First Day of Radiation and Oral Chemo

Today I began the next phase of my cancer treatment regiment with radiation and oral chemo.  I will be receiving daily radiation for 6 weeks or 28 treatments.  This number is slightly less than originally planned if the lumpectomy had been successful.  For my first treatment I had to lay on the table, put my arms overhead, and they setup the radiation machine using lasers and coordinates on my chest.  This part took about 30 minutes.  At first they didn't think I'd actually be getting radiation today, but I was in the system for it, so I did get my first treatment which took about 10 minutes.  For the treatment the machine shoots radiation from 3 different angles about 1ft from my body - angled from behind my left arm, angled from above right arm, and over my left breast.  The technicians ask me over the speaker to hold my breath for each shot, this pushes your chest up and your heart down and out of the path of the radiation.  After the treatment I felt some needles and pins in my left shoulder, but the technician thought that was attributable to having to lay in that position for so long not the radiation itself.  Driving to and from the hospital took 25min each way, and with 15min for treatment, I should be able to get there and back and be done in ~1hr 10min.  It would take me that long just to drive to the hospital in Boston!

Today I also began the oral chemo pill.  I really struggled with this last night.  Having an appointment and a nurse delivering IV chemo meant someone administered it to me and I had to do it.  The chemo pill means I have to do it and keep myself disciplined and on schedule.  And I'm not exactly excited to be going back on chemo.  But come morning I thought about my boys and how I need to be around for my husband, so the 5-7% increase in survival with this pill made it easier to swallow.  I take 2 in the morning and 2 at night, within 30 minutes of a meal, and with a full glass of water.  About 30 min after taking the pills I felt a little groggy, but otherwise no side effects.  I will take the pills 2 weeks on, 1 week off, with a lab check for blood levels.  So far so good.

Given the residual disease, margins, and receptor status, I pursued a second opinion from Dana Farber on my remaining treatment plan.  It's great they can do it all online and have full access to my records since they share the same patient gateway as MGH.  It took ~1.5 weeks for the DF doctor to perform the assessment, and like before, they came back with the same recommendations as MGH - radiation, Xeloda, and Tamoxifen.  A few important points differed from MGH.  First, ovarian suppression would only come into play if ovarian function resumes, however given low ER+ status it may be outweighed by possible side effects.  They also referenced another chemo trial but I'm not eligible in the trial period due to when I finish my other treatments.  DF also considered my margins to be positive.  Positive or negative, the treatment plan is the same.  Insurance won't likely cover a second 2nd opinion but it gave me reassurance I'm on the best treatment plan given my type of cancer.

This week I also returned to work after being on medical leave for 5 weeks.  The first meeting I was in was discussing the same topic when I left.  In other areas it was great to see the progress and hard work by the team paying off.  The absolute hardest part about getting back into work was the pace, it is incredible.  It has taken me 2-3 days just to get back in the mindset to be able to receive, process, and act on some many signals coming in at once - emails, calls, texts, IMs, meetings, action items, etc etc etc.  The people who work on F-35 are truly amazing to handle it all.

This whole cancer process has taught me to value your time with loved ones, accept help knowing you may never be able to repay it, and make yourself a priority.  I'm also a better manager/leader because I have had to practice delegation, empowering a team, and coaching.  Having cancer has afforded me the opportunity to be home, spend time with family and friends, and prioritize the things most important in life.  I am very fortunate to be where I am with all the people who support me.  Yes, cancer sucks, but I am grateful for the refocus on that which is most important - happiness.

The radiation room and starry sky