Then I am going to get my nails done and head up north to my friend Caren's house. Maryann and Vickie and I are spending the day together with Caren....Lunch at Caren's- Spa afternoon--Dinner out. (I think I might have my first drink before Noon). The 4 of us have known each other since 1974---- 42 years. There are 2 other great friends from that time period. Jan- she has to work - she is a teacher of Art down in Asbury Park.....and the other Nancy. I will miss them both on Friday. Nancy was not invited because she has drifted away from us "girls" so to speak. If I had my way, she would be included. I still want everyone to be together regardless of how relationships shift as I am not one to let go easily in relationships. Thank goodness for my friends- they really help keep me together. I feel loved and valued. And I count on them for plain FUN- The next day, 3 of us are going into Manhattan to see a matinee show and have an early dinner. Then I will be coming home to get ready to go to Atlantic City for the New Jersey Social Work Annual Conference- I really am looking forward to some alone time.
It is hard for me to have all of my feelings when I need to be concerned about other people's reaction. While I am alone, I can sort through my thoughts and emotions without judgment or fear. At the suggestion of another long - time friend and colleague, Rona, I made an appointment to talk to someone whom I used to see a year ago. At the very least, it will provide me with safety and maybe help me get a better perspective on living well with a cancer diagnosis.
Today at Radiation, I learned I am getting a "BOOST"- An in depth explanation is written below but basically, it targets the area of the lumpectomy to "boost" my survival rate and kill off cancer cells surrounding the surgical site. So I now have an extra tattoo and a big black mark around my surgical incision- I will wash it off tomorrow morning. Good night everyone, and sweet dreams.
A Radiation Boost - "A Little Extra" At The End of Radiation
Early-stage breast cancer is often treated with a lumpectomy or mastectomy and radiation therapy. Even though the tumor may have been small and no metastases were found, women and their doctors still look for ways to prevent a recurrence. The technique of giving a radiation boost at the end of treatment has been very effective in keeping breast cancer from coming back.
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A radiation boost is one or more extra treatments targeted at the tumor bed. This extra dose covers a small area and affects the tissue where cancer is most likely to return. Radiation boost treatments are given after the regular sessions of radiation are complete. Women who are 40 years old or younger at time of treatment get the most benefit from a radiation boost, but patients of all ages will have a lower risk of recurrence if they receive a booster treatment.
How is a Radiation Boost Given?
Breast cancer patients may have whole breast radiation (WBI) or partial breast radiation (given with external beams or brachytherapy), after which boost doses are given. If you're having a lumpectomy and are planning on radiation, surgical clips may be placed at the time of surgery, to help your radiation oncology team target your tumor bed during treatment. Your boost dose may be given with external radiation, via interstitial catheters, or from within a brachytherapy applicator.
The targeted boost dose may be given in one session, or during five to seven daily sessions.
Effect of Risk of Recurrence with Early Stage Breast Cancer
After being diagnosed with breast cancer, the first decision you may face is whether to have a lumpectomy or a mastectomy. You have to weigh that decision with the fact that breast cancer is most likely to recur in the same breast, right at the tumor site.
Many women opt to remove the whole breast, in hopes of never having breast cancer come back. A radiation boost is designed to prevent recurrence at the tumor site, even after a lumpectomy. Research has shown that women who had a radiation boost had fewer local recurrences - up to 50% less - when compared to those patients who didn't have the boost. Doctors hope that, because of better radiation techniques, more women will be able to choose lumpectomy over a mastectomy, and have a better quality of life after treatment.
For patients diagnosed with early stage breast cancer, either ductal carcinoma in situ(DCIS) or invasive breast cancer, a radiation boost protects against recurrence. Most patients who have a lumpectomy will qualify for radiation with a boost, and in some rare cases, mastectomy patients may also have radiation and the boost. There is some disagreement among radiation oncologists as to whether or not a radiation boost really benefits a patient diagnosed with DCIS, but it has become the standard of care.
It's thought that a radiation boost may decrease the need to have a mastectomy due to recurrence after a lumpectomy by 35%.
Effect on Survival
Even though a radiation boost significantly reduced the risk of breast cancer recurrence, it did not appear to have any effect on overall survival up to 20 years out. This does not mean that a radiation boost was ineffective, as concerns in addition to survival are important for people to consider during treatment.
Side Effects of Radiation Boost
A radiation boost is generally tolerated quite well, with fatigue being the most common symptom as with conventional radiation treatments.
A radiation boost does not appear to raise the risk of complications of radiation therapy, such as infection, and did not increase the risk of secondary cancers related to the extra radiation. Secondary cancers are cancers that arise due to the cancer causing effects of cancer treatments such as radiation.
Fibrosis is the most significant side effect of a radiation boost and radiation fibrosis can be quite annoying. Studies have found that at 5 years, as well as at 10, 15, and 20 years post radiation boost, the risk of breast fibrosis is substantial. Thankfully this risk is often less of a concern for younger patients.
