Making The Tough Calls

When I was diagnosed, everything was pretty much laid out for me by the surgeon, I didn't feel like I had massive decisions to make.  There really weren't any choices.  I either started chemotherapy, or breast cancer would take my life.  It was one or the other, we didn't really even toss the idea of not having chemo around, it was never even a topic of conversation.  I remember the intense dissatisfaction over not having any choices, not having any kind of control over what was going to happen to my body, to my life.  In retrospect, I suppose with everything that I had to do to prepare for treatment, that I didn't have to make a bunch of choices.  I probably wasn't in any kind of condition to make them anyway.

Just like that, the next year of my life would be mapped out on a piece of breast cancer pink (are you kidding me?) paper, a piece of paper with not 2, but 4 nipples.  (Was this some kind of sign?  An omen of what was to come?  Should I worry that I will awake for reconstructive surgery with 4 nipples?  Heck, I was worried about having none, 4 sounds worse.)  It disturbed me just a little bit that the surgeon didn't even have to think about it, she just started writing and drawing little arrows around the 4 nipples. How many times a day does she get to draw on the pink paper?

The pink paper would be posted to the refrigerator by my husband later that day where it would continue to hang for the course of my treatment.  He told me that he wanted me to cross the steps off as I went so that I could feel like I was making progress.  (I need to mark a bunch of steps off right now... oops!)  Progress is very important when your life is at stake.  I remember wondering at the time if we would get sick of looking at that pink paper hanging on our beautiful stainless steel refrigerator, the constant reminder that someone in the house had something wrong with her breasts.

And so the pink paper/4 nipple plan began, tests, labs, and more tests would start the ball rolling.  .... And she's off....  Oncologists, Radiation Oncologists (how does someone who doesn't even have a PCP end up with 2 oncologists in a matter of days?), MRI's, Echo's, PET scans....  Port surgery.  Start chemo.  Finish chemo.  Back to the surgeon to schedule surgery.

...Radiation.  And there is where the snag comes in.  I do feel like I have a choice.  I am not 100% sold that radiation therapy should be in my future.  I have serious doubts and concerns about radiation.  Doubts and concerns that I raised to my oncologist a few months ago in the midst of chemo.  She told me that we could discuss it once I was done with the chemo.  Well, I'm done, and there is going to be a big discussion in her office on Friday when I go for my stand-alone Herceptin treatment.

I have put on my medical cap, and read through all kinds of studies debating the merits of radiation therapy in a case like mine, and I've got to say, I'm struggling big time.  (I know I swore off internet reading back in February, but I have to be armed and dangerous, I have to be educated in order to make the best decision.)

On one hand, I don't want to do anything that is going to make it easy for the cancer to come back or spread to other parts of my body.  I really want it all gone- which is why I have chosen to have the double mastectomy.  There is going to be nothing left.  On the other hand, radiation can actually cause secondary cancers.  So, aren't I contradicting myself with this choice?  I'm also very concerned about my bones, I tend to take after my father's side of the family, and the bones aren't good to begin with.  What is radiation going to do to my bones?

I do not want to die of breast cancer, or any other cancer for that matter.  But, I also do not want to spend the rest of my life battling side effects from radiation therapy.  I have a feeling that already I am going to be dealing with some bizarre side effects from the chemotherapy cocktail that I just completed.  (Note to self, probably should quit calling it a cocktail.  When have I ever had a "cocktail" that made my hair fall out and my finger nails turn black... seriously?)  I do not wish to live in a bubble in a constant state of panic over what I can and cannot do, that's not living.  I feel like my body has been through enough, and I strongly believe that there are healthier, less invasive options for killing off cancer cells... although, I must say, I think that I have made my body such a hostile environment for cancer cells, that I doubt that there are any of them still hanging around, they're probably long gone.

Wish me luck, I have a feeling that this isn't going to be an easy choice to make, and I'm not entirely sure how receptive to these feelings my oncologist is going to be.  Hopefully, I have a clean PET to back up my argument.