Discussing Breast Cancer

When I was diagnosed with DCIS in 2003 I was treated quite typically with surgery and radiation. To be specific, seven weeks of radiation therapy, seven long weeks (technically just shy of seven).

Each weekday I headed up to the clinic at Yale and laid on the table for a five minute (or so) blast to my chest. By the end, I felt like I’d really been through something huge — and that was reassuring to some degree. It would take something huge (like a long period of time) to tackle something huge (like cancer). Since I skirted by without chemotherapy (which would really have me feeling I’d earned my survivor status), at least I had those seven weeks of treatment to make me feel I was really fighting.

Hard to imagine how I would have felt if it were only one week. However, electronic brachytherapy for the treatment of early stage breast cancer — using a small electronic, low-energy X-ray source that delivers controlled radiation treatment directly to the targeted area — I’m not too sure how I would have felt about that. Would one week have been enough time to allow me to feel I fought a good fight in my battle with breast cancer?

There are a few system for this type of radiation. One implants a small, balloon-like device, at the targeted area then twice a day for five days, the balloon is expanded and a miniature X-ray tube is inserted. Another uses several catheters (like 10-20). Here, read more about the technologies here or keep reading to get to the question I want to pose to you today.

Accelerated partial breast irradiation. What do you think? Worth limiting the duration of your treatment if you’re diagnosed at an early stage? Or, limiting the way you perceive your role in the fight?

breast cancer, cancer, DCIS, radiation, brachytherapy, health, wellness, health and wellness, survivor

Remember last week’s post on my daily radiation schedule? After that first day I was so relieved; radiation seemed so painless, so easy …

Then reality kicked in. Day after day I’d hop into my car and head up to New Haven — 1/2 hour there, 5 minutes for treatment, 1/2 hour home — day after day after day after day after day.

It just got so tiring. Even though the staff at the clinic worked to get me in and out of the radiation clinic quickly every single day I was there, there were occasional glitches: weekly appointments with the radiation oncologist, periodic appointments with a social worker, traffic congestion on the highway.

And eventually, side effects started to set in. At first, they were subtle. I just felt sleepier than usual. I found myself tired and emotional on Friday nights — just wanting to stay in bed and sleep, sleep, sleep. By the end of the weekend I’d feel rejuiced, but by midweek I’d start to slow down again … each Friday night was a little worse than the one before.

A friend of mine didn’t experience fatigue when she faced her radiation treatments. But then again, she didn’t have two kids at home wanting as much attention as they could possibly pull from their momma.

And though I slathered tons of cream on my chest after each treatment, eventually the burn just felt horrible. Just imagine getting a really bad sunburn, then going out in the sun the next day with that sunburn exposed yet again — ouch.

So while I thought I’d sail through … it wasn’t as smooth a trip as I had hoped.

Fortunately, Yale had a great complimentary therapy program. Therapeutic massages and Reiki treatments helped make radiation manageable.

Also, a close friend of mine put together a great Bon Jovi CD for me that helped make the driving manageable.

And fortunately, through all the daily doses, my kids were well cared for. My mother came up almost every day to stay with my boys while I went to Yale; a friend stepped in when she couldn’t. On Fridays, my best friend drove up to pick up my boys and bring them to her house for a sleepover.

So do share … what made your treatment manageable?

In yesterday’s post I mentioned my silent recitation of The Lord’s Prayer while I laid on the radiation therapy table. I find comfort in The Lord’s Prayer because I’ve had it memorized since I was a small child (yes, I am a cradle Catholic) — that makes it easy to recite during times of duress.

I’ve read, repeated and studied each line of The Lord’s Prayer and always find it the most complete, most perfect prayer there is. (That comes as no surprise because it is the one prayer Jesus himself taught us to pray as told by Matthew and Luke in the New Testament.)

It works for me but it is important for you to know, there isn’t just one way to pray, no right way to pray, no single prayer that is the only prayer you could/should say. (There are countless prayers and types of prayer; see Wikipedia article on prayer).

The important thing to recognized is the strong correlation between prayer and healing. Prayer has been proven to relieve stress and improve one’s spirits and wellbeing. Breastcancer.org, one of my favorite resources for breast cancer patients and their families, has an article explaining the spiritual component of breast cancer treatment.

Here’s a link to the preface (and order form) for a great book of prayers called “You Are Never Alone” published by the Oncological Nursing Society … “a constant companion for the patient with breast cancer.”

If you find yourself wanting to pray right now without a resource like that or other books or your own words … you can peruse this list of belief.net prayer topics and choose a prayer that speaks to you.

Or try repeating this prayer that I wrote tonight …

Dearest Lord, thank you for facilitating our diagnoses so that we can do our part to heal the cancer growing within our bodies. Please bless all survivors with the strength we need to withstand our medical treatments. Grant the medical professionals who treat us the wisdom and skill to cure us if that is your will; and if your will is for us to live with cancer then give us the peace that is necessary to truly say … thy will be done. Amen.

I’d need 33 doses of radiation therapy after my diagnosis of DCIS in 2003 and resulting partial mastectomy.

The night before my treatment I listened to the audio CD I had been given: A Meditation to Help you through Radiation. I fell asleep while listening to it; perhaps the messages got through subliminally I wondered when I awoke. But I was still afraid of the unknown.

As I was settling in on the table the very first day I could not help but wonder why something that was so dangerous everyone else had to be on the other side of the wall was deemed safe enough for me that I could lie there with half my body exposed.

On my chest I wore semi-permanent tattoos created with a purple Sharpie. The technicians laid me down on the table and lined me up just so … just so that the radiation was purposely aimed and precisely administered at my chest.

As I laid as still as I could I remembered the advice of a woman I’d met in a bible study I attended: at moments when you have the greatest fear, close your eyes, and visualize the face of Jesus. That’s just what I did. And, I said the The Lord’s Prayer to myself over and over again until two minutes had passed and the ladies walked back in the room.

“I can get dressed now?” I asked as they went about their business.

“Yes,” they answered, smiles on their faces. Amazing. I hadn’t felt a thing, no pain, no nothing. This I could handle, I thought. This I could handle.

Back to my story … a few weeks after my partial mastectomy, I had a consultation with my Radiation Oncologist, Dr. Bruce Haffty, of the Department of Therapeutic Radiology at Yale.

Dr. Haffty was all about science. He walked into the room for that initial consultation, opened my gown, and began to scan my breasts and study my chest in a completely clinical way. Suddenly, as if he remembered I was human, he stepped back, smiled and said, “I’m sorry. My name is Bruce Haffty. It’s nice to meet you,” and he shook my hand.

Dr. Haffty then asked me if he could open my gown and take a look. I consented, of course, that was why I was there. Later that day I realized it was okay that a doctor who would be looking at technological equipment and computers and clinical printouts and measurements was just a little bit … cold. Radiation therapy is methodical, precise and to some degree, impersonal.

FYI, Dr. Haffty is now practicing at The Cancer Institute of New Jersey — Yale’s loss, CINJ’s gain if you ask me.

A simulation of my treatment protocol was scheduled for September 11th; my first set of films were to be taken on September 16th; my first day of radiation was to be September 17th. My 36th birthday was to be September 18th.

As I laid topless on the table during the simulation, in a room straight out of a Star Wars set and in front of five or six people I hadn’t met, the tears just rolled down my face. I had no physical pain that day, the red laser beams of lights that were mapping out an action plan on my chest didn’t hurt at all, but my emotional well-being was suffering greatly.

This was cancer treatment. I had cancer. It was real.

See, up until that point, I was spending a large amount of time denying anything would change in my life. A day of outpatient surgery can come and go and life can go on as if nothing would really change. But that … that radiation therapy … the simulation, the x-ray films, the 33 sessions in the radiation clinic and the physical side effects of those sessions … that was all very, very real.

Those tears I shed on that table were not the last my treatment team would be seeing, I thought, unless I came up with something to get me through my treatment.