Last we left things the score was Treatment: 0, Cancer:1.  Endocrine (hormone) therapy was unsuccessful, so on to the next treatment option.  While chemotherapy was on the table for a hot minute – I spent most of July 4th weekend coming to terms with having chemo in my life – just a few days later the “team” came back to me with a proposal for radiation and surgery.  (As I mentioned in my previous post, I have to remember that I am living my life moment-to-moment).

At this point, radiation makes sense – the tumor is localized and there is no evidence that the cancer has spread to other areas of my body.  The goal of radiation is two-fold – shrink and sterilize the tumor.  Sterilizing means killing the cancer cells so that they can surgically remove the tumor without worrying about seeding (the medical term for spreading).

Yep, surgery…that’s a new one for me.  I didn’t really see that coming.  Indeed, I actually thought I’d have some good news on the radiation front – my radiation oncologist proposed to a “committee” that I have proton radiation instead of photon radiation.  Why would this be good news? Photon is the traditional form of radiation that zaps an area of the body, as opposed to proton which zaps a very targeted location.  It’s hard to think of an analogy; the best I can come up with is a lantern (which shines light on an area) versus a flashlight (which shines light only where directed).  The benefit of proton is reduced side effects – both long and short-term.  There are less than a dozen proton machines in the country and one is at Mass General.  Because there are so few machines – it is “competitive” to be approved – the radiation oncologist must demonstrate that the risks associated with the photon will be significantly reduced with the proton.

Unfortunately, I was not approved for the proton radiation.  The committee determined that there was no significant benefit with the proton.  I will move forward with photon (5 weeks, 5 days a week starting on July 30th) and then see what happens with the surgery.  I’m going to deal with what I have to do now and worry about the things I can’t control (surgery) when the time comes.  I am feeling relief that I have a plan for the next 5 weeks – I don’t feel trapped in the treatment conundrum.