Well, I’m entering a new chapter of cancerland: radiation. I have avoided the radiation dance up to this point.
Alas, here we are.
One of the ways they monitor my metastatic breast cancer is through blood work and what they call “tumor markers”. If the tumor marker value is below a certain threshold, no active cancer. If it is above that threshold, “probably” active cancer. My tumor markers have been slowly rising above the threshold for a long time and then rose rapidly recently. My scans did not show any progression so the interpretation of the oncologist was that the cancer was stable.
My hip/pelvis stabilization surgery last month showed significant “space” in my hip where basically the cancer had eaten away at the bone. That sort of thing does not show up well on imaging. So, the surgery was to shore up the bone, which it did.
The surgeon recommended a round of radiation to my hip to kill off any cancer cells that might be hanging out. For weeks now I’ve been preparing for the radiation therapy. This includes a consultation with a radiation oncologist, a preparatory appointment with a PET scan of the hip and then a simulation appointment where they line up everything in the radiation machine.
I’ve completed all of that.
I’ve learned that there is an entire team of medical professionals that work on my case. The radiation oncologist leads the team. Radiation therapists are experts in operating the machines. Radiation oncology nurses help patients manage side effects and also communicate with the family. The medical physicists work with the radiation oncologist and others to make sure each treatment is tailored properly for each patient. The dosimetrists work with the radiation oncologist and medical physicist to develop the precise treatment plan for each patient including calculating the correct dose of radiation.
No wonder it’s so expensive!
At my first preparation appointment I got a few tattoos! Not as exciting as it might seem.
I have 3 small black dots across my hips that will be used to align the radiation machine using lasers. It’s very common to get these small tattoos when getting radiation. The radiation technician joked that he has done more small black dot tattoos than any tattoo artist in Boulder!
Now that everything is set up, I’ll have 10 doses of radiation over two weeks. I show up at the same time every day. It’s 15 minutes from when I walk in the building to when I leave. Fortunately the cancer center is only a 10 minute drive from my house.
The only hiccup is one that is not shocking. Insurance.
Cigna called to say that my radiation therapy is still not approved. The first request was for a procedure that did not conform to NCCN (National Comprehensive Cancer Network) guidelines. The radiation oncologist submitted a revised request. This one is still pending. It was pending as of 3:30 pm Friday afternoon. I can’t risk going to my 8:45 am appointment on Monday and not having it covered.
So, we wait.
Likely this will just be a short delay. It probably won’t have an overall impact on my situation. It is worrisome though because if I were in a more urgent situation, it would be frustrating and potentially harmful to delay.
In the meantime I’ll be spending the weekend doing some treadmill walking, playing with the cat, and reading some scientific papers on lobular breast cancer. Wishing you a weekend that is exactly how you want to spend your time.
Stay tuned for the next episode of Cancerland!
Current medication: (2nd line of treatment) Fulvestrant, Ibrance, Zometa, Lupron
I wish you well with radiation. I have 5 tattoos. They were playing 80s music when I was being marked. Somehow it amused me to be getting tattoos with Billy Idol playing. Cancer puts you in some odd situations. Our tattoos are harder earned.
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I like that – ‘harder earned’. Ain’t that the truth!
Hi, Sweetie! Sorry to hear you need to go through this, and to have to worry about insurance is the most frustrating thing about most medical procedures. One of my surgeons told me that he thinks they have a protocol of saying “No” 3 times before any “Yes”. It’s the uncertainty that is so maddening!
Know that we are all keeping you in our thoughts and prayers and looking forward to any updates. (That machine is very intimidating!)
Love you so much,
Thank you very much!
I am thinking about you and sending positive thoughts and prayers. I hope the insurance approved this ASAP and you get what you need without side effects! Keep us posted!
Thank you. I will! I am optimistic that it is only a day or two delay 🤞
Thank you for the update, and for explaining how things work. I am sorry you are facing things, and am mad at insurance for holding things up even for a second! A question: Does the radiation change the “lines” you are on at all, or the path forward on that?
Thanks for asking! No, my treatment (medication) line will stay the same for now. If anything the radiation would help me to stay on that line longer. At least I think that is the case.
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Hoping we get to see you when we get to Colorado late February, but please take care of yourself and “diss” us if you need to! Not sure if I spelled diss correctly, Dave and I would have said “blow us off”!
I so admire your courage and humor throughout all of Cancerland! I know you have your dark days, but your blog is inspiring. And insurance, especially Cigna…don’t get me started! We like to say that disability would reject a quadriplegic person the requisite 3 times! Hang in there and know that we think of you and yours SO frequently. Sending our love.