Radiation Treatment Week 1

On the first day, they made sure things lined up still but didn't do any actual treatments that day.  They gave me my schedule and told me when to come back the next day. My appointment was scheduled for 3:15 but I had to come in 30 minutes early so the doctor can make sure my incision site that I tore open the week before has closed.  

The next day I went in at the time I was told but the folks up front told me my appointment wasn't until 4:15.  There seemed to be some mistake.  I asked if I should go home and come back and they said "no, we'll get you in."  So I went in to change and waited.  The doctor saw me but then I had to wait... and wait... and wait some more until 4:15 when I actually got my treatment.  I was pretty upset.  Work has been busy and stressful, and I was going to have about 5-6 hours of work to make up each week because of the treatments.  My time is valuable, and I didn't have an hour to waste.  I was pretty sure I was told my appointment was at 3:15 and I needed to show up at 2:45.  The nurses also checked though and said my appointment was at 4:15.  I thought maybe I was losing my mind.  Then I go home, look at the written schedule they gave me, and notice that I went at the correct time.  The only explanation was that someone changed the schedule since it was printed and no one told me.  Very annoying and a little concerning.

The rest of the week went a little smoother.  Check-in is usually really fast and I walk myself to the back to change into a gown and put Strata on.  They say to get there about 10 minutes before.  Sometimes I wait a bit, but at other times it goes a little faster and I can be in and out in about 30 minutes.  Foruntately, the cancer center is less than 10 minutes from me.  I hear some people in rural areas drive hours to their nearest facility for treatment.  I don't know how they do it.  I guess you do what you gotta do.

By the end of the first week I started noticing discoloration and hardening of the skin on the nipple.  It was upsetting to see.  My poor booby is going through so much.

Surgical Wound Reopens - Radiation Treatment Delayed

It takes about a week for the radiation oncologist to plan out the treatment and to get insurance approval.  The latter seems to occasionally cause delays, but mine seemed to have gotten through just fine.  I was slated to start radiation treatments later this week.  I had a business trip the week of September 29th, and the goal was for me to finish my 25 whole breast radiation before I leave, and then to come back and do the 5 boosters after I get back the week of October 6.  I was supposed have the practice run on August 21 and then start treatments on the 22nd.  However...

Now nearly 6 weeks out from surgery, I had gotten the all clear from my surgeon on physical activity the week before.  I hadn't resumed my indoor climbing gym membership yet, but I had my rec center membership and was making an effort to go to the gym few days a week.  Up until now I had been sticking to stationary bikes and really easy weights. Although some pain remained at the surgical site due to fat necrosis in the area, I was starting to feel pretty good and wanted to start doing more so I can get back to climbing.  Yesterday, I decided to try the elliptical machine.  Then after that I decided to try out assisted pull-ups and dips.  Big mistake.

I pulled my back muscle a little but that's not the problem.  I ended up busting open the surgical site on my outer right breast.  This was the surgical site for the actual cancer (if you recall I had two other surgical sites that turned out to be benign findings).  Unlike the incision site at the nipple, I had not had any issues on the side so I was startled to see a bit of blood.  It was a tiny amount, but it indicated that the wound had reopened.  I had to go in to see the radiation doctor who confirmed that there is now an open wound.  I had to delay my treatment start by about 5 days, at which time the doctor will check to see if I'm good to go before starting.  They also had to rearrange my schedule so that I would have couple of days where I would go in for two sessions 6 hours apart, so that I could finish my 25 treatments before my business trip.  I was also told to take it easy on my upper body for a while.  I had to be sure not to stretch out that area and do anything that would risk opening the wound again.  I guess I will not be resuming my climbing gym membership just yet.  

Radiation Simulation

 About a week after the initial consult I went in for a simulation.  During this appointment they created a mold of a cushion that I would lay on each time.  They also permanently tattooed three little dots on me so they can use it to align their machine onto me.  They also made a lot of other marks all over my chest with a pen and placed several stickers. They also did a CT scan of my chest area, which they will use to plan out my treatments.  

I also found out during this time that I would need 30 sessions instead of the 21-25 initially told. 25 full breast treatments and 5 boosters that target the area where the cancer was.  I didn't really get a good explanation for the change except that she sized me up incorrectly during initial consult.  

Consult with Radiation Oncologist

My first consult with the radiation oncologist was about a month after my surgery.  The doctor spent some time explaining the role of radiation in cancer treatment.  Radiation treatment to the breast is to kill any remaining cancer cells in the area from surgery.  Although I had a lot of reservations about radiation treatment, I decided to proceed with it since I wanted to reduce the chance of recurrence the best I could.

I had hoped for a targeted treatment where radiation is directed only in the area where I had cancer.  However, since the margins around the DCIS found during surgery did not have sufficient margins, she insisted on a whole breast radiation.  During the consult the doctor estimated I would need 21-25 sessions of treatment.  It would be everyday, Monday through Friday, for 5-10 minutes.  No treatments on the weekends or holidays.  Once a week, on Tuesdays, I would stay afterwards to be examined by the doctor.

The doctor recommended a prescription cream called StrataXRT to put on immediately before each session.  Insurance did not cover this though, so I would have to pay $89 out of pocket.  It's supposed to provide a protective barrier.  I looked it up after getting home and it seems studies show its benefits to be inconclusive.  The doctor also gave me a sample of Eucerin to moisturize the affected area at other times of the day.  Nothing besides the StrataXRT can go on my skin within 4 hours of treatment though.  The treatment area included the area under my arm, so no deodorant use for a while.

I was sent home with a booklet with some information on radiation and side effects.  Nothing in today's discussion or the booklet prepared me for what I went through with these treatments.