At last, I know.....less than I did before.

Yesterday I met with the radiation oncologist for the first time.  I was so hopeful that after that appointment I would finally have some certainty and know what was next and when that next step was coming.  But the appointment left me more in the dark than ever.

The surgeon prepared me for the fact that I was facing 6 weeks of daily radiation.  The medical oncologist also told me I was looking at 6 weeks of daily radiation.  But the doctor in charge of the radiation process isn't so sure about all of that.

I never realized I would potentially have other options.  But apparently I might.

One potential plan is the six weeks of once daily radiation that I've been mentally preparing for.  But I may be a good candidate for a more intensive round of twice daily radiation that lasts only five days.  That would certainly be easier on my life.  The side effects would be more intense, but not for nearly as long.  Perhaps I'd have to take a couple days off work to rest up, but compared to six weeks of daily radiation and weeks (perhaps months) of fatigue...the quick and intense option sounds appealing to me.

And another option that I never would have dreamed of would be even easier.  I might be able to skip radiation altogether.  The doctor put all my risk factors into something called the Van Nuys Prognostic Index and determined that my score is 6, which means I have a pretty good shot of this being over and done with without having to mess with radiation at all.

I've been dreading radiation.  It would be much easier if I didn't have to go through it.  But at the same time, the thought of skipping that precautionary step scares me.  A lot.  The last thing I want is for the cancer to come back.  And radiation will reduce the chance of the cancer coming back.  Sure...my score of 6 bodes well for not needing to be zapped.  But if my score had been one point higher--a 7--they wouldn't even be tossing this option around.  They would radiate me without question.  And I'm not convinced that I trust these people in Van Nuys enough to take that risk over one point...especially knowing that my mother's breast cancer did come back, even after she had been treated with radiation.  If the miracle radiologist hadn't found my lump in its ridiculously early stage, and this had all happened a year from now instead...I'd probably have been a 7.  Which is the greater risk--over-treating or under-treating?

Before any decisions are made, there is a CAT Scan in my future.  That will help the doctors to see something about the cavity where the lump was removed (sorry...the details started to blur at this point in the appointment) to see if the 5 day radiation is a viable option.  Then "Cancer Council" will convene to discuss me.  This is a group of doctors including my surgeon and the radiation oncologist and some other experts.  They'll talk amongst themselves as to what might be best for me.  Then the radiation oncologist will report back to me and I'll have to decide how to proceed.

In short...what I know now is that I won't really know anything about my future for at least a few more weeks.

Waiting.  Again.  Always waiting.