Monday, September 8, 2014


My penultimate radiation session is in the books, and I am still learning new information about this process.

But first thing’s first:  Carle was back from her trip to Minnesota.  It was so great to have her back, and did she ever pull a rabbit out of her musical hat for me today!  A few weeks ago, I happened to mention that I positively adore The Spinners.  That crazy B remembered, so today, I got “I’ll Be Around.”  What a treat.

After treatment, I had another talk with Alice, my radiation oncologist.  She again looked at my skin and again pronounced it healing as she would expect.  I’ll be seeing her again in about a month, but in the meantime, she asked if I had spoken with Ali, my medical oncologist, about Tamoxifen.   Sigh.

Tamoxifen is an estrogen-blocker that most women with estrogen receptor positive cancer – like mine -- take post-radiation.    It’s pretty much the standard of care these days, and it boasts some impressive results:  women who take it for 5 years experience fewer instances of cancer recurrences in the original breast, and also 30-50% fewer cancers in the other one.  Sounds like a no-brainer.

The problem is that Tamoxifen also comes with some gnarly side-effects.  There are the quality of life issues, like 5 years’ worth of hot flashes, not to mention vaginal discharge.  But there’s  also the more serious risks of blood clots and a huge increase in the risk of uterine cancer.  I already have a genetic mutation that makes me more prone to blood clots, and I don’t see the point in trading one cancer for another.  So I’m on the fence about this very powerful drug.  I will be seeing Ali at the end of October, and we’ll talk more about it then.  In the meantime, it’s one more decision that I will need to make regarding my on-going treatment.

I also learned that radiation can (directly or indirectly) affect appetite.  I had never heard any mention of appetite this whole time, and assumed that was only connected to chemotherapy…which is why I didn’t understand why my appetite has been so weird lately!  For at least a week now, the only food that actually sounds good to me is fruit.  Now, I have always been a bit produce lover, so that’s not weird.  But what’s weird is that I want produce to the exclusion of just about everything else.  And that definitely is weird, because I have never been the kind of girl to shy away from food.  And it’s not even all produce – just fruit.  Vegetables hold no appeal at all right now.  And every time I try to eat any animal protein (I eat chicken, turkey, and fish), I feel like more than a few bites is going to make me nauseous.  

I’m not sure what the nausea is about; nothing in the radiation treatment should be upsetting my stomach.  But I learned today that loss of appetite is often connected with radiation because of the extreme fatigue the treatment causes:  treatment causes fatigue and fatigue causes lack of appetite.  So at least that part makes sense.  I have also been dehydrated lately, which might explain why I am eating my body weight in watermelon and grapes and other watery fruits.  But it feels seriously bizarre to not want to eat.  

The good news about all of this is that I first got wind of it from my discharge instructions.  That’s right: discharge instructions, baby!  While my last treatment isn’t until tomorrow, today was the day I got all my follow-up information, and I kept feeling like the girl who was only one vote away from being prom queen.  Halleluiah!  

And then there’s the fact that one of the radiation therapists, who takes his extracurricular jobs very seriously, likes to change out the pictures on the radiation doors every month, always on a theme.  This month is crime fighting duos.  One door has Crocket and Tubbs from Miami Vice, one has Scully and Moulder from X-Files, and then there’s Crimefighter Carle, A/K/A Cagney and motherfuckin’ Lacey.  I really couldn’t ask for a better team.

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