Radiation Oncologist

Exactly four months since my initial diagnosis, with my rescued and nicely manicured wig in place (thanks to Maria and her sleight of hand), Al and I drive through a rainy Brisbane afternoon to meet my 'radiation oncologist' for the first time.

I've rescheduled this appointment no less than three times so I'm glad to finally be meeting her.

The Radiation Oncology Mater Center (ROMC) is directly opposite the Mater Mothers, and I can't help observing the juxtaposition of birth against a process generally associated with dying.

Located in a fairly old red-brick building, I present myself at the front counter and afterwards, go to sit in a virtually empty waiting room. I don't know how long this is going to take so look around for some reading material.

I am quietly amused to note the stack of novels on offer. Just how long do people have to wait here? A cursory inspection reveals that, thankfully, it's more a 'Mills and Boon' rather than a 'War and Peace' kind of waiting period. The tea urn, microwave and television also do not augur well, suggesting one should get comfortable.

It isn't too long though before I'm called in by Dr Judith Cox. She's older than I had imagined, a lady with a trendy short cut who immediately strikes me as being open, kind and friendly.

In what passes for her office, there's a little bit of a kerfuffle as we realise that several pieces of information are missing from my file and she's not 100% on the details of my case.

She doesn't know I've had a mastectomy, and then, I can't remember if I had one or two lumpectomies.

As we wait for the missing paperwork to be recovered, I launch directly into my pressing concern: whether I can wheedle my way out of radiation.

I talk about all my other friends with radiation, Kim who hasn't had chemo and I don't think she's had radiation either, Chrissy who didn't have radiation, Cathy who didn't have chemo, Mary who didn't have a mastectomy. Why do I have to have all four, including the hormone treatment? I'm going to have the other breast off. I'm pitching as hard as I can with Al also offering up any arguments he can.

You see, if I'm to have radiation, that will add weeks to my treatment.

But most vexingly, it will mean that I will have to wait six months until I can have a reconstruction and then, my options will be severely limited because of the extent of damage radiotherapy can do to your breast tissue.

The business of getting on with my life will be severely retarded.

As it is, initially, Dr Cox thinks I've only had one lumpectomy and she leads me to believe that perhaps radiation is unnecessary.

I can't believe my luck!

But when Dr Cox says she needs to see the results of all my procedures before she can provide a definitive answer, my hopes are quickly dashed.

I am interested in what the pathologist had to say about the results of my mastectomy: "The sections show residual classical lobular carcinoma in situ... There are three foci of residual invasive lobular carcinoma in this area measuring up to 2mm. There is extensive lobular carcinoma in situ throughout all quadrants of the breast. Further 2mm focus of invasive ovular carcinoma is present in the lower inner quadrant. The invasive and in situ carcinoma appear well clear of margins of excision. There is no lymphovascular invasion. There is no invasive ductal carcinoma identified. No lymph nodes are identified..."

To a layman, it would appear that surely, all is good? The margins are clear. The lymph nodes are not involved.

But Dr Cox is concerned about the occurrence of carcinoma in the inner quadrant which is the area closest to the sternum.

She produces a pen and starts writing in my file. She adds up the findings in the pathology report for each procedure I've had so far and it's close to five centimetres when she's finished.

I've already been through this with Dr Lambley so I'm not surprised.

Dr Cox says that my breasts are not particularly big (really!) which means the occurrence of carcinoma closer to the chest wall is a concern.

The verdict, alas, is that she strongly recommends radiotherapy. In fact, the look in her eye suggests I'd be a fool not to go through with it.

At this stage, it looks like five weeks with around 25 shots to be given in that period although this is still to be confirmed.

I ask her about side effects and she mentions skin changes in the treated area.

I ask her about fatigue and, apparently, if you've had chemotherapy, you won't notice any difference. (The fatigue can be chronic if you only have the radiation).

Dr Cox says I'll need to present next month for a 'planning meeting' and then, I'll commence radiation three weeks after my last chemo.

Apparently there is presently a 6-week wait for access to this service but I'll be sweet as I've come in to see her early enough so I'll be in the queue.

I can't say I'm excited. In fact, I feel as flat as, well, half my chest. It sucks.

That's five more weeks of being treated like a 'patient'. Five more weeks of hospitals. Twenty five more days of sitting in waiting rooms. An extra 50 hours minimum of travelling.

I know I should be grateful. Yesterday I spoke to Eddie who is doing some landscaping for us. He wanted to know about my bald head so I explained my situation.

Eddie used to be a bodybuilder. But he was also a smoker and you can tell from the raspy voice and the cough. (It's funny imagining him pushing weights and stopping in between sets for a drag on a Winfield Blue). Eddie had radiation and chemotherapy for both thyroid and pancreatic cancer he tells me. He received his treatment at the Atomic Research Centre in London. As a result of his chemo for thyroid cancer, the poor bugger lost all of his teeth. They fell out one by one. He was in his early 50s at the time.

He showed me his teeth and tapped them with a finger. "All false," he announced.

"Well, here you are live and kicking so I guess it's all worth it," I said.

"Yup," said Eddie. "I've got nothing to complain about."

"Yeah, we're really lucky, Eddie," I replied.

I'm lucky I have such great support - from medical staff, from family, from friends.

I'm lucky in so many ways.

Today my race simply got a little longer.

I'm just going to have to dig deeper for that second wind and hope like hell that when I cross the finishing line I won't be completely cactus.

What is there to do but buckle down.