44 E-mail: 7 more to go

9/6/2006

A CHANGE OF PLANS
This morning held a surprise for me that I didn’t like. It’s a change of plan for my radiation treatment.

Instead of 25 treatments of irradiating the whole breast (and nearby lymph nodes) and 8 treatments of the boost, I am now to have 28 treatments of whole breast irradiation and only 5 treatments of the boost.

The reason I don’t like this change is because the skin under my arm has finally reacted like a sunburn and begun to peel. Starting this weekend the skin has been peeling and the skin underneath is tender and easily irritated. Because the peeled skin is akin to the sensitivity and texture of new skin under a blister, it sticks to my arm when I bring my arm down. Lifting my arm up or forward causes the sticking skin to unstick and that’s when it hurts. Just a little bit. Many times an hour. Every hour I’m awake. Oh yeah, and then there’s the added joy of when my bra digs in just a little bit and makes it hurt some more. Radiation isn’t as tough as chemo but it still sucks, and now I get an extra 3 treatments of the radiation that’s caused this condition. Grrrrr…

Yesterday the nurse gave me a packet of an astringent called Domeboro (Aluminum Acetate). I am to combine the powder from the packet with water. Then I’m to dip a cloth in the water, wring the water out, and keep the cloth on the peeling skin for 15-20 minutes. Then I’m to let the skin air dry for 5 minutes before I apply lotion. And I’m supposed to do this 3-4 times a day. Yeah right. Like I have time for that.

I plan to try it this evening. Once a day is better than nothing. My radiation oncologist assured me today that the stuff works wonders and I’ll be amazed at how quickly my skin heals.

RADIATION EDUCATION
I decided to ask why my treatment plan has been changed. I still don’t exactly understand why fewer doses of the boost equals added doses of the full blast, but here’s the part I did understand.

Chemotherapy doesn’t help with the site where the tumor was removed because chemotherapy is systemic. It travels through your bloodstream to affect your system. Blood vessels were cut during surgery, so the healed area has scar tissue and blood that now travels differently in the site. Chemotherapy cannot help where it cannot reach, and it cannot reach through blood vessels that are no longer there. So that’s why we need radiation to kill the microscopic cancer cells that might have escaped from the surgery. That makes a lot of sense to me.

Furthermore, lack of blood flow means lack of oxygen. For some reason, cancer cells with less oxygen are harder to kill with radiation, so it takes more radiation to kill them.

(This next bit is my own mental leap here and not part of the conversation with my doctor.) I supposed that is why chemotherapy and radiation shrink tumors before surgery. Chemotherapy delivers the systemic poison when the blood vessels cancerous tumors create still feed the tumors. And oxygenated cancer cells die faster when radiation is applied.

My radiation oncologist reviewed my chart recently and found something of interest in my final pathology report. It you recall, I had essentially two lumpectomies. The first one was March 3 when the cancer was discovered and diagnosed. That’s when I was still pregnant. We thought from the preliminary pathology report that the margins were clean but learned in the final pathology report that the margins were dirty on one end. When I had the passport installed in my arm and the sentinel lymph nodes biopsied March 22, my surgeon made the original incision wider and removed extra tissue from the breast. It turns out that the final pathology report from that surgery reported no disease, and that’s what caught my radiation oncologist’s eye last week. No evidence of disease after the second excision means less call for the boost, so I get less of the boost.

A HALF RECALLED CONVERSATION
From the party Guy and I attended last weekend I remember part of a conversation but I cannot remember the source. This party-goer has a friend who has been working on a project using light to kill cancer cells. It was an amazing breakthrough, and I think it was shown that light waves at the right frequency shrank tumors and caused cancer cells to kill themselves. Something that causes cancer to go suicidal gets me excited.

I remember the person mentioning that the light technique is now in clinical trials. So I googled it. (Funny how that word “Google” has become accepted as a verb.) I typed in “light kill cancer clinical trials” and found this link on ClinicalTrials.gov. http://clinicaltrials.gov/ct/show/NCT00030589 The technique is called Photodynamic Therapy and in this trial it was combined with chemotherapy for lymphoma patients. (What’s humorous is that Google posed the question to me if I really meant to type “might kill cancer clinical trials.”)

After learning the proper name for the technique, I tried Google again and found this article at the National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/Therapy/photodynamic In a nutshell this looks like a promising new technology and it is already approved for certain kinds of cancer, such as esophageal cancer and non-small cell lung cancer, but it doesn’t apply to breast cancer. And it turns out that the treatment helps the immune system kill cancer cells. They don’t commit suicide.

I have to laugh at the quack sites that claim that the government is suppressing efforts to find the cure for cancer. Researches are trying all kinds of things to find a cure and kill cancerous cells. I know the FDA has a hand in trying to make sure new treatments are safe. If that’s governmental interference I’ll take it. There’s something about application of the scientific method and documented results of double blind studies under controlled conditions that makes me feel oh so much better about new techniques.

FLEXIBLE BABY
Kelric did something unusual today. According to one of his teachers at the Montessori school, he spent time in the stroller outside with his feet on the tray. Kelric pulled his own little feet from the normal position until they stuck out in front of him, between his torso and the tray. He stayed that way for a while, happy as a clam. She said that in all her years with all the different kids, she’s never seen any other kid do that.

I’m reminded of the ultrasound at 21 weeks where our first view of Kelric in the womb showed his feet by his head with his knees straight. The ultrasound technician said she had never seen a baby do that before.

It makes me wonder if he’s destined to become a gymnast, or a Cirque du Soleil performer.

I think I’ll go do some stretching now.

Angela

Previous - 43 Tiger-striped nails
Next - 45 POEM: Dessert