Last week I had my post-op appointment on Tuesday, January 20. Everything looked good and was healing the way it was supposed to. Dr. Livingston's PA wanted me to wait another week before resuming all "normal" activity and lifting more than 10 lbs. He said my skin was great and they would do surgery on me anytime (but I hope not anytime soon or ever again!). I was very happy I got to spend another week resting and healing and hanging out with Bryce (and trying to remember not to pick him up!) and Claire. My big frustration of the week was dealing with the benefits/leave administration people from my work but that is another story and all worked out.
Monday, January 26 was my first day back to work, but I had to come in late because I had an appointment with Dr. Kuhn, my radiation oncologist, first thing in the morning. I really liked her so that was good. I have to say I've been so happy with all my doctors.
Just as I suspected, I didn't come away with a concrete plan for radiation because we are still waiting for the Oncotype results. I did come away with a lot more information about radiation though. Dr. Kuhn said she believes that most likely all my cancer was removed in the surgery, but that being said, I should definitely still do radiation (I already knew this so not a big deal).
Radiation does not have horrible side effects like chemo can. She said it can cause physical changes to the skin that is radiated (that would be my breast in this case) that are similar to a sunburn... peeling, even blistering, and also the skin can just feel and look a little different. It can make you feel tired, especially over time, but she said someone "healthy" like me she would guess I might have 90% of my normal energy. There are a few risks involved, but she reassured me that the low dose of radiation I would be receiving can not cause cancer, it will be just enough to kill any undetectable cancer cells that could still be hanging out in my breast. Also I will be getting my first tattoo... they put a little dot/marker on you so that the machines are lined up right every time so the radiation goes in the exact same place.
The thing about radiation is that you have to do it every day Monday through Friday for 6 to 6-1/2 weeks (or maybe even a little more in my case). Every day! It doesn't take long... 15 minutes and then once a week I'll meet with Dr. Kuhn and that appointment might take a little longer. We live really close (like 5 minutes) from St. Luke's/MSTI Meridian so that will be convenient. And at least you get weekends off!
Right after I was diagnosed with this stupid cancer the news had a story on new research about a shorter course (3 or 4 weeks) with stronger dosage of radiation being just as effective as the traditional 6 week course. I asked Dr. Kuhn about this and she said that yes, it has been proven to be just as effective at preventing recurrence, however, we don't know yet about the long term side effects of the higher doses or radiation and also the appearance of the skin over time will not be as good. So for someone young and otherwise healthy like me she would not recommend it. She said if I was 80 years old then it would be fine or if I had to travel a long distance for treatment it might be worth weighing the risks and benefits. She said in my case, she would even consider a slightly longer course with lower dose which could lower the long term risks even more. This makes sense because I am planning to live a lot more years!!
Dr. Kuhn said I couldn't start radiation until at least 4 weeks after my surgery, so waiting for the Oncotype results will not hold anything up. If it turns out I don't have to do chemo, I'll probably start radiation mid-February. If I do have to do chemo, I will do it first, and then could start radiation a few weeks after that wraps up.
Juan asked Dr. Kuhn her opinion about chemo should my Oncotype score come back in the intermediate range. I was glad he thought to ask her this. Her short answer was basically that she would say I should do it... that were she in my shoes, she would... that I should consider the risks of course and determine where I fall on the spectrum of "I'm going to do everything possible to prevent this from ever happening again" vs. "I do not want to go through chemo even if someone holds a gun to my head" (that is not actually her quote but my interpretation). I have an idea where I am on the spectrum.
And so now, I continue to wait.
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