Time for a quick and dirty update. 😊
I'm feeling good most of the time. Minor side effects from my hormone (blocking) therapy. They largely amount to just an inconvenience so far. A bit fatigued, which is a little concerning since I'm off of work right now, but it might just be laziness. 😉 Still sore and somewhat limited range of motion, but I exercise regularly, and I think I'm pushing myself in appropriate ways. Aug 3 will be 2 months since my expander placement. Every practitioner I've seen is pleased with my condition and progress.
I had my consult with a radiation oncologist last week. Everyone talked her up as being awesome, and she lived up to the hype, which is a treat. The appointment was an hour and 45 minutes long. 😴 30 minute history review with a nurse, 15 minute wait while the nurse reviewed the history with the doc, then an hour with the doc and her resident.
Long story short--while I do not have any of the traditional markers that indicate a need for radiation (large tumor, spread to lymph nodes, positive surgical margins), the radiation oncologist wants some additional information from pathology before she rules out radiation because of 3 concerns with my circumstances: pre-menopausal, EXTENSIVE DCIS (stage 0 cancer), and close surgical margins. She also wants me to consult with a rheumatologist because of my history of reactive skin.
Doc said I'm in a "light gray" area. She used that particular phrase twice. She did create an entire radiation plan and walked me through EVERYTHING I need to know about it, but she is clearly not ready to recommend that course of action.
She also said that radiation cuts risk of recurrence by 50%, whatever that risk of recurrence is.
Clearly, if there were no question and radiation were obviously recommended and necessary, I would do it. That is not the case here. And even if I'm cleared by a rheumatologist and my radiation doc gets what she needs to form an opinion, even if she did "recommend" radiation, it would be just barely, from what I can tell.
I'm left with the question: what cancer risk reduction makes it worth the short and long term side effects (and inconvenience) of radiation therapy? Especially since if I were to do radiation, I would be doing it after the window in which it is most effective. (Research indicates radiation should be done no more than 12 weeks post-mastectomy. Given staffing issues and delays, the earliest my doc will have more detailed pathology results is the end of August. I wouldn't be able to start radiation till October, at the EARLIEST, more than 16 weeks post-mastectomy.)
Once I consult with the rheumatologist and have follow up communication with radiation oncology after pathology details come in, I will ask all my questions, carefully consider what is best for me, my future and my family, pray, and make a decision.
It would be nice to have everything settled, but I've learned the past few months that breast cancer is a chronic health condition, not something I can really be done with. I still have way more good days than bad, which is all anyone can ask for, cancer notwithstanding. 😊 One thing I continue to be happy about is that every time I see a new practitioner, they tell me that I made the exact right decisions in terms of my treatment choices. I was so very, very worried that I would have regrets, and thus far, I have not a single regret, and I am so very grateful for that.
Just as I am grateful for the village that surrounds me.
