Radiation Therapy: The Beginning
For radiation treatment, I chose to go to a radiation oncologist at Alta Bates in Berkeley, instead of staying with UCSF. My reasons were practical; I have to drive to radiation every weekday for six and a half weeks. No way am I getting stuck in Bay Bridge traffic everyday.
Alta Bates is not the closest hospital; their cancer center is a 40-mile round trip for me. It would have been more convenient to be treated and John Muir Hospital, just four miles away. However, doctors in San Francisco never know anything about the doctors in Walnut Creek so they could not recommend anyone. Yeah, it's only 30 miles away, but you'd think it was off the edge of the map in that area with the sea monsters. I did not want to take chances with radiation, so I decided to go with someone who has an excellent reputation and she happens to be at Alta Bates.
One of the coolest things about this cancer center is that they have free valet parking. You may wonder why that's a big deal. Well, at UCSF, it costs $5.25 per HOUR to park in the parking garage, and sometimes it is hard to find a spot. At Alta Bates, I just drive up and step out of my car. Woo! FAN ME.
The facility is very attractive, with tall windows letting in lots of light. Watching how they processed patients, I had to admire their systemization. I'm a girl who digs things like that.
They took me back to the new patient registration and a woman went over my paperwork with me. I was wearing Aqua Purple, my favorite wig. It's like a good luck charm. Another woman behind the counter leaned over to see me and said, "I like your hair. Where do you have it done?" I was confused for a moment then answered, "Hong Kong." She laughed when she realized that it wasn't real.
I just assume everyone knows I'm wearing a wig, but they often don't. Personally, I think fooling people at a cancer center is quite an achievement. Either that, or everyone is just humoring me.
They took me down to radiation (which is always in the basement) and a financial counselor met with me while we waited for the doctor. Insurance was reporting my coverage incorrectly, saying I had a co-pay and some things might not be covered. I knew this wasn't true (I made SURE to check this out beforehand) and just let the counselor know he needed to ask someone else about it.
The radiation oncologist then came in and we started. She is from the UK and, for no rational reason, that scores points with me. I'm such a silly Anglophile. I had seen her on a video presentation that she had done for the cancer center. I think it was her project; she created a video that gives new patients information about breast cancer and the phases of the treatment process. I was most impressed by this. I couldn't help but wish that UCSF had that sort of thing for their patients, too.
Anyway, because she narrates the video, I sort of felt like I had already met her before, so we started off comfortably. (She loved my hair and I respond well to that sort of flattery.) She asked the history of my diagnosis and treatment and I gave her the quick run-down. When she found out that I had Taxotere/Cytoxan chemo, she said, "Let me see your fingernails." I laughed gleefully and held out my hands. "Aha!" I said, "But I have a secret!"
While she looked at my healthy pink fingernails, I told her about the frozen glove treatment that I did. She hadn't heard of the study and was very interested. She said that all her patients who have had Taxotere have scary brown nails, if they have fingernails at all. I promised to send her links to the study. She said she was going to present it to the medical oncologists upstairs so that they could try this with their patients. So exciting!
She explained the 3-D planning session that I need to do on Friday, where they map out how the radiation beams will intersect and plan how to protect my heart and lungs. Then the regular radiation sessions will begin daily and I will see her each Friday for an evaluation. She wants me to start applying Aloe Vera gel to the radiation area three times a day. If my skin starts to break down later in the process, they'll have other skin care things for me to do.
I told her that my father was very concerned about the effect that radiation might have on my heart (since my mother had a lot of heart damage from radiation) so I was hoping she would tell me something that might allay his worries.
She said there was a retrospective study done my a doctor at Oxford looking at the relationship between women who had left breast/chest radiation and heart attacks. He found that there definitely was a correlation for radiation done in the 70s and 80s, but that there was none for the current method of radiation (particularly with 3-D planning). She explained that the 3-D planning helps make sure that the radiation is more homogenous so that you don't get the kinds of hot spots (areas that get more radiation) that happen without it.
The other thing I wanted to ask her about was a claim that women under 45 who had radiation therapy had a 50% higher chance of getting cancer in the other breast. A friend had sent me a book that mentioned this, but when I looked up the actual 1991 study that it referenced, I found that this used data from the late 70s and early 80s. I asked if she knew more about it. The oncologist said there is no evidence at all of an increase in breast cancer on the other side and that several studies have looked at this.
I hope that when I pass this information along, people will stop mentioning their objections to me doing radiation therapy. Although, they might not. People are funny that way. The thing is, this is something I feel I have to do to reduce my recurrence risk, based on the data. I'm doing the best I can. Now, on with the show.
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