Radiation

I met my radiation oncologist, Dr. Finkelstein, yesterday. I'm exhausted, and spent most of the meeting crying between rounds of questions and answers and a tour of the facility. After chemo and surgery, radiation will be step 3 of 3 in fighting this disease, and - as Dr. F put it - is hopefully superfluous. But just in case there are 2 or 3 rogue cancer cells floating around in my chest wall or nearby lymph nodes, the radiation will do them in. Current imaging only shows groups of cells once they've formed their own country; a household or small town would go undetected. Radiation eradicates those small cancer communities.

I'll have somewhere between 25 and 30 treatments, 5 days a week for 5 or 6 weeks (with weekends off for good behavior). From what I understand, radiation works because the photons they shoot into me scramble the DNA of the cells (both normal and cancerous) in the targeted region, damaging them pretty severely. While normal cells can repair themselves, cancer cells are not so good at that function, and so they die when their DNA is this disrupted.

It never ceases to amaze me that cancer treatment is in essence about as much cell damage as possible without killing the patient. How much can your body handle? One piece of good news: the cancer was on my right side, so they don't have to worry about hurting my heart in the process. I like to think that means there's no risk my heart will get broken here.

Dr. F did warn me about the side effects of radiation. There are the immediate ones - from fatigue to skin irritation - as well as the possibility of delayed side effects, such as an increased risk for certain other types of cancer down the road. Like when I'm 80. I told him if I'm around when I'm 80, I'll kiss him. That set off a whole new torrent of tears.

For women with localized disease, radiation is proven to help prevent recurrence. Where there isn't much data is for women like me, who present with advanced and aggressive disease. And the statistics they do have are ugly, quite honestly. So I ignore them. When he was fighting pancreatic cancer, my father-in-law frequently said that statistics are great for the general population, but they don't mean anything for the individual patient.

And as confident as I feel most of the time that cancer is totally out of my body, that I'll get to watch Quinn grow up, get to have a long marriage with the man I love, that this was a fluke and is never coming back, talking yesterday about the real possibility that cancer could come back put a huge lump of fear in my throat. I ran out of vocabulary, and just kept repeating to Chris through my tears: Fuck this fucking fuck disease.