BC Becky

Never thought I'd want to be a breast cancer survivor

Category: Radiation

  • And then there was one

    And then there was one

    Tomorrow will be my last radiation treatment – yay. So far I’ve managed without too much skin irritation (yay again). The doctor did mention that things could get worse or better over the next couple of weeks, but within a month I should be fully recovered skin wise as well as internally, which affects fatigue. She cautioned that it will take time to rebuild my stamina, but that is no different than any other insult to the body.

    In case you are wondering, this is what the machine looks like. I lay down in it with my hands over my head in the arm rests. The radiation techs align my tattoos with the various green lines in the room. The machine goes around me, first doing a scan, and then when they are sure things are lined up, it goes around again giving me radiation. For radiation, it is starts at about the back of my shoulder (shoulder blade) and then goes around to my neck, then back down again (so two passes). Then it is done. The whole process takes about 10 minutes, with about 7 of those minutes being the techs lining me up perfectly.

    Radiation Machine

    I’m glad that it will all be done. In the US, when radiation treatment is finished you get to “ring the bell”. That isn’t a thing here. Instead I decided that eating cake was appropriate – but then in conversation with a neighbour we realized that lots of people in the community have bells – so I invited people for cake and encouraged them to bring a bell – so I could ring many different bells.

    What I really enjoyed the last weekend I was home was all the short visits I had with my friends and neighbours. I got to see many different people and catch up on how they were doing. It was something I really missed during chemo when I was mostly staying away from people. The extrovert in me was very happy for all the visits. I’m looking forward to continuing that.

    Now I get to spend a month or two healing before we start talking about the next phase of treatment. I’m still doing Herceptin (denosumab) every three weeks. That will continue until the fall. The next phase is hormone therapy, which I’m not looking forward to, but I’m also not really thinking about. I get to have two months of no additional treatments to recover from chemo and radiation. I plan to take that time to get back to regular beach visits or hikes with my puppy who I cannot wait to snuggle with when I get home tomorrow.

  • Clearing the brain

    Clearing the brain

    Clearing the brain

    I got some good news today. The results of the CT scan of my head are clear, meaning there is no sign of cancer in my brain. I’m cancer free – actually, I’ve been cancer free since my surgery back in August (August 23rd – I had to look it up). However, without the brain scan there was a lingering question. I have headaches – are they caused by cancer in my brain. The answer is no. That is a huge relief.

    I am finding that I’m worrying about every new feeling in my body being a sign of cancer. That being said, it is more of a passing worry – or passing thought – that I usually dismiss.

    I’m now 2/3 of the way through radiation. I’m getting tired of being in Halifax all week without my puppy. I’m looking forward to a long weekend at home. Next week treatments start on Tuesday and now run until Friday. We will head home tomorrow right after my treatment.

    Since I don’t have fatigue yet, I’m trying to get outside for exercise. In Halifax that has mostly been walking (it is cold and windy out today). I’m hoping that tomorrow and the rest of the weekend I’ll be able to get out cross country skiing and snowshoeing. I am wondering if my intentional activity is what is fighting off the fatigue from radiation. At least that is what I have been hoping.

    I’ve also been thinking about cancer anniversaries. Since my first diagnoses, every year on December 17, I’ve been celebrating another year of being cancer free. It was a significant date that I marked with close friends. Now my cancer free date is August 23rd. It doesn’t really feel like a significant date – I actually had to go back to my calendar to see which day my surgery was! I do remember December 17, 2015 and initially thinking I didn’t want to do anything – I mostly felt sad – since then, I found I like to spend that day by having dinner with a few close friends. I might keep that tradition up, regardless of this recurrence.

    With the clear brain scan, clear bone scan, and clear chest/abdominal CT (except the cancerous lymph nodes), this really has been a regional recurrence. In some ways, my thinking is more that I will be leaving with this cancer forever. I will be NED – no evidence of disease – but I’ll be on some form of treatment for a while yet. I still have to finish out the year of herceptin. In the summer I’ll most likely be starting some form of hormone therapy for an indeterminant amount of time. It is like starting over again – because it is starting over again – only this time the surgery and chemo were much easier on my body.

    Today, I know that my brain is cancer free. That is a win!

  • Intentional Living

    Intentional Living

    The routine of radiation involves me getting up and walking to the hospital for my appointment. This week, my appointments have been in the morning. It is a 10-15 minute walk which has reminded me how much I enjoy walking in the morning – even when it is snowy – but especially when the sun it out. I am reminded that I used to walk Cali every morning (around the pond or around the block). Since chemo I have not been doing that walk. Others have taken Cali for walks – so she isn’t missing out – but I’m missing out. During radiation, I’ve decided to get out and walk as much as I can before the fatigue side effect kicks in. So far I’ve been pretty lucky, with minimal side effects. When we are in Halifax I’m walking at least 4km each day.

    Today’s treatment got cancelled due to a broken machine. This means we will add a day to next week’s treatment. Fortunately, we had room in our schedule for it. It means this week and next week will both be four treatment weeks. I think the lower frequency is helping reduce the side effects.

    Of course my day off treatment isn’t a day of appointments. I had a root canal today – well, the finishing of a root canal that was started a few weeks ago in Bridgewater. Unfortunately, this turned out not to be finished – the doctor put some medicine in that needs to be there for two weeks before he closes the root canal. He mention there was some necrotic tissue that needed to be treated. This means I’ll have to come back to Halifax for a dentist appointment the week after I finish radiation!

    On an emotional front, my thoughts lately have turned a little morbid. It started with thinking about this being my last good summer – that has changed – I’m now thinking with a five year time horizon. On the drive up, I asked Scott what he would want to be doing if he only had five years left to live. He changed that a little and asked what he would want to do if I had only five years left to live. The thing is, we have already started planning it. We hope to be camping a lot this summer, and we are living where we want to be living, in a community that we love, close to amazing nature. In many ways, Treehouse Village will be part of our legacy.

    When I think about what I would be doing differently, the biggest thing is spending less time dealing with Treehouse renovations. I feel like I need to be selfish now and spend my time walking on beaches or hiking with my puppy – and hopefully my hubby. He is still so intertwined in finishing Treehouse – such that I occasionally get sucked back in – but then I use cancer as my reason for pulling myself back out and doing what I want to be doing rather than what I feel like I should be doing.

    Fortunately, what I want to do is often physically better for me. I feel better when I can spend three hours a day exercising.

    I want to do some renovation work – especially at our old house. I want to pull up the carpets – I’d love to do it, but I know that if I do I’ll just suffer from back pain. My body doesn’t like the work. It much prefers that I walk or hike, or sit at my computer and type. So, I will need to pull back from renovation work in order to keep my body as physically healthy as I can.

    Unfortunately another thing that my body dislikes is standing and therefore cooking. I realized last week that my back was feeling much better – and I attributed that to walking a lot more – but realized on the weekend that part of it is that I’m not cooking. I’m not standing in the kitchen, and standing aggravates my back. I need to find better ways to cook – because I love cooking and we still need to eat – that doesn’t require me to stand so much. I also need to be more aware of the pain coming on and doing something about it before it gets bad. I’m not particularly good at that part.

    I am looking forward to camping this summer. Interestingly, I mentioned that to one of the radiation techs and she commented that she goes to the south shore in the summer. That is one of our challenges – it is no nice at home we don’t want to leave it – but we also want to explore more of this beautiful province. This summer, I’m hoping to see more of Cape Breton – and I’m looking forward to visiting folk festivals … then there is our broader travel. I’m going to California in late April, and we are going to Iceland in early June.

    I am using the ‘regret test’ when I plan things. That is, I ask myself if I will regret not doing it. The trip to California definitely fits the regret test. I so happens that my planned timing aligns with Lilani’s memorial – which means that I will be able to attend, and I will likely be able to see and hug so many of my friends. It was hard leaving during Covid and not being able to say goodbye. I’m looking forward to proper goodbyes on the trip.

    And so, I’m feeling like I will live for five years, but I am only planning until the end of the summer. I do plan to go back to work in September. I’m looking forward to some the changes and challenges in my courses as a result of AI.

    It occurred to me when I was typing that AI changes meaning for me. AI in the breast cancer world is aromatase inhibitor – one of the stronger class of estrogen blocking therapies (and one that I will start in the summer). In the context of work, AI is Artificial Intelligence. Generative AI specifically is changing how we go about creating course materials.

    OK that is enough thoughts for today. I’ll try to write a little more frequently in the next couple of weeks.

  • Radiation is a mental struggle

    Radiation is a mental struggle

    Radiation treatment, in theory, is easier than chemo. It is easier on your body – in that the physical side effects are skin issues and fatigue. You don’t need to deal with all the other side effects of chemotherapy. However, for chemo I only had to convince myself to go four times. I had four cycles of TC chemo, so I had to go four times.

    For radiation, I need to go 15 times. I need to convince myself that this is a good idea. I need to mentally prepare for the treatment each time. The treatment itself only takes a few minutes, and the last couple of times I’ve barely had enough time to change before they called me in. But I find it a mental struggle – it weighs heavy on me.

    So far, I haven’t really had any side effects, except for a little worsening of my lymphedema – which I cannot do much to treat until radiation is over. I’ve been trying to elevate my arm as much as I can, and that does seem to help. Since we live more than an hour away, we are staying in Halifax during my treatment. I’m taking advantage of being in the big city to see a different lymphedema specialist. She can help with a consultation on compression and can do a treatment on my left side, which has a little swelling

    I’ll also get that root canal fixed. I don’t know if I blogged about the failed root canal – I spent two hours in the dentist chair in Bridgewater but the dentist couldn’t find the second root, so I’ve been referred to an endodontist in Halifax. I called them today and I now have an appointment booked for next week. That will save us a special trip into Halifax just for that.

    We are also eating out – but trying not to eat out too much and to enjoy it when we do. Tonight we are going to Drift and tomorrow we are going to The Bicycle Thief. We brought food for some lunches and breakfasts – so we don’t need to each out all our meals. We tried the cafeteria at the hospital today because they gave us vouchers, but they didn’t have anything gluten free except pre packaged muffins. So Scott had a nice omelette and I had a muffin and coffee. We might try some of the other hospital cafeterias to see if they are any better.

    Overall things are going well – just a little stress to keep things interesting.

  • Radiation and Losing Friends

    Radiation and Losing Friends

    Radiation started this week. So far it has only been two treatments. They go pretty fast. Immediately afterwards I find myself wondering if I’m feeling anything. Can I tell that the invisible beam is attacking part of my body?

    We did have a bit of a misunderstanding, for which the radiation oncologist felt bad. I might have just been misremembering. Radiation is on the lymph node chain the goes from my under arm to my neck – that part I knew – but it also covers around the surgical area. She showed us the CT and where the surgical clips were, and the radiation target areas which included the area between the surgical clips. It makes sense, I just somehow didn’t realize it.

    Last week I also lost a friend – Lilani – who loved to send me postcards from where ever she was travelling. She loved to send and receive letter mail. She was diagnosed metastatic just at the beginning of covid. She was such a light in this world, I am so sad that she is gone.

    I met Lilani at a young survivors support group when I was newly diagnosed. I had just had my head shaved, so had not lost my hair yet. She taught me how to tie a headscarf and commented that wearing dangly earrings was the key to making the headscarf look good. I remember that as if it were yesterday. Myself, Lilani, and Katie were all from south bay, so we carpooled together for that evening support group. Later, after initial treatment, I convinced her to join BAYS – which at the time was hosted at my house. BAYS – Bay Area Young Survivors – is a peer led support group and became my close friend circle. I miss being near all my BAYS friends, and I do hope to get down to California to visit them in the Spring. I need their hugs.

    I’m mad at cancer. One of the things I was looking forward to in the fall was a trip to California to see my friends – a trip that was cancelled when my recurrence was found. One of the friends I was looking forward to hugging was Lilani. Cancer took that away from me.

    On the drive to Halifax for my first radiation treatment, it occurred to me, the lymph nodes that I’m getting radiated are the same ones where Lilani found her metastatic lump. We had been at a sleep over and she noticed something under her collarbone. And now, I’m getting radiation under my collarbone. It is so triggering.

    Radiation also seems to have me crying more often. I don’t know if that is a side effect of the radiation or just a reaction to everything that is happening.

    Lilani and I at the end of the Avon Walk in 2015
  • Radiation, Recall, and Lymphedema

    Radiation, Recall, and Lymphedema

    Today I start radiation treatment. It is a 15-session spread over 4 weeks. The first two sessions are this week, then for the next week and the week after, I go for 5 days. For this week, they are putting us up in a hotel that is a short walking distance to the treatment center. They also said they would pay for a taxi to bring me if I wasn’t up for walking. It really isn’t that far.

    Food is going to be a challenge – but this trip it is really only dinner and breakfast. My appointments will be done before lunch. We will likely want to eat before we leave town.

    I’m also hoping to get a couple of short cross country skis in. The recent snow means there are a bunch of places with a couple/few km of trails nearby. We will be closer to them in Halifax than we are in Bridgewater. We may detour through the valley on our way home as there are many more places to cross country ski there.

    I am experiencing some random chemo recall side effects. I think it is because my cells are all regenerating at the same time which means they are also dying at the same time. This is definitely clear with my eyebrows. They grow back and then they all fall out again. It takes a year or two before the growth gets staggered so they aren’t all falling out at the same time. Fortunately, I seem to have kept my eyelashes. I had mouth sores over the last few days – and I wonder if this is just another chemo recall side effect. Hopefully they won’t keep coming back every three to four weeks – that would be annoying.

    A couple of days ago my left hand began to swell. Fortunately it appears to be just in my hand on the left side. I’m completely swelled on the right side. With the start of radiation I can no longer do lymphatic drainage massage. That will wait until after radiation. I’m not sure how long after radiation I’ll have to wait before I can go back. So far I haven’t had a lot of success with compression therapy, but I’m hoping to find a compression solution that works. I have also been swimming, however, I’m not allowed to swim during radiation so that is now on hold as well. Hopefully my arm doesn’t swell too much while I go through treatment. I’m still looking for someone who can actually treat lymphedema as I feel like I’m largely left to manage it on my own – using trial and error rather than know what might actually work. I’m glad that this isn’t my first experience with it; otherwise, I’d be a lot more stressed about it.

  • All marked up

    All marked up

    On Thursday we made our way into Halifax for my radiation marking appointment. When I arrived at check in, there was a distinct lack of information. The person at reception showed me where to change and told me where to wait after I was finished changing – however, she didn’t tell me how I needed to change. I decided that I only needed to take my top off, as they were not looking at my lower body.

    They brought me into a room with a CT machine, lined me up, put some markings with pen on my body – specifically, under each armpit and one on top and the another on the bottom of my sternum. They put me in the CT, took a few pictures, then put small tattoos in the four spots. Three of the tattoos are generally covered by clothing, but if I were to wear a low cut shirt, you would see the top sternum one. Fortunately, it looks like a dark freckle.

    I can see why some breast cancer patients really dislike the radiation tattoos. Now, everytime I look in the mirror I see them. Everytime I shower, I see them. They are a constant reminder of radiation. That being said, I have a lot of scars that are constant reminders and I get used to them. I’m pretty sure I’ll get use to the tattoos as well.

    The next step is to wait for a phone call. The CT information goes to the radiation oncologist and she plans out the radiation. When there is availability of the radiation machines, they schedule it. It can start on any day of the week – so although it is 15-sessions, it might not start on a Monday. Typically, patients get about 2-days notice. When the phone call comes, they also schedule accommodations – either Hope Lodge or the Lord Elgin Hotel – depending on what is available. At this point, either works for us.

    We also decided to spend Friday Feb 9 in Halifax so we can see JP Cormier and the Nova Scotia Symphony do a Tribute to Gordon Lightfoot. It is a late birthday present.

    I’m also still waiting for the head CT. I haven’t received a call about it yet – so I’ll call the doctor’s office tomorrow and mention it. I will also ask them to mention that I have a port, so I need an appointment during the day when there is someone available to access it (if contrast is needed).

    Now go on with our lives until we get the phone call. I’ve spending my time doing various sewing projects, exercising, and doing some painting in our new home.

  • Radiation Therapy

    Radiation Therapy

    The main purpose of our trip to Halifax last week was to consult with the radiation oncologist about radiation therapy. While we were waiting, I picked up a copy of all the various handouts they give when you are having radiation therapy. They provided some really useful information specific to having radiation therapy at the QEII (the hospital in Halifax).

    A skeletal image showing the lymphatic system indicating that the lymph nodes in the right axilla region have been removed.
    A skeletal image showing which lymph nodes were removed during my lymph node dissection

    The radiation oncologist explained that the target of the radiation would be on the lymph nodes along the same chain as the ones that were removed – that is the nodes that would be “next in line” if the cancer were to spread. These nodes are located in placed under bones and muscles making them difficult or impossible to operate on. In addition, if these nodes do get cancer, they can be very painful and there is little to be done about it. Radiation now would reduce the likelihood of the cancer returning to those nodes.

    A close of up the lymph node system showing the lymph nodes going under the collar bone.
    A closer look shows how the chain of lymph nodes moves under the collar bone towards the neck. There are also muscles and nerves that would be affected by a cancerous lymph node in that area.

    One of the unfortunate side effects is that there will be damage to the upper lobe of the lung. This will show up as scaring in x-rays. It is not expected to affect my breathing, as most people breath with their lower lungs – and I know that I certainly have since my initial mastectomy surgery – I rarely use the top of my lungs.

    The lymph nodes with the lung underneath showing how the target lymph nodes are right about the upper lobe of the lung.
    Shows the lymph system and the lungs. As you can see, the upper lymph nodes are above the upper lobe of the lung.

    The next step is to do an appointment for markings. In the US they call this appointment simulation. That is scheduled for Monday 15 January. The process of pre-treatment radiation markings involves using a CT scan to determine the exact areas that will be radiated. Pinhead-sized tattoos are then created to help locate these areas with precision during the actual radiation treatments.

    Once that is done, I’ll get a call to schedule my appointments. The person who does that also sets up accommodations in Halifax. The pamphlet says it is either at The Lodge that Gives or Point Pleasant Lodge. That being said, a friend of mine was put up at the Lord Nelson Hotel when her husband was having radiation. I think it really depends on availability and length of treatment. Either way, we will be staying in Halifax Monday – Friday for three weeks. They reserve the late Monday and early Friday treatment time slots for those of us who travel for treatment, which is nice. It will mean we can spent more time at home on the weekends.

    Finding the images for this blog post really helped me better understand where the nodes are that they are trying to radiate. I’m curious where the tattoos will be. These will be my first ever tattoos – hope this isn’t a gateway to getting more, although I’ve always thought getting an orange calla lily coming out of my port scar would be cool.

  • Scanxiety

    Scanxiety

    In my post from Tuesday, I mentioned that the radiation oncologist had ordered a head CT. This is to check to ensure there is no cancer in my brain – which is one of the places breast cancer likes to metastasize to. I’m amused that I can write that so nonchalantly without any emotion.

    I don’t yet have an appointment. The CT will be in Bridgewater, but I don’t think it was marked urgent as it wouldn’t change my current treatment.

    I am not anxious about it yet – in part because it hasn’t even been scheduled. My scanxiety (anxiety around scans) usually starts shortly before the scan itself – usually on the day of the exam or as I’m walking into the hospital to register. The height of the anxiety is in that time between the test itself and getting the results.

    I find that doctors here are slow to pass along results, especially some of the specialists. I don’t know for sure if the radiation oncologist would be slow or not, but my family doctor gets copied on the results, and I now have a deal with him that I get a call once new results come in.

    For now, no scanxiety yet. Mostly I’m focused on recovering from this last round of chemo and starting to think about three weeks of radiation in Halifax.

  • Lymphedema

    Lymphedema

    Yesterday, I summarized the key points from our trip to Halifax to see the radiation oncologist. There were many different things discussed in that consultation and in my blog post that require further explanation.

    The first topic I want to address is lymphedema. Since I already have lymphedema on my right side, the oncologist informed me that it will worsen and become permanent. The surgery increased my risk, and radiation will further increase it. However, since I already have lymphedema, the radiation is not increasing the risk but rather the severity.

    I have heard before that my lymphedema was permanent, but I am skeptical about it. The lymphatic system is not well understood by many people.

    The last time I had lymphedema, it lasted about six months. During that time, I wore compression garments every day and swam almost every day. At that point, I was swimming about a mile. I believe these two factors contributed to the resolution of lymphedema in my left arm.

    Unfortunately, I am currently unable to swim, and wearing compression garments is making it worse. On Christmas Eve, I burned my arm while cooking (yes, it was the arm affected by lymphedema). The wound is still healing and still bleeds when I change dressings. It is almost healed, but I will not be able to swim until it is completely healed. Once it is, I plan to swim as much as possible.

    Another step I am taking is seeing a physiotherapist for manual lymph drainage. I have booked weekly visits for January and will evaluate the results afterwards.

    I am also engaging in virtual boxing. One of the things that brought me to tears in the doctor’s office was the thought that I would no longer be able to go boxing. I cannot box with lymphedema as the impact exacerbates it. However, I can still engage in virtual boxing. When I injured myself last year and couldn’t box, I purchased a Quest VR headset. Now, I use an app called Supernatural to box to music in visually appealing environments. It is a great workout that does not involve impact (there is minor haptic feedback from the hand grips, but no impact).

    During radiation treatment, I will not be able to swim or receive manual lymph drainage. Virtual boxing may still be possible, but it remains to be seen. I will simply have to accept the situation as it is.

    The oncologist recommended considering compression sleeves once everything has settled down. Chemo prevents it from healing, and radiation aggravates it. Once I have completed radiation, I will be able to focus on things that can improve the condition.

    Despite the doctor’s assertion that lymphedema is permanent, I choose not to believe it. Only time will tell which one of us is correct!

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