Radiation Burns & Bad Days

So, on Wednesday I met with my radiation oncologist. She told me that this coming Wednesday, they will be reducing the radiation field so that it is focused just on the cavity where the lesion was removed. I asked, “So my armpit will get a break and begin to have a chance to heal?” She told me yes, and I nearly jumped up and did a dance. You see, this is what my armpit looks like.

The very red area in the middle right is where my lymphadenectomy scar is. In the previous photo I posted, it was quite red. After that, it began to blister, and eventually opened. The dark skin all around is dead skin that has been fried by radiation. You can see where it, too, is beginning to peel. The skin underneath is new skin and very raw. Discontinuing radiation in this area was extremely important to me as the area hurts 24 hours a day, makes it very difficult to do normal, everyday tasks, and is also interfering with my sleep. More radiation there means frying that new skin, developing more blisters, and having the possibly of moist desquamation – that is, a blister that opens and instead of revealing dry new skin underneath, reveals moist, undeveloped skin, which can be a gateway for bacteria and infection.

So on Wednesday, when I got the news that I only had three more radiations to that area, I came home on a cloud. Sadly, yesterday the techs did the X-rays to determine what area the last seven treatments would cover, and the open, painful area falls just inside the border. So instead of only two more weeks of pain and skin deterioration in that area, I am facing another month of it.

As a result, I cried. I cried on the table and then I cried again in the changing room. I cried last night and then I cried again today. I think I am done crying now and can just face this and soldier on, but boy am I tired of pain and sleepless nights. Essentially the area hurts so much that when I roll over in my sleep, the pain wakes me. So I will talk to my doctor about that when I see her next week.

I really try to stay positive and upbeat and not let the little things get the best of me, but this has been the longest eight months of my life. Later I will post a photo of my naked chest so that the difference between the radiated side and the non-radiated side is visible, because it’s actually both interesting and shocking. Frankly if someone goes through all this and then the cancer comes back, that is just the ultimate insult. That should be against the laws of nature. Me getting cancer, eh, you could say it’s not fair, but I’d say that’s debatable. Someone doing all this and then having the cancer come back? THAT’S unfair.

Anyhow, in conclusion, to quote Bart Simpson, I didn’t think it was physically possible, but this both sucks and blows.

Radiation 12/35

I was cruising along so well that I got comfortable and thought maybe I could do this without any majorly ill effects. I was wrong. And I’m not even halfway done – the treatment cycle or the week.

My right breast is swollen and tender. My right nipple has gotten darker and is sore like a bruise – like a terrible sunburn, the kind that turns your skin nearly purple. Maybe I could deal better if I didn’t have – and LOVE – my children climbing all over me all the time, kneeing me in the chest as often as resting their heads on it. The scar in my armpit from my lymph node removal gets pinker and pinker, and the skin looks thin – not what I would expect from scar tissue. I am slightly afraid it will split, as I have read radiation skin can and often does.

I will ask my doctor about it when I see her Friday.

Funny, the side effects from this treatment really are minimal compared to chemo, but somehow it seems worse in some ways. I think the side effects of chemo were immediate and tangible, but the side effects of radiation are cumulative, so there is more anxiety involved.

And speaking of chemo – six weeks out from the last one today, and the joint pain unfortunately continues. Advil helps, but I try to use it sparingly as I don’t need a destroyed liver on top of the joint pain! Have had acupuncture twice and have noticed no effect (other than the hour lost sitting bored with needles in me). I’ll keep trying.

So, blah. Not a great day for me today, BUT – we did get Gregory’s ear tubes yet and he has had an immediate and overwhelming improvement in his hearing that has made us all giddy. So I’m trying to focus on all the beauty and good outside of my own body for the time being.

More results, more good news!

A few things to report but I’ll just cut to the chase right here at the beginning:

Wide clear margins on the removed cancer cells, lymph node negative for cancer! CANCER IS GONE!

I tried taking a pic of the damage a couple days ago but it’s tough to tell what’s going on because of the steri strips. Then the steri strips in my armpit just started falling off, probably because I have such sweaty pits, so here’s a photo of that incision, which is now exposed. You can see the ones on my breast to the side.

So some bruising obviously and yes a big old wound, but given that the operation was done on Monday and this pic was taken this morning, not so bad!

I still have quite a bit of soreness in my armpit, but have been off the narcotic pain meds for about 2 days – just taking ibuprofen as needed now. The incision in my breast doesn’t hurt at all unless I accidentally brush it (or one of the kids leans on it, as is more often the case). Very tired a lot of the time – long sleeps at night and also often daytime napping. I think my body is putting all its energy towards healing itself and as a result my energy is sapped. As long as that means I am healing well and fast, though, I’ll take it!

I’ve had a few amazing friends bring food, company, and send flowers, so my spirits are as high as ever, and now with good news to back it up! Next steps are appointments with medical oncologist, radiation oncologist, cancer naturopathy department at Swedish, and follow up with Dr. Smith.

Onward and upward!

Preoperative fear fest

I went in for my preop today and it wasn’t as bad as I expected. I got two prescriptions – one for a painkiller and one for an anti-nausea patch. Very smart of them to give you the scrips ahead of time – I hate when they give you a pain scrip the day of and you have to enlist someone to go get your prescription for you.

There was definitely a daunting list of side effects and possible risks, which is why I was nervous today. I had to sign the paper and give it back to them, or I’d take a picture. Most of them the doctor feels won’t affect me, but of course any of them could.

The lump of tissue he’ll take out is approximately the size of a ping pong ball, and then he goes back in and shaves the sides of the excision just to try to ensure clear margins. So essentially I’ll be losing about a golf ball-sized lump of boob tissue. He says he has a strong concentration on cosmetic results and will have a team of plastic surgeons behind him in case there are any issues. Still, that’s a lot of boob! Little worried about that.

So in the briefest way, the overview is: under local anesthetic, they use a needle to insert a radioactive seed in the tumor with the aid of ultrasound; then they give me an injection of radioactive dye to identify the sentinel lymph nodes; then they give me general anesthetic and begin the procedure, which should take around an hour; he makes two incisions, one to remove the cancer cells and one to remove the lymph nodes, and uses a probe in both areas to identify the radioactive spots and remove them; then I go to post-op, and when I’m stable, go home. I need to rest the first day, then after that, moderate rest with no lifting anything over 5 pounds for a week.

They make it all sound so simple and my doctor literally walked into the room and congratulated me (!) because of all the positive test results we’ve gotten, so my hopes are high for a good outcome.

That’s all for now!

Update on timeline

I talked to my doctor. He has no problem moving things forward, but here’s the catch.

I need to have an MRI before I can have the lumpectomy/axillary lymph node removal. The most accurate MRI results will not be till at least day 7 of my menstrual cycle, which is not until the second week of October. What does having an MRI before then mean? Potential false positives, i.e., areas of shading that appear to be cancer but are not. What happens if the MRI turns up (false) positives? Additional biopsies.

The biopsy SUUUUCKED and I do not enjoy the thought of having additional, possibly unnecessary biopsies. BUT I also do not enjoy the thought of chemotherapy, or twiddling my thumbs for another two weeks while I ponder the lesion growing in my boob.

With that said, MRI has been moved forward to 9/30, and results should be available 24 hours after the procedure. After that, doc says the lumpectomy/axillary lymph node removal (which from now on I’m calling ALNR because come on) can be scheduled fairly quickly.

So now, MRI in a little over a week. Fingers crossed for good (and in this case, “good” means “negative”) results so we can just go ahead and get this sh*t out of me without any further testing.

Out, out damn spots

So I emailed my doctor this morning, because I want the damned cancer out.

They KNOW I have two small spots of high-grade – that’s dangerous, fast growing – cancer in my right breast. Based on the tests they have done – mammogram, ultrasound, and biopsy – they THINK there is no other cancer in my breasts and that the cancer has not yet spread to the lymph nodes. And finally, only 1 in 500 women tests positive for the BRCA gene, and since neither of my grandmothers, my mother, nor any of my aunts have had breast cancer, AND my 23andme results came back negative for the three BRCA mutations they test for, I feel fairly certain mine will come back negative as well. With all these things in mind, how much sense does it make to keep waiting? It’s fast growing but not in the lymph nodes yet – how long will it take to get there? What if it only takes a month? So then I have to do chemo because rather than act quickly we chose to bide our time and see what the stupid test results said? The only test result that truly matters already came back and it said HI YOU HAVE BREAST CANCER.

My doctor replied and said he’ll call me today to discuss options. We’re going out of town this weekend and I am hoping he presents me with the “You can have the lumpectomy on Monday after you return” option.

A rolling stone gathers no moss and all that. Will update when I know more.

Hurry up and wait

This is the new scarf I bought myself. It has skulls. I am not doing a good job of smizing here.

I’m kind of dreading writing this cause it’s going to be long and boring. I’ll try to make it as concise as possible.

So, first and foremost, the doctor told me my cancer is a Stage I, approximately 8mm wide, and that currently we are looking at treatment for a cure – i.e., this is not life-threatening. It is invasive ductal, which is the type that approximately 75% of breast cancers are. It is high grade, which means it is fast-growing/spreading. He said I am very lucky I found that benign lump, as the two spots they identified because of it are not palpable, and in a year from now, we’d be looking at a very different situation.

From the scans they have so far, my lymph nodes appear clear, and the two spots in my right breast – right next to each other – that were identified appear to be the only abnormalities.

Now it’s just basically test, wait, make a plan, repeat. I had the blood test for BRCA today. The results for that may take up to three weeks to come back. They’re important, though, because as it stands right now, based on the limited information we have, the course of action would be lumpectomy to remove the spots, removal of several lymph nodes in the area of the spots, and then examination of the removed tissues. IF the lymph nodes are clear, which the doctor expects them to be, the next step would be radiation therapy, and possibly hormone therapy with tamoxifen. Hormone therapy is recommended if the tumors are ER+, which mine, based on the biopsy, are. Okay, digressing. IF the BRCA test comes back positive – which it could, although the percentage of women who have it is fairly low – the general recommendation is a double mastectomy. So we have to wait for those blood test results to form our treatment and surgery plan.

Now as I mentioned before, I am getting the MRI on October 6. The doctor actually immediately mentioned moving it forward, in spite of the MRI lab’s suggestion that it has to be done between days seven and 10 of my menstrual cycle. He said they tend to follow that recommendation because it’s when they get the clearest results, but he wasn’t sure if maybe we should do it sooner. He then went on to say that in actuality, it might not make any difference, since we have to wait till the BRCA results come back before we can do anything anyhow. In the end, he called the radiologist and asked for his recommendation. He said that the problem with doing it at another point in my cycle is that the results would be less accurate, and there was liable to be more shadows on the MRI that appeared to be something they weren’t, which could lead to more biopsies, etc., or could hide things that were there. He said in the end, the radiologist and he discussed what they would do if it was their wives, and they agreed they would want the most accurate results, but he left it up to me. I agreed with them. So October 6 it is.

Ai yi yi, okay, so where am I. Okay, so, once we have the gene results and MRI results, we can formulate an actual treatment plan. Again, back to based on what we know now, it appears that the treatment plan will be lumpectomy and lymph node removal (an outpatient procedure), followed a month later by 6 1/2 weeks of radiation. IF the lymph nodes come back positive for cancerous cells, then I will also have to have chemotherapy. In spite of all this scary stuff, it’s the tamoxifen that really scares me. I guess it’s a drug that prevents estrogen from entering the breasts. Side effects can be like menopause, I cannot get pregnant or nurse on it, and I have to take it for FIVE F**KING YEARS. This is the one part during the consult where I cried (to be fair, I’d taken two Xanax beforehand, so maybe I would have been bawling the entire time otherwise). I would very much like another baby, and I would ESPECIALLY very much like to breastfeed another baby. That said, I’m just going to try to roll with the punches here, cross the bridges as we come to them, and accept that God has a plan and it’s the right one.

I think that’s all the info I have now! This is such a super bummer because to be honest I NEVER liked the way my boobs looked and I thought having kids would only make it worse, but ever since I had them I actually like my boobs more. So I’m finally into them and now I guess they’re like, “Too little, too late, lady. This is what you get for years of shit talking.”

In conclusion, here’s a nice thought from my friend Annie and my fave actor Donal Logue. With Declan Murphy on my side, I can’t lose.

Also, Happy 71st Birthday, Dad! Thanks for the heads up, buddy.