On Thursday (April 23) I met with Dr. Tonya Kuhn, my radiation oncologist again. The last time I saw her I didn't know if I was going to need to do chemo yet so it was a while ago! Back when I had hair.
She said the radiation will be yet another insurance policy against any returning cancer. For all intents and purposes, all the cancer cells were removed during my surgery... however, it is possible there could be something lurking in there that modern medicine has no way of identifying at this time, and so radiation is one more thing you can do to kill any abnormal cells.
She said I could start my radiation anytime starting the week of May 11... so May 11 it is! I want to get started as soon as possible so that I can finish as soon as possible. She is prescribing me 33 treatments... the first 28 treatments will be whole right breast radiation and the remaining 5 treatments will be concentrated on my lumpectomy site. Assuming all stays on track, I should finish up my rads the week of June 22. This makes me very happy because I will be all done before my cousin's wedding in July (and the bulk of summer, too, maybe we can even get a vacation in there!).
After meeting with Dr. Kuhn, I had my radiation simulation. This is where they take 3-D images of your body using CT scan technology in order to map your body and figure out exactly where the radiation will be directed at each and every treatment. The technician who performed my simulation was named Debbie and she was great at answering all my questions and explaining how it all worked. I'd never hat a CT scan before but was told this is the same machine they use for other kinds, but I didn't have to have an IV or any dye injected into me so that was nice.
Debbie explained that the CT room is set up exactly like the radiation room, which is right next door. Both rooms have a set of lasers, one on the ceiling and one on each side of the room. They use the lasers to triangulate your body position so you are in as close to the exact position each time as possible. Of course in order to do that they need to put some permanent marks your actual body that they can line those lasers up with. And that is how I got my first tattoo. She joked part of her job is to give the most expensive, least impressive, tattoos ever.
She had my lie down on the CT machine/table with my arms over my head and then put some special wire/tape in the spots where the tattoos would end up going. The special tape shows up on the CT scan images. Then it was time for the actual scan. Not much to it... I just lay there and the table moved back through the doughnut-shaped machine. I could hear it whirring and spinning. I don't quite understand how it works, but after a few minutes the whirring stopped and Debbie came back in the room to do the tattooing. At some point she'd made a couple marks on me with a sharpie where that special tape was. The tape markers came off and she just did a tiny little injection (the needle looked like one used to give an insulin shot), then wiped the area with alcohol to make sure the ink was under the skin.
Now I have three tattoos. One in the middle of my chest pretty much right between my cleavage and the other two are one on each side, kind of under my arm/outside my breasts. They truly are very unimpressive and look like a tiny freckle. That was all there was to the simulation. The tech showed me the images and that was interesting. The special tape showed up as little white dots on the screen. She pointed out some of my organs which apparently are all where they are supposed to be so that is good.
Next she got me on the schedule and was even able to get me in the first time slot of the day which was nice. I think I will be glad to just get it over with first thing each morning. The only thing is I have been going in to work around 7 am and the first appointment they offer is at 8 am. Since MSTI is right by my house it doesn't make sense to go to work, then back to the appointment, and then back to work. So I will have to go into work a little later and stay a bit later - which is what I did when I had to get Claire off to school before Juan was in his "home office" so that is fine.
My very first appointment on May 11 will be at 9 am (can't remember why the first one had to be a bit later). Every Monday I will meet with Dr. Kuhn after the treatment, but the rest of the week will just be the radiation... in and out.
I haven't watched my informational radiation DVD (I chose DVD over the class this time) but from what I already know it shouldn't be too bad. Radiation does not cause side effects like chemo. Chemo is systemic and it's in your blood stream and attacking all those different cells throughout your entire body... which is why you can feel so terrible (or just a little terrible like me) and lose your hair and things like that.
Radiation is very specifically targeted to a specific area of your body and it so doesn't attack other kinds of cells in the way chemo does. They use the lasers to line you up and angle the radiation machine in a very precise way so that the radiation will be passing through only my breast and touching other areas as little as possible. That way it only damages the cells in that area, and it affects cancer cells more than the healthy cells. It can cause irritation to the skin, like a sunburn, but most people I've talked to said it wasn't that bad. Also it causes fatigue, which builds up over time. Dr. Kuhn said she would expect me to tolerate it well... maybe be at 90% of my regular energy by the end so I can handle that.
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