Thursday, 21 February 2013

Meeting Dr Zap

Maybe I should read this whilst in the waiting room....?
Today I went to St Luke's Cancer Centre in Guildford for the radiotherapy planning for the next stage of my treatment. The point of radiotherapy is to target any cells that may be left in your body after chemo and surgery. The amount (strength and duration) you need varies from person to person. I'm having 3 weeks worth with a weeks' worth of booster added onto the end.
Macmillan do a great information booklet and have a lot of info on their website about Radiotherapy. Click here to link to their site.
To make sure that the radiotherapy is as effective as possible, it has to be carefully planned. Planning ensures the radiotherapy rays are aimed precisely at the cancer, it makes sure that the cancer gets the prescribed dose of radiation while normal body tissues get as little as possible.
I arrived at my appointment and was taken through a consent form which detailed some of the side effects of radiotherapy, the reasons for having the treatment and a bit of information about the whole process.
I am having a new type of radiotherapy called Deep Inspiration Breath Hold (aka DIBH). It's for people with left sided breast cancers and the idea is to reduce potential cardiac damage from the radiation. Basically if you breathe in, you fill your lungs and rib cage with air which pushes the heart further back and therefore away from the radiation dose. During my treatment, I will have to hold my breath for 12 seconds. It's harder than it sounds because you're not allowed to exhale at all or let any air escape from your nose. The radiographers can tell exactly how you're doing on your breath holds because you have to wear some goggles that look like something from a computer game and have a little box taped to your chest. The box records your breathing and movement and then the goggles are connected to this. On the screen in front of your eyes you see two lines. One is a static blue box and the other is a yellow line which moves up and down in time with your breathing. When you do the breath hold, the yellow line moves up and the idea is that you get the yellow line into the blue box and it goes green. You then have to keep the line green (by holding your breath and staying very still) for those 12 seconds. If your green line drops out of the blue box and becomes yellow, the radiation will automatically shut off, it's very clever! Try holding your breath now and time it, it honestly feels longer than you think!

Here's some more information about DIBH
I had to undress my top half and put on my dressing gown and walk to the radiotherapy room (which was freezing cold!). There was a CT (computerised tomography) scanner there which basically scans you and takes a series of x-rays which build up a three dimensional picture of the area.

                                                           A CT Scanner
I then had to lie on a fairly hard bed and was moved into a very specific position with my arms above my head (Dr Zap had already asked me if I had full arm movement, this is important as your arms have to be out of the way of the radiation).

They then put the goggles on me and I did a couple of test DIBHs to make sure I could get the yellow line to go green.

I was then taken into the CT scan, which is all open and nothing like the MRI Scan and had to do 2 x 12 second breath holds whilst staying as still as possible. You have to stay still so that the measurements are accurate and your exact position can be recorded. This record means the radiographer can check you are lying in the correct position every time you have treatment.

Once the treatment area for radiotherapy is finalised, the radiographer will make small tattoos on your skin. Nothing like as bad as it sounds I promise! They literally look like pen dots. I have 3 black ones. One in the centre of my chest, one on my left side and one on my right side. These show the therapy radiographer where to direct the radiation beams.

After that I was all done so got dressed & collected my treatment schedule, last one is the day before Rob's 30th.

I start on March 4th, bring it on.

Friday, 8 February 2013


This evening I went to Olivine & Alison - a lady I met at the BCC Brighton Forum - came along too which was cool and she seemed to enjoy it.

Having not been there since November, it was a good opportunity to let them all know where I was in my treatment schedule (last time I went I was a fortnight post last chemo), to pick their brains about radiotherapy (my next lot of treatment) and to show off my hair!

When we got to Olivine, Marilyn. gave us something called a Big Box of Love, you can read more about the idea and how the company was born here. It was an enormous box and me & Rowena unwrapped it and I read the letter enclosed out to everyone. We then all got to unwrap a pressie :) I got a fab lavendar bath set, Alison got some bath salts, Rachel got Bathing Honey, there were nice notebooks, a make-up set, make-up bags and other bits - was really generous and what a lovely idea to send to people when they are having treatment to pick them up.

Sometimes at Olivine, we have someone coming in to talk to us, in the past there has been nutritionists, crystal healing, my new hair; and tonight we had a lady come in from Pretty Permanent Make-Up.

She spoke about what permanent make-up is and about the different types of permanent make-up that you can have. Although not my cup of tea (I'd be too scared of the needles!), the results did look pretty fab :)

Friday, 1 February 2013

High Five!

Today was results day of WLE #2. I'd managed to almost put the thought to the back of my mind and then as Andy came down to stay after a work meeting in Gatwick on Thursday night I didn't really think about it until I went to bed. So after a very restless night and all morning feeling sick, Rob drove us to Redhill for my meeting with my surgeon and BCN.

Sat in the waiting room at 10h45, waiting for my 11h00 meeting, I thought my heart was going to beat out of my chest it was going so fast. Annoyingly they were running 40 minutes late, which didn't help my nerves one bit.

Eventually my name was called, my legs were so wobbly I thought I was going to fall over as I walked to the room. As soon as I walked in the door (I didn't have time to even sit down or take off my coat), my surgeon shook my hand and said "We got it", I think I didn't hear him properly so I said "sorry?" and he said "we got clear margins".... I promptly burst into tears and high-fived him!!

What is a clear/negative margin:

He then told me that I would need 3 weeks of radiotherapy (aka rads - which is the minimum time they can give it to you for) and (as my BC is ER+) to take Tamoxifen for 5 years. I have to start the tamoxifen straight away and the radiotherapy will start 6-8 weeks from the date of my operation, so that will start around 5th-19th March.

My BCN then had a quick look at my scars, one where I had my SNB during the first operation and the other where I had both WLEs (they went in the same incision during the second op) and she said both were healing nicely. The reason there is the 6-8 week wait from the date of the operation, is that they need to make sure the skin is completely healed before they start rads on it.

I have a planning meeting on 11th February when I'll find out a bit more about what radiotherapy. involves. Until them, I'm off to celebrate!!