knowing I made the best decision with the information available to me at the time was worth the extra 11 days of treatment.
One thing I have learned through this whole process is that you have to be your own advocate regarding your treatment. I know I made my oncologist upset when I asked some very direct questions regarding my treatment but in reality I think if you dont make them think twice or question them regarding treatment to your body that you arent doing yourself justice. I questioned my dentist too . . . and I avoided having a bridge because I made him think outside of the box. I also think of it like the time I went to China and was at their market that was similar to a swapmeet where all prices were negotiable. I learned I had to insult them by offering a really low price in order to end up with a good price. I need to make sure my oncologist knows this, but every time I see her it is a whirlwind and I barely have time for my questions.
Back to radiation - I have finished 24 of my 25 whole breast treatments and will complete the 6 boosts on 2/19/13. I even get to have treatment on the Presidents Holiday. I am having some skin reactions. About treatment 18 I started having some pain in my armpit. They are not targeting my armpit but it is being affected due to its proximity to my breast. It is only the lower half of my armpit that receives treatment. It started to look very dark and be painful. I have been good about putting the Aloe Vera on the area 2 to 3 times a day but it was hurting and looked really dark. The doctor said it may have been my hair trying to regrow but I didnt believe him. Then a couple days later I noticed my skin start peeling. In the dark area there were patches of pink. I met with a Physicians Assistant who prescribed 2.5% Hydrocortizone as the Aloe Vera will sting once the skin breaks open. I think that was part of the pain, that the aloe vera was getting in the skin where it was starting to break open. The PA mentioned that the first areas to have an issue are the ones with skin on skin contact - in my case the armpit and the fold of the breast. Well thankfully the fold of my breast does not touch anymore since my surgery. I was also told I could use Aquaphor lotion on the area. I personally hate how greasy the Aquaphor is but I have been using it along with the Hydrocortizone and using the Aloe Vera on all areas except my armpit.
I am told that the skin can continue to get worse for two weeks after I am done with treatment. The rest of the treatment area is looking pinkish/brownish, kindof like my skin looks after going to the beach but the color is not evenly distributed - some areas look normal, some are a little brownish, some are pinkish and then the armpit is very dark and my sentinel node biopsy scar is almost black with a little pink where it is starting to break open.
Friday, February 15, 2013
Sunday, January 20, 2013
Radiation Therapy for Lumpectomy
The word Radiation is a scary word, but it is also a good word. Radiation therapy takes something that can be used negatively and refocuses it on healing and treatment, so I think of it as a hopeful word. I created a new online profile name when I started this journey . . . radioactivegirl. It was started after I had to have some tests in the nuclear medicine department and there were several radioactive signs around. In addition to my username it is my cancer fighting alter ego.
I started radiation therapy on Tuesday (1/8). If you have a lumpectomy you always have radiation for breast cancer. Some people with a mastectomy also have radiation if they have positive nodes, but for me I am having radiation because I had a lumpectomy to get the same survival rates as if I had a mastectomy, but I got to keep my breasts.
Preparation for radiation takes time. They put you on a machine and take some x-rays and do some mapping. They put these marks on my skin with a sharpie and then put some clear stickers over them. I was told to keep them on my skin until my next appointment a week later. I'm not sure exactly what they did but they mapped it and had the physics department review it. Then I went back and they did some stuff to make sure it was aligned correctly and removed the stickers and gave me 5 tattoos. Yep, tattoos or permanent markings. These arent the tattoos like you are thinking about - they are small black dots. The technician put some ink on my skin and then used a single needle for these medical tattoos. I looked at them afterwards and I have moles that are bigger than these tattoos. Before I had them I was thinking of having them removed after treatment because they will remind me of treatment. But I may keep them because someone made me think of these as battle scars. I am undecided at this moment, but even though they are small they are black and stand out among all my brown moles.
Radiation itself is usually a quick and painless process. I get undressed and into a gown. Then when I get called in to the radiation room with a giant radioactive sign and a 5 inch door I lie down on the table/bed thing. There are notches and groves so that your head is cradled and they put a triangular pillow under your knees and you put your hands above your head and there are braces to support them. There are laser beams of light that are pointed at your body and I believe they use those to lign up with your tattoos. I cant actually see what they are doing but they do always move me around a little. Then they leave the room and close the 5 inch thick door. The radiation machine starts making noise and there are lights flashing to indicate that the beam is on. Then they come in, the machine moves to another position and the process is repeated.
I am usually pretty calm until I hear the noise that indicates the beam is on and I start to breathe heavily and freak out a little. I always have my eyes closed and I try and think good thoughts. I also use this time to send people good thoughts. I don't really pray, but I do send people good thoughts and I figure that is a good a time as any to do that since I have some quiet alone time.
I have radiation in two positions and after the second one they tell me I can get up and go. It is totally painless and uneventful. This is repeated every weekday for a total of 25 times and then I get 6 boosts which I think are just targeting the area where the tumor was, not the whole breast. The most common side effects of radiation are reddening of the treatment area and fatigue. My radiation doctors recommend using 100% aloe vera gel. I have been using it religiously one to two times a day to prevent any radiation "burns" that arent really burns but look like a bad sunburn. If my skin does get red then the doctors have other things they can prescribe. In the meantime I am slathering on the aloe vera in hopes of preventing any skin reactions. I do see the doctor after every 10 days of treatment so they can monitor me.
So far I have had 9 out of 31 treatments and I do not really notice any reddening of my skin or have fatigue. I think, like chemo, that the effects are cumulative so that may come later but so far so good.
I started radiation therapy on Tuesday (1/8). If you have a lumpectomy you always have radiation for breast cancer. Some people with a mastectomy also have radiation if they have positive nodes, but for me I am having radiation because I had a lumpectomy to get the same survival rates as if I had a mastectomy, but I got to keep my breasts.
Preparation for radiation takes time. They put you on a machine and take some x-rays and do some mapping. They put these marks on my skin with a sharpie and then put some clear stickers over them. I was told to keep them on my skin until my next appointment a week later. I'm not sure exactly what they did but they mapped it and had the physics department review it. Then I went back and they did some stuff to make sure it was aligned correctly and removed the stickers and gave me 5 tattoos. Yep, tattoos or permanent markings. These arent the tattoos like you are thinking about - they are small black dots. The technician put some ink on my skin and then used a single needle for these medical tattoos. I looked at them afterwards and I have moles that are bigger than these tattoos. Before I had them I was thinking of having them removed after treatment because they will remind me of treatment. But I may keep them because someone made me think of these as battle scars. I am undecided at this moment, but even though they are small they are black and stand out among all my brown moles.
Radiation itself is usually a quick and painless process. I get undressed and into a gown. Then when I get called in to the radiation room with a giant radioactive sign and a 5 inch door I lie down on the table/bed thing. There are notches and groves so that your head is cradled and they put a triangular pillow under your knees and you put your hands above your head and there are braces to support them. There are laser beams of light that are pointed at your body and I believe they use those to lign up with your tattoos. I cant actually see what they are doing but they do always move me around a little. Then they leave the room and close the 5 inch thick door. The radiation machine starts making noise and there are lights flashing to indicate that the beam is on. Then they come in, the machine moves to another position and the process is repeated.
I am usually pretty calm until I hear the noise that indicates the beam is on and I start to breathe heavily and freak out a little. I always have my eyes closed and I try and think good thoughts. I also use this time to send people good thoughts. I don't really pray, but I do send people good thoughts and I figure that is a good a time as any to do that since I have some quiet alone time.
I have radiation in two positions and after the second one they tell me I can get up and go. It is totally painless and uneventful. This is repeated every weekday for a total of 25 times and then I get 6 boosts which I think are just targeting the area where the tumor was, not the whole breast. The most common side effects of radiation are reddening of the treatment area and fatigue. My radiation doctors recommend using 100% aloe vera gel. I have been using it religiously one to two times a day to prevent any radiation "burns" that arent really burns but look like a bad sunburn. If my skin does get red then the doctors have other things they can prescribe. In the meantime I am slathering on the aloe vera in hopes of preventing any skin reactions. I do see the doctor after every 10 days of treatment so they can monitor me.
So far I have had 9 out of 31 treatments and I do not really notice any reddening of my skin or have fatigue. I think, like chemo, that the effects are cumulative so that may come later but so far so good.
Saturday, January 5, 2013
Oncoplastic Breast Reduction Surgery Recovery
All in all the recovery has been much easier than I thought. I did have a horrible sore/dry throat that showed up the morning after surgery. It hurt to talk, it hurt to swallow, it hurt to eat it just plain hurt. Kindof like the worst sore throat from a cold, but I didnt have the other cold symptoms. Whispering hurt and I resorted to using the fewest words possible and doing a lot of pointing. My throat was pretty battered from chemo and the breathing tubes really irritated it. I didnt really eat much between my stomach issues and the sore throat :-(
The day after surgery I had an appointment with the Plastic Surgeon's nurse to change my dressings (they would have removed the drains then too, but I didnt need any drains). The nurse did a quick check, changed some of the gauze and made sure I had feeling in the nipple. She also told me that over the counter sore throat drops would help me. On the way home we stopped at the store and got the strongest Cepacol lozenges they had. Sweet relief. I used them for the next day or two until it felt "normal" again. I put normal in quotes cause I still have some throat irritation and sensitivity to acidic foods that are a result of chemo.
After the initial issues with the pain medicines and my stomach I was afraid to take more, but it turns out I didn't need it. I was very surprised. I had some tenderness and discomfort but there were also times that I "forgot" about it and reached for something and was reminded that I just had surgery. I didnt take any more pain medicines after that, yippee.
I didn't really lift anything or reach for anything for a couple of days. My instructions said to use common sense with what you do. I didn't push it - I reached for things and if it hurt I stopped and asked someone to get it for me.
The biggest complaint I had was itching. The incision along the bottom fold of my breast itched. It would be fine then all of a sudden it would itch like crazy. I had steri strips along all incisions and I was wearing a sports bra 24/7 as instructed. I couldn't really scratch but pulling up the bra and rubbing along the steri strips helped. The suture knots or whatever you call the fishing line looking stuff that was taped down was what itched the most. I had them removed about two weeks after surgery and the itching mostly stopped at that time so I think that was what was causing the itching.
I still have some issues in the car, mostly when I ride in a truck. When we go over a bump or the road is not so smooth I feel it in my breasts. And the rough roads I am talking about are the same roads I have driven on for years with no issues and I only notice it in a truck, my guess is because the suspension is different than in a car. It isnt all roads all the time, just older sections of the freeway or potholes that have been filled or even somewhat newer roads that are kindof wavy (I never paid that much attention before). I can deal with it, it is just uncomfortable.
My instructions also said to massage and put lotion on the incisions twice a day to help break down the scar tissue. I do notice that the scars, particularly along the fold do look like there is some scar tissue forming and I hope that the massaging will help. I have not done it 2x/day every day but I am trying. The massage does not feel good as it does make it feel sore afterwards. I haven't been doing it because I forget to do it, a lame excuse I know :-(
I am now 4+ weeks out from surgery and I am happy with the results. I am noticing that the nipple is starting to look oblong and I hope that is just because some areas are settling differently than others. I first noticed this on the cancer side but am now seeing a little on the non cancer side.
I'm not exactly sure how much smaller I am but they are smaller and firmer and more perky. So far I am mostly happy with the results. The slightly oblong nipples do not make me happy but I know my Plastic Surgeon did make some adjustments because she was compensating for the effects of radiation. I'll reserve my final thoughts for after radiation.
If you found this blog because you are thinking of having an oncoplastic reduction feel free to ask me any questions you may have.
The day after surgery I had an appointment with the Plastic Surgeon's nurse to change my dressings (they would have removed the drains then too, but I didnt need any drains). The nurse did a quick check, changed some of the gauze and made sure I had feeling in the nipple. She also told me that over the counter sore throat drops would help me. On the way home we stopped at the store and got the strongest Cepacol lozenges they had. Sweet relief. I used them for the next day or two until it felt "normal" again. I put normal in quotes cause I still have some throat irritation and sensitivity to acidic foods that are a result of chemo.
After the initial issues with the pain medicines and my stomach I was afraid to take more, but it turns out I didn't need it. I was very surprised. I had some tenderness and discomfort but there were also times that I "forgot" about it and reached for something and was reminded that I just had surgery. I didnt take any more pain medicines after that, yippee.
I didn't really lift anything or reach for anything for a couple of days. My instructions said to use common sense with what you do. I didn't push it - I reached for things and if it hurt I stopped and asked someone to get it for me.
The biggest complaint I had was itching. The incision along the bottom fold of my breast itched. It would be fine then all of a sudden it would itch like crazy. I had steri strips along all incisions and I was wearing a sports bra 24/7 as instructed. I couldn't really scratch but pulling up the bra and rubbing along the steri strips helped. The suture knots or whatever you call the fishing line looking stuff that was taped down was what itched the most. I had them removed about two weeks after surgery and the itching mostly stopped at that time so I think that was what was causing the itching.
I still have some issues in the car, mostly when I ride in a truck. When we go over a bump or the road is not so smooth I feel it in my breasts. And the rough roads I am talking about are the same roads I have driven on for years with no issues and I only notice it in a truck, my guess is because the suspension is different than in a car. It isnt all roads all the time, just older sections of the freeway or potholes that have been filled or even somewhat newer roads that are kindof wavy (I never paid that much attention before). I can deal with it, it is just uncomfortable.
My instructions also said to massage and put lotion on the incisions twice a day to help break down the scar tissue. I do notice that the scars, particularly along the fold do look like there is some scar tissue forming and I hope that the massaging will help. I have not done it 2x/day every day but I am trying. The massage does not feel good as it does make it feel sore afterwards. I haven't been doing it because I forget to do it, a lame excuse I know :-(
I am now 4+ weeks out from surgery and I am happy with the results. I am noticing that the nipple is starting to look oblong and I hope that is just because some areas are settling differently than others. I first noticed this on the cancer side but am now seeing a little on the non cancer side.
I'm not exactly sure how much smaller I am but they are smaller and firmer and more perky. So far I am mostly happy with the results. The slightly oblong nipples do not make me happy but I know my Plastic Surgeon did make some adjustments because she was compensating for the effects of radiation. I'll reserve my final thoughts for after radiation.
If you found this blog because you are thinking of having an oncoplastic reduction feel free to ask me any questions you may have.
Tuesday, January 1, 2013
Goodbye 2012, Hello 2013!!!
2012 started out as a good year for me but was marked by bad news and tough times . . . and then I found out I had breast cancer and had to have chemo.
Chemo is by far the hardest thing I have ever been through and I have been through a lot. I am 7 and a half weeks out from chemo and I struggle with a lot of things I shouldn't, newborn babies have more hair than I do, and I don't have the stamina or focus that I used to. But I am alive and I showed Cancer that it is not welcome here.
I am not one to make New Year's Resolutions but I do want to make some changes in my life. First I want to do more things. Do things that make me happy, do things that scare me, do things that remind me I am alive. I want to experience all I can with each passing day cause I never know if it will be my last.
I want to go Ice Skating more - I started skating as an adult and took lessons off and on for 10 years. I want to get back to going. But I can't right now - I have horrible balance and muscle tone. soon though, really soon.
I want to travel more. I have been lucky enough to be able to travel to lots of places and I want to continue that.
I want to feel motivated to post happy things on Facebook. I am currently posting negative or complaining posts. I want to change that. Correction - I will change that. I know the better I feel the happier my posts will be, although my favorite post all year was my Pathology Post.
I guess what I am rambling about is that I just want to make sure I live every day to its fullest :-)
Chemo is by far the hardest thing I have ever been through and I have been through a lot. I am 7 and a half weeks out from chemo and I struggle with a lot of things I shouldn't, newborn babies have more hair than I do, and I don't have the stamina or focus that I used to. But I am alive and I showed Cancer that it is not welcome here.
I am not one to make New Year's Resolutions but I do want to make some changes in my life. First I want to do more things. Do things that make me happy, do things that scare me, do things that remind me I am alive. I want to experience all I can with each passing day cause I never know if it will be my last.
I want to go Ice Skating more - I started skating as an adult and took lessons off and on for 10 years. I want to get back to going. But I can't right now - I have horrible balance and muscle tone. soon though, really soon.
I want to travel more. I have been lucky enough to be able to travel to lots of places and I want to continue that.
I want to feel motivated to post happy things on Facebook. I am currently posting negative or complaining posts. I want to change that. Correction - I will change that. I know the better I feel the happier my posts will be, although my favorite post all year was my Pathology Post.
I guess what I am rambling about is that I just want to make sure I live every day to its fullest :-)
Monday, December 31, 2012
Pathology Results :-)
"I am pleased to inform you that the pathology from your surgery showed no remaining cancer. This is the best possible result!" . . . direct email quote from my surgeon on 12-11-12. :-) I later found out they tested the "good" one too and there was no cancer their either :-)
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