6.11.09 - radiation #18, a good tomotherapy surprise, and fear of ending treatment

radiation #18

i thought i was halfway through, but i'm actually three-fourths of the way through! i will be finished with radiation in two weeks! i was originally scheduled to have 28 regular radiation doses and 7 boosts, but dr. rost said that it's safe with tomotherapy to combine regular radiation with the boosts and finish a week early in order to avoid skin issues. i'm starting to get lots of bumps and up near my clavicle, which itch like crazy. i asked kevin (who sent the e-mail yesterday, who works at tomotherapy) if this is standard procedure, and he asked a co-worker (thank you, kevin!!) who is an expert, who sent this info:

“This will be a boost simultaneously with the main treatment, instead of having the main treatment then 7 more days of radiation to a smaller boost area. This is commonly done with Tomo and the ability to do it is a special capability of the system. With other technologies, Deborah would get the same dose overall to each region (main area and boost area), but this is a more efficient approach that can reduce skin redenning, as Dr Rost indicates.”

Here’s a link to a recently published paper on the approach (this is a “technical note”, so keep in mind it discusses it more pragmatic/procedural-based, than clinical): http://www.ncbi.nlm.nih.gov/pubmed/19044322?ordinalpos=49&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

And here’s an interview we have on our site with Dr. Jim Welsh, in which he speaks about Tomo for breast cancer and boosts using Tomo: http://www.tomotherapy.com/video/tags/tag/james+welsh+md

Dr. Welsh and Dr. Rost were two of the first docs in the world to use Tomo to treat patients. They both a lot of experience with this new technology, so have a head start over many who have more recently adopted Tomo. That’s probably why you’re not finding a lot of info out there. Hope the background helps. <<

june 25th will be my last day of treatment instead of july 6th. when i first found out, i was elated! but then when i imagined actually going to radiation for the last time, walking out of that room and down the hall and then leaving the hospital, walking through those same doors that my son james and i went through the morning of november 20, the day of my mastectomy, i realized i'm very afraid. ever since my surgery, things have been done to my body to proactively kill cancer cells--all that chemo, all this radiation. i've had doctors and nurses and techs hovering over me and testing me and sticking me with needles and taking blood and giving me results. when this is over, that's when it's all up to me and fate. i have to stay healthy and be active and eat right and live every day trying not to worry about cancer recurrence. i know i'm going to worry that without all this daily treatment, cancer cells are going to start growing again. every headache, every bone pain - we know what that means. fear that cancer has spread to the brain or bone or liver. i'm going to have to find a way to be fatalistic about cancer, to do my best to stay healthy and happy, but be okay with whatever happens. i'm so glad i never have to have another mammogram again and never have to wait for the results. but i can only imagine what it's going to be like every three months when i get bloodwork and tumor marker tests and wait for results. i have to accept that this is just not going to be easy, but it might get easier over time. it's the "new normal" we keep hearing about.

even better news is that dr. rost told me he can do my bloodwork and tumor markers and continue to be my main "cancer doctor," and i can dump my medical oncologist (who has made my life miserable the last nine months). with pleasure. i am very fond of dr. rost and trust him.

this afternoon i had a 1-hour massage, the first i've had since my diagnosis. the veins where i had chemo are shot, and my arm hurt like hell when it was massaged. but other than that, it was pretty much heaven. and it's a treat i'll be having every two weeks from now on. no more postponing pleasure!!