Sunday, March 24, 2013

Countdown to Treatment

Tomorrow I'm going to start to do something I haven't done for three years: a daily commute. I know, how nice for me. But this commute is especially... dramatic. Monday through Friday I'll have pelvic radiation. There was a lymph node that was cancer-positive post surgery, which means the cancer cells have learned how to travel. So pelvic radiation will blast my whole pelvis in an effort to kill any cancer cells that have traveled.

Radiation works because it kills cells as they are dividing. Cancer cells are always dividing, whereas healthy cells divide cyclically and more slowly. Chemotherapy works in a similar way, but I'll have low dose chemotherapy. This will not be enough to kill cancer cells, but it will weaken them so the radiation is more effective. Other cells that divide often include white blood cells. So my immune system will be weakened. There will be other side effects, probably some chemo related ones like a bit of nausea. But I'll have anti-nausea meds. Maybe my hair will fall out, a little (hair follicles are also rapid dividers), and if so it will grow back.

Long term, there are some risks. For example, radiation is another form of x-rays. X-rays are a mutagen, which means sometimes they cause normal cells to mutate into cancer cells. Great. Also, the radiation is likely to dry out my mucous membranes. Things like my uterus are probably going to get a bit more dry, frail, less stretchy.

The first couple of weeks I probably won't have many side effects from the radiation. My radiologist said it's cumulative, so probably during week 3 I'll start feeling more and more tired, fatigued, and I may have some nausea (but again, anti-nausea meds). I may be a bit incontinent - pelvic radiation, definitely radiating my bladder, lower intestines, the rest. Those will be, most likely, temporary side effects. My menstrual cycle will also be affected, most likely only temporarily.

Historically, the ovaries are also affected by pelvic radiation. This has meant that women become infertile and often they go through early menopause. My surgeon, ever at the forefront, is one of the only doctors in Berlin who does a rather new procedure that moves the ovaries upward and out of the area where the radiation will be. My radiologist says my ovaries are in a great position and will only receive some scatter, no direct radiation.

On the eve of this next phase of treatment I am positively excited. I know that sounds like some kind of positive thinking bullshit, but it's not. I've been allowed to wait long enough to feel totally healed from surgery - partly because we opted to do the fertility stuff. Those two weeks were valuable because they allowed me to heal and get strong again. I'm ready to start and finish the process that will destroy all the cancer cells that threaten my health.

I'm also a bit excited because of a comment a doctor made on Friday. Now, I've always been into complementary therapies and medicine. My dad is an acupuncturist and I am a certified reflexologist. These and many other therapies are helpful, they help people every day, and some, like acupuncture, have been helping people for centuries. So why not? I'm also a firm believer in the efficacy of modern medicine, especially for emergency medical care and for diseases like cancer, which have had a lot of money thrown at them. Of course, vaginal cancer isn't necessarily included in the money thing, but I'm confident that the treatment I'm undergoing is going to do what it's supposed to do.

I believe that there's a place for modern medicine and complementary, traditional, alternative medicines and therapies. There is a holistic hospital here in Berlin - actually a bit on the outskirts of the city, by a lake, that is an option for treatment. There are a few holistic hospitals actually. However, you have to have more comprehensive health insurance to be able to go to them without paying out of pocket. My public, basic option doesn't cover it. But it will cover an initial consultation there, so my dad convinced me that I should email the head doctor, who he'd already been in touch with.

Last week we tried to make an appointment, but it didn't work out. He called on Friday and told me a couple of things that would help me. First, he said that we should meet after I started the chemotherapy, so we'd know what kind of side effects I'd be dealing with. The whole point of going to see him will be to get some recommendations for complementary therapies that have been helpful in reducing side effects from modern medical techniques like chemotherapy.

Secondly, he said that many people don't have any side effects, and I should focus on that and the fact that I'll probably be just fine throughout treatment. YES. Third, he said that just in case, I should bring some ginger tea to the hospital, because they won't  have any. If I do have nausea, I should drink two strong cups. And finally, he said I should prepare myself mentally, I should, 'remember that chemo is my friend.' This from the guy who will recommend acupuncture or cranio-sacral therapy if I have negative side effects.

Chemo is my friend. That's right, chemo is my ally right now. Chemo and radiation are the help I'm getting. I mean... duh. Why didn't I think of that?

We all know that attitude and mindset influence recovery and outcomes. The hippies and the medical-industrial complex agree that if you laugh, are optimistic and hopeful, and if you stay focused on getting better, you have a better chance of a full recovery and it'll happen more quickly. But I was somehow missing the piece where you use the positive attitude to think about the treatment as a good thing.

A friend of mine sent me a story that I'm going to summarize here but have posted in full elsewhere (I hope that's cool with my friend).

A Sudanese woman refugee who suffered atrocities and walked across the Sahara to Kenya with her children arrived at a refugee camp and learned that she had tumors in both her breasts. As a result she was fast-tracked for asylum in the US and received a double mastectomy. She is alive and well today because of breast cancer. I encourage you to read the whole story, but for now, let's just remember that some people have it worse, some people have it better, and cancer and treatment can be anything.

I've mentioned that I'm not afraid of treatment or cancer. But it's more than that, I guess, I'm also glad that I'm getting the treatment that is available to me, so I can get better. Here's to 6 (or 7) weeks of chemical cocktails and irradiation. Let it be mild and successful.

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