Mom and I met with the radiation oncologist today. Who is fabulous, btw. I was skeptical when the nurse coordinator told me to plan two hours for this appointment. Apparently she knew what she was talking about. That's two hours after the nurse did her usual new patient things. And none of that included time spent waiting around for the doc (which was minimal). That was two undivided hours with the doc. She explained the radiation therapy process so clearly and thoroughly, I'm pretty sure I'm now qualified to perform the procedure. And! She spent many years working with the NIH. So she spoke in statistics and research, facts and figures... she was speaking my lanuage!

So allow me to give you the dime store version of what she said.

Lymph nodes act like tiny filters in our bodies to help fight off infection. You've got them in several conveniently located places in your body, and the co-located body parts "drain" to their neighboring nodes. If you've got an infection or something equally uggy, the ugginess should get "filtered" through your nodes where it will be combated by all the white blood cells that like to chill there. So your lymph nodes are like MTV Cribs for your white blood cells.

Your breasts "drain" to your axillary, aka your arm pit. Must be a rent controlled neighborhood. Anyway, if you have cancer cells in your breast, they can bust loose and one of the first places they flee to is your axillary lymph nodes. Kinda like Upper East Side kids who try to be rebelious and slum it in... oh, I don't know... the village.

If this happens, you may plan to make good friends with this machine.

Why do I say may make good friends? Because that will depend on what's found when I go in for surgery. Because my biopsy was positive for cancer cells (bummer, I know) my surgical oncologist will also remove some of my left axillary lymph nodes in the same procedure that she's removing breast tissue. (Removing lymph nodes comes with its own bag of tricks - like lymphedema - but I'll save that for another post.) The results of those biopsied nodes will determine my radiation fate.

If the chemo didn't kick all their little cancer cell asses, radiation is a for sure. If the chemo did its job and those nasty little cancer cells ran away with their tails between their legs... then radiation is up for discussion. It has a lot of pros and its fair share of cons.

Biggest "Pro" of Radiation: It nicely rounds out the trifecta of breast cancer treatment. And, when you're 31, that triple-threat is a nice thing to have on your side. Both from the medical stand-point, and for peace o' mind, it's a good thing to have brought out all of the big guns in your cancer ass kickin' arsenal.

And now the cons:

No, not that kind of con.

1. Radiation causes cancer. And by that I mean it's hell on your skin. In the process of zapping any last cancer cell that was stupid enough to stick around through chemo and surgery, radiation does a lot of damage to your oh-so-sensitive skin cells. This is bad for a lot of reasons. One of which is that it makes life harder on the reconstructive surgeon (and on the reconstructed patient). Pretty much, the radiation docs and the plastic surgery docs are at war with each other. Kinda like the Bloods and the Crips.

Hey, way to keep your references current!

2. Radiation is bad for your heart and lungs. But they try to keep as much of both out of the radiated area. So yay for that.

3. Treatment is five days a week for six-and-a-half weeks. Oh yes, you've read that right. 30+ sessions of getting zapped in the boob. The good news is it's a fake boob by... so zap away!

And about those fake boobs. Some plastic surgeons prefer to wait until after radiation is complete to perform the exchange surgery (swapping out the temporary tissue expanders for the permanent implants)... typically 6 months after radiation so the skin has lots of time to recover. So that means an extra 6 months with the hard, tennis-ball like expanders. I think we'll chalk that up as Con #4 of radiation.

And in other non-radiation related news, tomorrow is Chemo #5. Which is awesome (I know - using chemo and awesome in the same breath - WTH?) because Alyssa has signed up to be my chemo buddy. And because she paid a special visit to her meat buddy, Lothar, for some iron-rich goodness. So lots to look forward to.

More tomorrow, have a great evening!