- They will avoid my lungs and ribs as much as possible, but will likely not be able to avoid them altogether. That means there will be a scar on my lungs from the radiation, and my ribs will be more brittle in that area. These will be long-term effects because the radiation will shrink the blood vessels in that area, so the bones will not be able to recuperate completely.
- Because my tumor started out at 5 cm, they will be giving me 6 1/2 weeks of radiation. 5 cm is apparently the threshold they use for determining lots of things, and when you start with a tumor that large, the current medical wisdom is more radiation, not less, even if the cancer "appears to be gone" from your body. They worry that with a tumor that large, microscopic cells may have been missed in areas not touched by the surgery (such as the lymph nodes below my breastbone and in my neck, even though they showed up clean on the most recent PET scan). The doc did say he will be looking at that most recent PET scan before deciding how broadly to do the radiation, particularly since the biopsy of the lymph nodes in my neck so many months ago came back inconclusive (that darn biopsy is sure causing a lot of worry on the part of the docs). He seems as amazed as anyone else that a tumor that large is completely gone - I get the feeling this doesn't happen very often. He is unwilling to believe that the cancer cells are completely gone. I am praying his disbelief isn't causing him to do more radiation than is truly necessary, so I am trusting God with this one, praying that He will touch the heart of the doc if the breadth or depth of the radiation is more than is really needed.
- We could start the radiation either early Oct. or late Oct., but there were two reasons we decided to start in late Oct.: 1) the doc was leaving for vacation and wouldn't be here for the first three weeks of radiation if I started early in Oct. and 2) my left arm was still pretty stiff from the surgery when we saw him, and he wants me to be as limber as possible before we do the radiation. He told me that I will have to stay in one position for about 2 min. (that's as long as it takes in the machine, he says), but I will have to lay with my arms above my head holding onto a bar of some kind. My arm has limbered up quite a bit since I went to see him a week and a half ago, but the tendon under my arm is still somewhat tight, and there is still some pain associated with that that sometimes runs down that arm and into my wrist and/or hand. He made a referral to a physical therapist and lymph-edema specialist so that I can have my arm checked out and to make sure I don't do things that could make it worse. I have my next chemo round tomorrow (Monday), so I'll be asking the medical oncologist about this since neither the PT nor the lymph-edema specialist have called (and they were supposed to - the referral wasn't for me to call them). And if you don't know what lymph-edema is - I wouldn't have if I hadn't gone through this - it's swelling caused by too much lymph, the fluid produced by the lymph nodes. It is a possible side-effect of the removal of lymph nodes (I had only one removed, so my risk factor is pretty low for lymph-edema) and radiation. If not properly cared for, it can cause lots of issues down the road. The radiation doc didn't seem too worried by the tight tendon, and said I had more range of motion than he would have expected, but he was a bit concerned about the amount of swelling still existing under my arm - thus the referrals.
- The appointment when we DO set the dates for radiation is set for October 21. They call this a "planning appointment" (the one I had in Sept. was apparently a "pre-planning" appointment). At this appointment, they will put "tattoos" on me so that they line me up in the exact same place every time I go in. They will take lots of x-rays to use in strategizing and making measurements, partly to make sure they do avoid my lungs and ribs as much as possible, and partly to ensure that they completely avoid my heart - they made it clear they don't want to hit that at all. They told me that it will be about a week after this appointment that I begin my radiation, so that means either sometime the last week of October or the first week of November. Once I have dates, they will go up on the Care Calendar.
I think that at some point in all of this I heard that my life would never be the same because of the cancer, and part of me understood and believed that: never again can I mark "no" beside those "Have you ever had...." questions at the doctor's office; never again can I claim to have a completely clean bill of health; never again will I be able to take my health for granted, because there are things I have to think about now that I never would have had to think about before. Part of this I understood. But part of it I didn't, and hearing that the scarring on my lung could possibly cause me to need oxygen later in life, that being in a car accident at any point down the road could cause me to have broken ribs (not that that wasn't a possibility even without cancer), that I will have tattoos (and not the pretty kind that you get to choose) on my skin as more permanent reminders of all of this (as if I don't already have enough scars to remind me) was about more than I could handle when we left the doctor's office a week and a half ago. I fought tears all the way home, and still fight them now sometimes when I think about this too hard.
I think there are many reasons for this. First, I thought I'd put the scary stuff behind me. Everyone I talked to said that chemo was the worst part of cancer - and even though the recovery from surgery wasn't my idea of fun, it was certainly waaaaay easier than chemo. So facing radiation seemed like a piece of cake before I met with the doc. Second, I think that having gotten such a great report from the surgery made me a bit too hopeful that they would cut the number of weeks I'd be required to do radiation (they initially told me 5 weeks), so to hear that I'd be doing even more than what I'd first been told was tough. Last, I'd heard from so many people that "radiation is nothing" that I didn't really consider that there might be side effects beyond the burnt skin. It was beyond hard to hear that now I'll need to be aware of how I breath every time I climb a flight of stairs.
I'll admit to a bit of Scarlett O'Hara syndrome with this - the "I'll think about that tomorrow" mindset. Avoidance is a strategy that can come in handy at times. But I can't avoid looking this in the eye forever, and every time I do, it stares back with a mean eye that has me shaking in my boots.
Yet I know that "God has not given us a spirit of fear, but of power and love and discipline." (2 Timothy 1:7) Think about the juxtaposition of those ideas: fear, power, love, discipline. What that says to me is that the tools to fight fear are power, love, and discipline. As I rely on God's power in this part of the journey, He will remind me of His faithful love. When I discipline my mind to remain steadfast on Him and His power and love, He will keep me in perfect peace, because that steadfastness demonstrates my trust in Him (Isaiah 26:3).
So the conclusion I've had to come to is this: my life has never been my own. I gave it away to my Savior years ago. He is in charge for how ever many days He chooses to leave me here on this earth. The cancer hasn't changed that - it's just made me count my days more carefully and recognize their brevity: "So the Lord has compassion on those who fear Him. For He Himself knows our frame; He is mindful that we are but dust. As for man, his days are like grass; as a flower of the field, so he flourishes. When the wind has passed over it, it is no more, and its place acknowledges it no longer. But the lovingkindness of the Lord is from everlasting to everlasting on those who fear Him, and His righteousness to children's children, to those who keep His covenant and remember His precepts to do them." (Psalm 103:14-18). My job is not to live in fear of cancer or its side effects, but in fear of the Lord. He knows "when I sit down and when I rise up; [He] scrutinize[s] my path and my lying down, [He is] intimately acquainted with all my ways....[and He has] enclosed me behind and before, and laid [His] hand upon me.... If I say, 'Surely the darkness will overwhelm me, and the light around me will be night,' even the darkness is not dark to [Him], and the night is as bright as the day.... In [His] book were all written the days that were ordained for me, when as yet there was not one of them." (Psalm 139:2, 3, 5, 11, 12, 16). He knew, long before I did, that cancer would strike in April of 2015; He knew how dark I would find the path at times. Yet He prepared me for this trial long before He took me down this path. And no matter how dark or long it has been, He has never left me. I know that just as He has had the results of the first biopsy, and the 2nd biopsy, and the chemo, and the surgery in His hands, He has the radiation and its results, short and long-term, in His hands. His faithfulness is everlasting; blessed be the name of the Lord: "The name of the Lord is a strong tower; the righteous runs into it and is safe."
Running into the safe, strong tower of His name, where fear and darkness have no place,
Sherri
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