14 6 / 2011
As I said in my last post, we went to see the radiation oncologist. He was great. Very logical and clear. We asked him the million dollar question (the one that, if answered correctly, would make my oncologist comfortable with me switching to radiation). “Can you treat me with the same or less toxicity / risk of future cancer than 2 more rounds of chemo”? (ABVD is associated with increased risk of other future blood cancers such as lymphoma or leukemia). He answered in a logical roundabout way…not exactly the “yes” or “no” answer we had hoped for. He noted that risk of future cancer (typically a tumor) would be about 1%. However, risk for breast cancer increases significantly, about 50% increase over whatever my “baseline risk” already is. This made me cringe, because in all honesty, I would love to have implants one day. (Think what you want…so I’m vain…maybe it was Victoria Beckham’s fault, never should have photoshopped my head on to her body. For anyone who has used them to feed a child, you understand). I thought the increased risk would dash all hopes, then I quickly said “so…my “friend” was wondering if implants would interfere with breast cancer detection”…he smiled and said “no, but I think you have bigger things to worry about at the moment”. Radiation would be a walk in the park compared to chemo. No side effects (except possible fatigue and slight sunburn where laser hits) - no Neulasta shots - no port accessing or needles - hair could start growing back - GLORIOUS. It would, however, require me to wear a really creepy horror movie type mask that is fitted around my entire upper body and then nailed to a table so I can’t move while they aim laser beams at the “cancer spots” shown on the original PET scan. I’ll take it. A total of 45 minutes every day for 2 weeks. Then I would be done, assuming I still show a complete response. I ask if they have the best machines for this type of treatment. He says “our machines are top of the line. If machines can be sexy, they’re sexy”. Only a radiation oncologist would find those machines to be “sexy”. I certainly don’t. If I have to choose between another future blood cancer (always treated with chemo and not as good of a prognosis), or a solid tumor/breast cancer (possibly cured by surgery - better prognosis) I would obviously choose the latter.
He asked if there was anything else he could do for us. My response was “yes, make the decision for me”. Again he smiled and said that unfortunately he couldn’t do that. I asked what he would do if he were me. He answered my question with another question. Very doctor-esque. “Do you have a history of breast cancer or ovarian cancer in your family”?…”no”…”have you had a child”…”yes” (apparently having a child by my age reduces risk of breast cancer)…”do you have a history of heart disease”?…”yes”…”well then, I might take into account that your specific chemo regimen can be tough on the heart, and that you are beginning with what seems to be a very low risk for breast cancer”. Interesting way of putting it - and really made me think. Weighing risk is important. Also - the reason they say there is such an elevated risk of breast cancer is because the most recent study was done while full upper body radiation was still in practice, and now they have much better technology and lasers that can pin point the cancer spots perfectly, with little excess radiation to areas where breast cancer may form. So the risk is definitely less than it was - we’re just not sure how much less…
We decided that switching to radiation sounds like the best bet (we also prayed about it) however, there is a catch to this. My body has to show a “complete response” to the chemo on my upcoming PET scan on June 24. (Basically that the PET scan can show no sign of cancer). If my body only has a “partial response” they automatically have to administer more chemo, and they may possibly have to do radiation after that. If my body shows no response - then it gets really fun.
Tomorrow I will be going in for some lab work and to see a nurse practitioner. On Wednesday, I will be going in at 8:30 am for chemo and Rituxan. Thursday is the Neulasta shot. To be honest I love going in the middle of the week because the adorable “therapy dogs” are there. They wear cute little vests and are taken around to visit patients. I think I should bring Tessa in.
Chris was supposed to be in Montana with his friends from Thursday until next week, and he cancelled his trip because he said he couldn’t leave me right after an infusion (it was pretty rough this last time…chemo seems to have a cumulative effect) and he wanted to be able to help take care of Cole. Even after I told him to go multiple times and my mom planned to stay with me and help. Some of the friends that were going to go with him got a hotel in St. pete for the weekend so that he could hang out with them when possible and still take care of me. Basically…I have an amazing husband, and he has amazing friends. My friends are pretty awesome too.
Ps. Please be careful if you ever attempt to type my blog web address in yourself. Apparently if you’re one letter off you can end up on a porn site, quite a few of my friends have gotten quite a surprise. (I haven’t checked to be sure, but I think the “L” in my name is pretty important). Unfortunately one of them was at work and thought she could remember the web address, and another thought I had been really drugged up on narcotics and went insane. Please be careful. :) There’s another Shea Morgan blogging out there, and it appears that the name is all we have in common.