Decisions, decisions
I met with the radiation oncologist on Friday to discuss the possibility of radiation treatment to mop up any lingering cancer cells, if there are any. He showed me my PET scans and went over the fields he wanted to target and told me what the possible side effects were.
Basically, at the beginning of chemo, I had activity in the neck, armpits and chest. After 2 cycles of ABVD and a mid-way PET, I just had activity in my neck. Two more cycles and my PET showed no evidence of disease (NED). My doctor wants me to radiate my neck (both sides) and my armpits. Risks for this could include, but not be limited to, the following:
Neck:
-Damage to the salivary glads, resulting in loss of taste and dry mouth.
-Damage to the teeth and gums.
-Damage to the thyroid, possibly resulting in hyper- or hypothyroidism or cancer.
Armpits:
-Damage to top part of the lungs
-Increase chances of breast cancer down the line by at least 15%.
Immediate side-effects are fatigue and sore throat for duration of treatment, plus a couple of weeks after. Duration would be 17 days, and radiation dose would be 30 gy total.
I told my doctor that I would think about it over the weekend and let him know on Monday if I was going to do it.
Man, I didn't realize how hard a decision this would be. I've flipped-flopped several times from yes to no.
On the one hand, radiation is, without a doubt, dangerous. You definitely don't want to do it if you don't have to. On the other hand, how do you know if you have to? Therein lies the rub - you (and your doctor) just don't know for sure. PET scans cannot see anything under a billion cells, so even a "clean" scan could be missing a few million cancer cells. Thus the radiation is insurance. Salvage treatment (treatment after relapse) is very harsh and if you can do anything to increase your chances of not relapsing, you should do it. In this instance, I apparantly already have an 80-85% chance that I've been cured with chemo alone, and radiation would increase that to 90-95%.
So do I gamble on the chance that I am already cured and forgo the dangerous radiation, or do I invoke the "insurance" and gamble on getting life-long problems and/or secondary cancers down the road?
AHHHHHHHHH!!!!!
This is a very, very hard decision. I've talked with my friends and family, and done a ton of research, and I think I've come up with a decision, but I need to talk to my doctor about a couple of things first. I called him a couple times today but he didn't call me back. Hopefully I can get a hold of him tomorrow.
Basically, at the beginning of chemo, I had activity in the neck, armpits and chest. After 2 cycles of ABVD and a mid-way PET, I just had activity in my neck. Two more cycles and my PET showed no evidence of disease (NED). My doctor wants me to radiate my neck (both sides) and my armpits. Risks for this could include, but not be limited to, the following:
Neck:
-Damage to the salivary glads, resulting in loss of taste and dry mouth.
-Damage to the teeth and gums.
-Damage to the thyroid, possibly resulting in hyper- or hypothyroidism or cancer.
Armpits:
-Damage to top part of the lungs
-Increase chances of breast cancer down the line by at least 15%.
Immediate side-effects are fatigue and sore throat for duration of treatment, plus a couple of weeks after. Duration would be 17 days, and radiation dose would be 30 gy total.
I told my doctor that I would think about it over the weekend and let him know on Monday if I was going to do it.
Man, I didn't realize how hard a decision this would be. I've flipped-flopped several times from yes to no.
On the one hand, radiation is, without a doubt, dangerous. You definitely don't want to do it if you don't have to. On the other hand, how do you know if you have to? Therein lies the rub - you (and your doctor) just don't know for sure. PET scans cannot see anything under a billion cells, so even a "clean" scan could be missing a few million cancer cells. Thus the radiation is insurance. Salvage treatment (treatment after relapse) is very harsh and if you can do anything to increase your chances of not relapsing, you should do it. In this instance, I apparantly already have an 80-85% chance that I've been cured with chemo alone, and radiation would increase that to 90-95%.
So do I gamble on the chance that I am already cured and forgo the dangerous radiation, or do I invoke the "insurance" and gamble on getting life-long problems and/or secondary cancers down the road?
AHHHHHHHHH!!!!!
This is a very, very hard decision. I've talked with my friends and family, and done a ton of research, and I think I've come up with a decision, but I need to talk to my doctor about a couple of things first. I called him a couple times today but he didn't call me back. Hopefully I can get a hold of him tomorrow.