Radiation update

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.