Path Report

Now that chemo brain is gone it has been really difficult to stay inside and do nothing so I have been out and about lots and totally avoiding my computer.  As a result I am totally behind in the adventures in cancerland.

I did have a fun day in Whistler

And an uneventful trip up and down the Sea to Sky

(Wow, I really need to clean my phone camera lens.)

I saw my surgeon………I think, a week ago?  Maybe longer.  No, it must have been a week, last Thursday the 8th.  How ever long ago that was.  What day is today?   Wednesday? No, Thursday, the Canuckleheads play today.  Thank goodness they finally won last game, I thought the band wagon was going to crash.

Anyway, I saw my surgeon last week, the 8th.  Great.  Now I’m getting so loopy I’m repeating myself, I really need to go back to work.  All of the pathology is back.  I have cancer.

Oh wait, we already knew that.

There were 23 lymph nodes removed (no wonder my armpit feels so funny!!!) and one node had isolated tumour cells.  That is as close to being negative for cancer cells as you can get without actually being negative.  My radiation oncologist classifies it as negative.  That is fine with me.

The most important thing regarding the tumour – all margins clear.  Yay!!
The only downside is that there was only a 1 mm margin at the chest wall and 2mm is preferred, but radiation will cover that.
All in all, my surgeon did an excellent job of hacking the cancer out of me.

With the pathology report now available, the next step was the radiation planning session.  That started with a meeting with a radiation resident who asked me if I knew the results of my pathology report and understood what it had said.  Then we covered the basics around what happens during the planning session and then he answered my questions.
My most important question was whether a person can have radiation multiple times at the same site.  This is a potential issue for metastatic cancer patients as radiation is used to control pain of bone metastases.
It turns out that one area can be irradiated more than once but it depends on how much radiation that area has already received and when it was done.  If a lot of radiation was given to a spot, a repeat could not be done within a year or two.  If, however, that spot needed to be done 5 years later, that would probably be okay.

So, now that you have all this new radiation knowledge plus the path results, I tell you that I will be getting 16 treatments, which is a pretty standard course of treatment, instead of the originally planned 10 treatments.  Can anyone guess what that means, remember at the same time about those other keys phrases, “due to my age” and “how well the tumour responded to treatment”?
Pretty much that means we are back to the “we’re gonna try and cure you even though we can’t really cure you” method of thinking.  The original plan of 10 treatments was apparently decided based on the thought that in the not to distant future the tumour would be involved in my chest wall and then I would have to be hammered with radiation to get it under control.  Now the path report combined with my PET scan makes me a perfect candidate for radiation and they are going to treat me like a plain old breast cancer patient with cure in mind rather than the metastatic patient I really am.
I think that falls in the good news category.

The remainder of the planning session involved getting a CT scan done, once breathing normally and once holding my breath.  I hold my breath for one scan so that my lungs are full of air (obviously) which causes my heart to be pushed down and thus further from the radiation.  Not all patients actually have to hold their breath during the radiation treatments but sometimes it is necessary to protect the heart. Fortunately each radiation zap would be for 30 seconds or less so the chances of me passing out are relatively slim.

My radiation oncologist reviews that scans and decides exactly how the radiation machine has to be angled to hit all of the required area with hitting things like my heart.  Once that plan is made I will get a call from the Cancer Agency telling me when radiation starts.
I hope that call comes soon.  I really want to get  on with the rest of my life.

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