Radiation Oncology consult

I asked to meet with the head of radiation oncology.  My surgeon had told me that whether I need radiation would not be decided until after my surgery, based on whether any more lymph nodes are "involved" and how many.  I read some research articles that seemed contradictory regarding the specific criteria. The radiation oncologist spent a very long time talking with me. He told me my impressions from the research articles were correct and then showed me a couple of articles he has published attempting to clarify the guidelines for radiation. He basically told me straight out that I should definitely do radiation, based on what is already known about my profile.  He showed me statistics that demonstrated that radiation would improve my survival more than the Taxol I'm currently receiving.

This was hard to hear, because I already knew that options for reconstruction are not good (from my perspective) following radiation.  He told me that more people are choosing not to do reconstruction and that it doesn't turn out well for many people.  I felt this doctor was being very straightforward with me.  He said that everyone on the team wants to feel they're responsible for saving the patient's life but in reality it's the whole team working together.  I told him that I'm concerned about lymphedema, because from what I've read, if I have lymph nodes removed and have radiation, I'm almost certain to develop it. He said that's not true, that he would be very careful not to overlap certain margins, and that the chance is smaller than I'm thinking.  Here's hoping.

The radiation oncologist told me that I am eligible for a research study in which I would be randomly assigned to radiation or no radiation, but he advised me not to take the chance and to just do radiation.  He asked me if I would like to have my case discussed at a case conference and I said that would be fine.  Later the nurse left me a message saying that the team discussed my case and they were all in agreement that I should have radiation, regardless of the outcome of the lymph nodes removed during surgery. I will have to go every day for 6 weeks, from late May through early July.  They said that it will be okay for me to go to Guatemala in late July/early August.

In the end, I'm grateful that I have another caring and thoughtful doctor and that radiation will be walking distance from my office. Many people have to arrange temporary housing while going through radiation, so I do feel fortunate to have access to great care.