I needed some turbulent waves this afternoon and my faithful friend, the sea, provided. Dodging the pebbles thrown into my path on one side and falling chalk on the other, I was yelping in thrilled delight before long. Thus the remnants of my frustrating morning visit to the oncologist were purged.
I had a different oncologist than usual and this appointment was to discuss the upcoming radiotherapy. First he went over my pathology report and some info came to light. Apparently there are three places where lymph nodes are found under the arm. The surgeon took all of them but only the ones at the lowest position contained cancer. A good sign he said. A sign that the cancer cells only made it to the first bodily hurdle and got stuck.
Next up he ran through the basics of radiotherapy. To be honest it was very basic and only now I’ve done some Googling and dug deep into my A level science, I feel I get it. It works in the same way as chemo did in that it damages everything and relies on the cancer cells being a bit rubbish at repairing themselves. Healthy cells are better at bouncing back.
The technician will basically aim a giant ray gun at me and shoot my boob with X-rays, 50s sci-fi styley. The X-rays are super dooper high energy ionised particles. Don’t panic about the word ion. It just means the particles have an more or less electrons than protons. Normally they were would be the same amount but when they differ the particle gets very ready to party with other atoms. So when the particles meet cancer DNA it nicks or gives electrons and screws up the DNA. The cell then dies.
Now this is also what happens when the X-ray meets healthy cells although they are better at repairing themselves. But there is a chance that the damage done to the cell can mean a mutation and a second cancer. The cure could become the disease. Enter the stats. The risk of a second cancer is 0.5% compared to 33% chance of a reoccurrence of the original cancer if I don’t get the radiotherapy.
The X-rays are intense though. I’ll get a dose that is equivalent to what you get from just hanging out on the planet for about 8500 years. A normal chest X-ray is about 10 days of background radiation. It’s a lot. And there will be repercussions. I’ll get tired, really tired. Now I have many words for different kinds of fatigue. I’ll gain a new one in the coming weeks.. radio-poopery? I wonder if the high energy particles steal energy from my body on its way through.
Anyway, that wasn’t the frustrating part. When I go to be prepared for the therapy, the radiographer will permanently tattoo two pinhead-sized black marks on my chest. This is to make sure the machine is lined up precisely every time so the same area gets blasted. But they’re permanent. I had heard from another breast cancer patient that you could request they use a marker pen instead and avoid the tattooes. So I let the oncologist know that’s what I wanted. He was pretty surprised, resistant and unhelpful. I left feeling I would have to fight for this and belittled by his lack of understanding.
After being at home for an hour the phone rang and it was the hospital wanting to make the appointment for the tattooing. I asked to speak to the radiographer and once I told him what i wanted he immediately said these words: “I totally understand.” Being acknowledged and understood as having valid feelings is so crucial. It’s a tried and tested technique in counselling and a powerful thing in a situation where you feel a lack of control. I haven’t had many options in the last year. I have accepted that and submitted to the trust and care of strangers. This time I could wrest back a tiny decision on an even tinier impact on my body.
Perhaps the oncologist didn’t get this. He was bemused that I was acting so irrationally on such a minor issue. He even tried to scare me into compliance with the small possibility that I might need more radiotherapy in the future and they would need exact information for previous treatment. Luckily the radiographer had a more emapathic approach and put his own needs second to mine. He added a disclaimer that if I needed future treatment the beam might be a bit off and mean a double dose for a centimetre of tissue. A risk I’m willing to take. But the risk is mine, the decision mine. He was much more concerned that I was as relaxed as I could be for the treatment. Being stressed and tense would have more impact on his precise measurements and therefore success of the therapy than some imagined future issues.
Thankfully the situation has transformed from being in conflict to now feeling confident and happy with my caregivers. My stormy morning has turned as calm as the cafe I now sit in.