Radiology Oncologist

Today was the Radiology Oncologist's turn to weigh in - Dr. Kastner. Nice guy with more unfortunate news. Actually, I came out of the appointment less shaken than after the chemo appointment, but Lisa and Josh didn't feel the same.

Our discoveries:
1. Radiologists actually USE 'tangents' that you learned about in high school geometry (I had to use spell checker for both tangent and geometry - shows how much I use those two words!)

2. Radiation beams don't stop at the site at which they're shooting (duh!) - hence, 6 ft. thick cement walls and lead plates. What this means biologically is that in order to get to the lymph nodes, they need to use geometry and tangents to avoid things like lungs, spine, esophagus, thyroid, brachial nerve (that runs down your neck to the shoulder), etc. Before beginning treatment, they do a 3D CAT scan to get a picture of the 'virtual me' and use that to find the best angles for zapping the nodes and areas they want to target while avoiding tissues that they do not want to effect (affect?). Sounds easy enough to me, but if you noticed all the tissues they try to avoid, you can also read between the lines of the possible side effects.

What did surprise me was the larger area that they/he wanted to target. I was envisioning zapping the nodes under the arm and breast bone, but he spoke of hitting the ones that run up and under the collar bone as well as the (former) tumor site. Apparently the mastectomy scar, or that particular area, has a significant rate of reoccurrence. That is to say (for all you worriers) that there seems to be something about that particular area, even though surgically it is clean, cancers can show up again later in the skin, so by targeting it with local radiation, they reduce the chance of recurrence.

So why chemo AND radiation? It's an additive effect. For whatever reason chemo does a great job of targeting cancer cells that have 'gotten loose' in the body, but is not as effective locally (at the tumor site) which is where radiation is very efficient.

On a less factual side, we've learn a lot about not just the illness of cancer, but the manner in which it changes the person and all those near. I have a new empathy when I hear of one's diagnosis or treatment progress. It's not just a doctor's appointment and a lot of drugs with side-effects, there's an emotional roller-coaster that goes with it. Or/And... I was a person who never needed a doctor except for pregnancy and strep throat - even that's debatable :) Now suddenly, I'm one who needs to be vigilant of a multitude of side-effects for my life time. I'm understanding what it means that you are always 'a person who had cancer' -- though I'm still coming to terms with the fact that doctors keep calling me a cancer patient b/c I don't feel like one yet. :)