JOURNAL: Changing course: from chemo to radiation

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On Friday, I met with my oncologist to discuss the results of my recent CT scan, which took place on Thursday, Sept. 2.

He told me that most of lymph nodes have returned to normal, except for two tumorous masses next to my heart.

This, of course, was not the news that either of us wanted. The best case scenario would have been to have a clean scan, which apparently could have resulted in a discontinuation of treatment, followed by a period of observation.

My oncologist then pulled up my scans on the computer screen. With a scroll of the mouse, he went through many images of my torso, each photo representing a cross-section of my body, as though it had been rendered into fine slices by a meat slicer.

He paused at the image of my heart. To the right was a tumorous lymph node, less than one centimeter in diameter. With another scroll of the mouse, he showed me another tumor, only this one was a little bigger than a centimeter, but longer than the other and slightly wrapping around the front and left side of my heart.

While a lymph node of less than one centimeter is considered normal, my doctor was not comfortable ruling the cancer to be gone, so he referred me to a radiological oncologist, who will discus my options for radiation therapy.

At first, I was really concerned, not only because the cancer was still in me, but because it was in such close proximity to such a vital organ. To be sure, the scans were great improvement over when I began treatment. When lymph nodes seemingly filled my rib cage, squished my organs, causing great pain with every movement, sneeze or cough, and burrowed into my sternum.

While radiation can lead to long-term damage to soft tissues and organs, my doctor assured me that my risks were low. He said computers are used to chart a course for the radiation, delivered in small laser beams. Those beams are shot into the body from may different angles, so as to not burn the skin and to limit collateral damage. Those beams then intersect at the tumor, which would left to bare the brunt of the radiological wrath.

He also believes side effects will be mild. Only accumulative fatigue.

The primary goal of treatment, my doctor said, was to cure my body – yes, he said cure – of the cancer. The second was to limit any long range effects of treatment – problems I might have 15-20 years down the road.

He believes radiation – most likely delivered in 15-minute sessions, five days a week for four weeks – carries fewer risks than chemotherapy. Chemo does not only attack cancer cells, but blood cells, too. It can also lead to respiratory and heart problems, not to mention its taxing effect on your liver, kidneys and digestive system.

If there is one bright spot, however, it is that I may be able to stop my chemo, which I consider to be great news. The side-effects of chemo are becoming more difficult to deal with – both emotionally and physically – and I do not look forward to my three-hour treatment sessions. I already feel liberated, if only by the hope that I – and my family – may no longer have to endure these gruelling sessions.

Generally speaking, however, I have struggled to put this news into into the greater context. Is it good news? Or bad news?

I have come to the realization that it’s neither. It’s just news, the opening of a new chapter in my fight against cancer.