Zap!

I visited with my Radiation Oncologist this week. Went in with a positive attitude (positive because I didn't want to have radiation as well as chemo, and the chemo doctor had told me that I wouldn't need it because of...a whole list of criteria!).

Yeah, well apparently the criteria have changed, and the radiation doc says I should, in fact, take the radiation treatments too. She'd been to a recent conference where they laid out new guidelines based on many studies, and the results are so much more positive with radiation treatment than without.

Back to my pathology report. Each doctor looks at different items, and neglects to point out others when explaining their own point of view. My report listed my biggest tumor as 3.5 cm, about the size of a golf ball - grade III/III, poorly differentiated, meaning it was extending its little tendrils looking for expansion, meaning little pieces could be off wandering around anywhere - there was lymphovascular invasion present, meaning it had metastasized to the lymph system - and the lymph nodes showed focal extracapsular extension, meaning the cancer showed signs of spreading into the adjoining ducts, meaning, again, it could be anywhere.

All those stats mean radiation is recommended. She described chemo vs. radiation as whole body treatment vs. localized treatment. The chemo looks to poison cancer cells throughout the body, while the radiation is directed at the original location to get the specific strays before they can latch on somewhere and cause more destruction.

The literature she gave me on the recent studies showed the following:

• Patients can be divided into low-, intermediate-, and high-risk groups on the basis of axillary nodal status (how extensively it has spread into the lymph system), estrogen receptor status (mine is only 30% receptive, which is a lot lower than they would like), lymphovascular invasion (mine shows positive for invasion), and age at diagnosis (I'm high range for age). I am rated intermediate-risk.
• With Postmastectomy Radiotherapy (PMRT), the intermediate-risk group shows a 99% rate of 'probability of local-regional control' at 5 years, meaning an extremely low risk of recurrence at the original site. 85% for those who have no PMRT.
  
• With PMRT, the 'probability of being metastasis free' (that it won't have spread) is 87% at 3 years, 86% at 5 years and 80% at 8 years. 81% at 5 years for those with no PMRT.
  
• With PMRT, the 'probability of overall survival' (nice term, but at least the patient is still alive) is 90% at 3 years, 87% at 5 years and 79% at 8 years. 82% at 5 years with no PMRT.

All in all, those are pretty positive stats. I'm withholding a decision until later in the course of chemo, to see how I'm doing. The radiation treatment would be every day (Monday to Friday) for six to six and a half weeks. The time frame is based on the fact that I'm one of those 'big-breasted women' - meaning there is more coverage area, and lower daily doses are shown to be better tolerated. There is a standard regime, a certain quantity to do the job - so lower doses means a longer time frame to deliver the set standard treatment.

Minor little side effects - my skin will look badly sunburned, and is damaged such that it loses its softness and elasticity, making reconstruction difficult.

On that cheery note, I'm going to take a drive and try to find some of the incredible wild flowers that are out there this spring!