Today, I will go to radiation for the last time.
I'll enter the cancer centre and turn right at the door marked radiotherapy, scan my card to get in the queue, go and change into my robes (one backwards and one open at the front) and sit in the waiting room.
When my name is called, I will go and lie on a table that has been set up just for me. I'll slip out of my robe, lift my knees so they can put a cushion under them and tuck my left hand under hip. My right arm will go over my head and into a special brace. I won't move again until the end of treatment.
The therapists will spend some time making sure I am aligned perfectly, with the help of lasers, lines they have drawn on me (with permanent marker) and the five little tattoos I was given before I started treatment. When they are satisfied that everything is set up the way it should be, they will drape something called a bolus (pliable plastic-like material that draws the rays to the skins surface. Treatment will be interrupted part way through to remove it) across my chest.
Then they will turn off the lights and leave the room.
The door will close with an audible click, a green light will turn to red and treatment will begin.
The machine they used looks like a giant lamp, with jaws at it's centre that open and close to control the amount of radiation emitted. As it moves around me, it makes a whirring noise and a high-pitched buzzing with each dose.
It will take only a few minutes to treat my back, chest, axilla (under arm) and clavicle (this felt like so much longer during the first week of treatment when I was still freaked out about being treated with radiation).
Then the therapists will come in, I'll say 'thank you' and be on my way.
I might cry.
Radiation was a pretty dehumanizing process. As a coping mechanism, I deliberately engaged the radiation therapists, asking questions or making observations. I am very grateful to the therapists and nurses who took the time to respond and who treated me as a whole person and not just body parts to be treated. I hope they realize what an enormous difference this made.
Wednesday, September 6, 2006
Monday, September 4, 2006
bizarre
Cancer treatment is a very strange thing. The purported cures come with a whole host of side effects that I'm convinced are not fully understood by anyone.
I know a woman who was travelling abroad to celebrate the end of treatment. One day, she noticed that her treated breast had turned brown.
On her return home, she consulted her radiation oncologist, who insisted that this change could not have been brougth on by treatment.
She raised the subject with an alternative practiotioner, who said, "Don't ask your doctors. Ask other women."
The next time her support group met, this women mentioned what had happened to her breast. Four of the twelve women in the group had experienced the same thing. None had told their doctors.
Brown breasts, blistered skin, blackened toenails and bald heads.
Sometimes I think we haven't come that far since the days when people were treated with leeches.
I know a woman who was travelling abroad to celebrate the end of treatment. One day, she noticed that her treated breast had turned brown.
On her return home, she consulted her radiation oncologist, who insisted that this change could not have been brougth on by treatment.
She raised the subject with an alternative practiotioner, who said, "Don't ask your doctors. Ask other women."
The next time her support group met, this women mentioned what had happened to her breast. Four of the twelve women in the group had experienced the same thing. None had told their doctors.
Brown breasts, blistered skin, blackened toenails and bald heads.
Sometimes I think we haven't come that far since the days when people were treated with leeches.
Saturday, September 2, 2006
sometimes it's hard
I'm a bit of a mess these days.
I've got quite a bad burn from radiation and have been afflicted with a fatigue that defies description (a bit dramatic that, no?).
So, it's not surprising, I guess that my emotions are all a little close to the surface. I was especially feeling it earlier in the week. Frustration, the effects of treatment, the time I've lost to cancer and ramifications of battling a life threatening illness...it all hit me with the force of a tidal wave.
I'm feeling quite a bit better now, though. I spent the week doing as little as I could. Resting, reading. I even had a friend come with me to radiation (this had been planned for a while but the timing could not have been better).
My spouse and the boys have gone away for the week end. Last night they saw Spamelot in Toronto. Today, S. and my spouse are taking part in the year's most highly anticipated event - a comic book convention. Before leaving, S. hugged me and said, "Don't die while we're gone."
I started to reprimand him and then realized that he wasn't joking. He asked me, "There isn't a chance, is there, that you could die before I come back?"
I reassured him that the cancer treatment was to make sure that all the cancer was out of my body. "And you know what, if it ever does come back, we'll treat it again."
"So does this mean that we don't have to worry for at least a year?"
"Yes," I answered.
He looked so relieved.
Sometimes, I hate how hard this is.
I've got quite a bad burn from radiation and have been afflicted with a fatigue that defies description (a bit dramatic that, no?).
So, it's not surprising, I guess that my emotions are all a little close to the surface. I was especially feeling it earlier in the week. Frustration, the effects of treatment, the time I've lost to cancer and ramifications of battling a life threatening illness...it all hit me with the force of a tidal wave.
I'm feeling quite a bit better now, though. I spent the week doing as little as I could. Resting, reading. I even had a friend come with me to radiation (this had been planned for a while but the timing could not have been better).
My spouse and the boys have gone away for the week end. Last night they saw Spamelot in Toronto. Today, S. and my spouse are taking part in the year's most highly anticipated event - a comic book convention. Before leaving, S. hugged me and said, "Don't die while we're gone."
I started to reprimand him and then realized that he wasn't joking. He asked me, "There isn't a chance, is there, that you could die before I come back?"
I reassured him that the cancer treatment was to make sure that all the cancer was out of my body. "And you know what, if it ever does come back, we'll treat it again."
"So does this mean that we don't have to worry for at least a year?"
"Yes," I answered.
He looked so relieved.
Sometimes, I hate how hard this is.
Thursday, August 31, 2006
herceptin
Well the Alberta government has finally seen fit to make Herceptin available to all breast cancer patients who would benefit from this drug.
For more info on Herceptin, check out this excellent article from the CBC (Canadian Broadcasting Corporation, www.cbc.ca) web site:
The promise of Herceptin
Last Updated August 30, 2006
CBC News
When the government of Alberta announced that it would begin picking up the tab for the breast cancer drug Herceptin for patients in all stages of the disease, it became the last province to do so.
Before the Aug. 28, 2006 announcement, Alberta covered the cost of the drug only for people in the advanced stages of breast cancer treatment. That's what the drug was approved for by the U.S. Food and Drug Administration in 1998. And it had proven quite effective in lengthening the lives of women in the late stages of breast cancer.
Herceptin therapy can cost $40,000 a year per patient. Alberta's health minister — Iris Evans — estimates the move will cost the province about $8 million a year.
"I'm very satisfied that the clinical trials have given strong evidence that this is an important therapy for us to use," she said.
Most provinces began paying for the drug for patients in the early stages of breast cancer a year before Alberta's move. Evans said the province wanted to wait until clinical trials were complete before making the same decision.
For advocates of the therapy, the evidence of Herceptin's effectiveness had been indisputable long before Alberta agreed to follow the lead of the other provinces.
Herceptin is an antibody that binds to a protein on human skin cells — the human epidermal growth factor receptor 2 (HER2). It is believed an excessive amount of this protein increases breast cancer growth — and increases the risk of recurrence of the disease and death.
Approximately 25 per cent of patients have this aggressive form of breast cancer.
In May 2005, three large-scale studies of the drug were abruptly halted because of overwhelmingly positive results.
The studies showed the rate of breast cancer recurrence was reduced by more than half when Herceptin was given to women undergoing chemotherapy compared to women who received traditional chemotherapy alone.
Among the findings:
* After two years, there were 261 events (such as return of the cancer, second primary cancer or death before recurrence) in the control group and 133 events in the group taking Herceptin.
* After three years, 87.1 per cent of patients taking Herceptin were alive and disease-free compared to 75.4 per cent in the group not taking Herceptin. After four years, 85.3 per cent of patients on Herceptin were still alive and well compared to 67.1 per cent for those on standard chemotherapy.
* Women taking Herceptin with a particular chemotherapy regimen had a 33 per cent reduction in risk of death.
Dr. Brian Leyland-Jones of Montreal's McGill University was the lead author on one of the studies. He called Herceptin the most important advance in breast cancer therapy in 30 years.
He noted that in traditional breast cancer therapy, one in four women will see their cancer spread sometime after undergoing surgery. In the Herceptin studies, that number dropped to one in 10.
"We're not quite sure [how Herceptin works]," Leyland-Jones said. "There are different factors that stimulate the growth of cells in your body. The targeted therapy interferes with the binding of this stimulating growth factor."
In October 2005, the New England Journal of Medicine reported on the three clinical trials. In an editorial, the Journal called the results "revolutionary."
"The results are simply stunning. With very brief followup (one to two and a half years), all three trials show highly significant reductions in the risk of recurrence of a magnitude seldom observed in oncology trials," the editorial said.
As many as 5,000 Canadian women a year stand to benefit from early use of Herceptin.
There is one significant side-effect. There is a small risk of heart damage in women undergoing Herceptin treatment. Approximately one woman in 200 could suffer heart damage.
For more info on Herceptin, check out this excellent article from the CBC (Canadian Broadcasting Corporation, www.cbc.ca) web site:
The promise of Herceptin
Last Updated August 30, 2006
CBC News
When the government of Alberta announced that it would begin picking up the tab for the breast cancer drug Herceptin for patients in all stages of the disease, it became the last province to do so.
Before the Aug. 28, 2006 announcement, Alberta covered the cost of the drug only for people in the advanced stages of breast cancer treatment. That's what the drug was approved for by the U.S. Food and Drug Administration in 1998. And it had proven quite effective in lengthening the lives of women in the late stages of breast cancer.
Herceptin therapy can cost $40,000 a year per patient. Alberta's health minister — Iris Evans — estimates the move will cost the province about $8 million a year.
"I'm very satisfied that the clinical trials have given strong evidence that this is an important therapy for us to use," she said.
Most provinces began paying for the drug for patients in the early stages of breast cancer a year before Alberta's move. Evans said the province wanted to wait until clinical trials were complete before making the same decision.
For advocates of the therapy, the evidence of Herceptin's effectiveness had been indisputable long before Alberta agreed to follow the lead of the other provinces.
Herceptin is an antibody that binds to a protein on human skin cells — the human epidermal growth factor receptor 2 (HER2). It is believed an excessive amount of this protein increases breast cancer growth — and increases the risk of recurrence of the disease and death.
Approximately 25 per cent of patients have this aggressive form of breast cancer.
In May 2005, three large-scale studies of the drug were abruptly halted because of overwhelmingly positive results.
The studies showed the rate of breast cancer recurrence was reduced by more than half when Herceptin was given to women undergoing chemotherapy compared to women who received traditional chemotherapy alone.
Among the findings:
* After two years, there were 261 events (such as return of the cancer, second primary cancer or death before recurrence) in the control group and 133 events in the group taking Herceptin.
* After three years, 87.1 per cent of patients taking Herceptin were alive and disease-free compared to 75.4 per cent in the group not taking Herceptin. After four years, 85.3 per cent of patients on Herceptin were still alive and well compared to 67.1 per cent for those on standard chemotherapy.
* Women taking Herceptin with a particular chemotherapy regimen had a 33 per cent reduction in risk of death.
Dr. Brian Leyland-Jones of Montreal's McGill University was the lead author on one of the studies. He called Herceptin the most important advance in breast cancer therapy in 30 years.
He noted that in traditional breast cancer therapy, one in four women will see their cancer spread sometime after undergoing surgery. In the Herceptin studies, that number dropped to one in 10.
"We're not quite sure [how Herceptin works]," Leyland-Jones said. "There are different factors that stimulate the growth of cells in your body. The targeted therapy interferes with the binding of this stimulating growth factor."
In October 2005, the New England Journal of Medicine reported on the three clinical trials. In an editorial, the Journal called the results "revolutionary."
"The results are simply stunning. With very brief followup (one to two and a half years), all three trials show highly significant reductions in the risk of recurrence of a magnitude seldom observed in oncology trials," the editorial said.
As many as 5,000 Canadian women a year stand to benefit from early use of Herceptin.
There is one significant side-effect. There is a small risk of heart damage in women undergoing Herceptin treatment. Approximately one woman in 200 could suffer heart damage.
Monday, August 28, 2006
Wednesday, August 23, 2006
a conversation
As I sat waiting for my family to pick me up outside the cancer centre yesterday, I was approached by an elderly woman who had been sitting on the next bench.
"You have beautiful skin," she said. I was of course thrilled at the compliment, as I have been feeling anything but beautiful lately.
She asked if I was in treatment at the centre. I said that I was.
"I have lung cancer," she said. "I never smoked but I worked in intelligence. I worked mostly with men. The rooms we met in would be blue with smoke."
"And also, the spyplanes brought in films taken overseas which I handled regularly" she continued, "They had a coating on them. My colonel says he wouldn't be surprised if that's what caused the cancer, as several others we worked with also have it."
I told her that I have breast cancer. She replied that her sister had breast cancer and is doing well but is nervous as she approaches the five-year mark.
"I have lung cancer," she repeated. "And it's not the good kind of lung cancer."
"I'm thinking of going to San Antonio, Texas. There is a doctor there...They can cure cancer now but if the drugs don't make money, then the drug companies won't sell them. And the doctors here, they won't do anything that isn't in the medical mainstream."
"I think I'll go. But I need to find out more. I shouldn't say this, but I have lots of money. Still, I want to make sure they aren't quacks. I looked the place up on the internet and it looks good. I have a brother who is a doctor in Victoria. Im going to get him to look into it but I think I'll go."
"So many people have cancer now."
She paused to look at the book in my lap, "What are you reading?" (It was The Lighthouse, by PD James). "I haven't read that one. She's not my favourite. Well, her stories are OK, but as a person...(makes a face)."
"Are you waiting for a ride?" I ask her.
(Laughs) "Yes, my daughter. She drives an old jalopy. It's a wreck. She has a million dollar house but still drives that thing. She's not a showoff, that's for sure."
"Such beautiful skin," she says again, and reaches out to stroke my face.
I go back to my book, and shortly after, her daughter pulls up in a battered blue Toyota Camry, with the windows rolled down.
She waves goodbye as she gets in the car.
I liked her.
I wonder how much of her story was true.
"You have beautiful skin," she said. I was of course thrilled at the compliment, as I have been feeling anything but beautiful lately.
She asked if I was in treatment at the centre. I said that I was.
"I have lung cancer," she said. "I never smoked but I worked in intelligence. I worked mostly with men. The rooms we met in would be blue with smoke."
"And also, the spyplanes brought in films taken overseas which I handled regularly" she continued, "They had a coating on them. My colonel says he wouldn't be surprised if that's what caused the cancer, as several others we worked with also have it."
I told her that I have breast cancer. She replied that her sister had breast cancer and is doing well but is nervous as she approaches the five-year mark.
"I have lung cancer," she repeated. "And it's not the good kind of lung cancer."
"I'm thinking of going to San Antonio, Texas. There is a doctor there...They can cure cancer now but if the drugs don't make money, then the drug companies won't sell them. And the doctors here, they won't do anything that isn't in the medical mainstream."
"I think I'll go. But I need to find out more. I shouldn't say this, but I have lots of money. Still, I want to make sure they aren't quacks. I looked the place up on the internet and it looks good. I have a brother who is a doctor in Victoria. Im going to get him to look into it but I think I'll go."
"So many people have cancer now."
She paused to look at the book in my lap, "What are you reading?" (It was The Lighthouse, by PD James). "I haven't read that one. She's not my favourite. Well, her stories are OK, but as a person...(makes a face)."
"Are you waiting for a ride?" I ask her.
(Laughs) "Yes, my daughter. She drives an old jalopy. It's a wreck. She has a million dollar house but still drives that thing. She's not a showoff, that's for sure."
"Such beautiful skin," she says again, and reaches out to stroke my face.
I go back to my book, and shortly after, her daughter pulls up in a battered blue Toyota Camry, with the windows rolled down.
She waves goodbye as she gets in the car.
I liked her.
I wonder how much of her story was true.
Monday, August 21, 2006
good to be here
I ran into a group of friends yesterday, one of whom I hadn't seen in a long time. When she said that it was nice to see me, I replied, "It's good to be here."
My friend C., who was in my shoes two years ago, said, "It means a whole lot more than it used to doesn't it?"
It does indeed.
It's good to be here.
My friend C., who was in my shoes two years ago, said, "It means a whole lot more than it used to doesn't it?"
It does indeed.
It's good to be here.
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