Winter has come in with a roar–very cold with a good deal of wind, and a day of light snow that led to lots of accidents because it was such a surprise. I am ready for spring!
Following my last chemotherapy–my very last!–I had a rough time with great fatigue and feeling just plain crummy. That lasted almost three weeks and, toward the end of that time, I went to the cancer center to be hydrated, hoping that would help me feel better, as it had at an earlier time. An alert nurse got permission from my doctor to test my blood. My white count was critically low and that was the cause of the fatigue and feeling crummy. There’s little that can be done other than to beef up good nutrition and rest. I did both and I am now feeling better. What I want, however, is to feel good!
It had been made clear to me in the beginning of my treatment that one possibility after chemotherapy and radiation therapy was that I might be a candidate for cranial prophylactic irradiation. That would happen only if the results of the other treatments were positive. It would kill off any undetected cancer present in the brain and prevent metastasis to the brain. Chemotherapy and radiation to the lung have been positive–the tumors have shrunk so much that some consider me in remission–yeah!–so, the question was put to me as to whether or not I wanted the brain irradiation. My first response was “yes,” without much thought.
Then I began to think about the possible consequences of having my brain–that with which I think–irradiated. I began to do some research on the web and discovered some possible problems that concerned me. And, my cousin called with news that a friend of his brother-in-law had had brain radiation and had suffered cognitive loss as a consequence. I did not want that. One article I read said that it was contraindicated in the elderly, and I certainly qualify for that! A result of my gathering information led me to question my earlier decision. My radiation oncologist, a fine doctor, was willing to make an appointment just to discuss my concerns.
The doctor was able to point out that some of the negative data I had collected were outdated and changes had been made in the procedure to compensate for the problems. He went over the typically positive results, including a possible long-term remission. (He used the word “cure,” but I know that’s not a popular word in the world of cancer treatment.)
Following my conversation with the radiation oncologist, I walked down the hall to talk with the social worker about the same issue. She pointed out that I was concerned about my cognitive functioning and, if the cancer metastasized to the brain, my cognition would truly suffer. It was also likely that I would not be able to stay home alone, but would need to be in a nursing home. I want to avoid a nursing home at all costs–don’t we all?
I made a decision. I will have the CPI (cranial prophylactic irradiation). The radiation oncologist agreed that I could start after Christmas, but not as late as the first of January. I will have the preparatory work done–which includes having a mask made and paper work–on December 14 and begin the CPI on December 27. It’s a decision I’m not fully comfortable with, but which makes sense when I look at the statistics and consider the alternatives.
love,
nan