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Breast cancer treatment: After radiation therapy ends

My dream of living a life free of breast cancer seemed possible when my radiation therapy at the University of Miami Sylvester Cancer Center ended on Thursday.

My naked torso looked like a Piet Mondrian cubist painting, as a reddish square covered the left side of my chest. My skin was irritated. It was peeling. The burns hurt, but I was feeling happy.

If all had worked as planned, the radiation I received every week day for about a month had destroyed the remaining menacing cancer cells.

“Your skin did great,” said radiation oncologist Dr. Cristiane Takita. It didn’t look that way.

During the last week of treatment, when the alcohol-free aloe gel had stopped working, Takita prescribed Silver Sulfadiazine, a white thick topical antibacterial cream. “Just continue to apply it. Your skin will heal in a few weeks,” she said.

But as painful as the burns were, the fear of suffering in vain was far more haunting.

Cancer cells are vicious. Even after being exposed to chemotherapy, even after the tumor was removed, even after the remaining tissue was radiated, the cells can metastasize. Like silent killers, they can spread and multiply with a vengeance.

“I am really scared of developing a secondary tumor,” I said. Many women my age have suffered and died after a recurrence. I had read some of their blogs online. Takita said a high level of suspicion was to be expected.

Cancer that begins in the breast often ends up spreading to the lung, liver and skeleton, according to the American Association of Orthopaedic Surgeons. Patients with metastases to the lung and liver experience no symptoms during the early stages of the disease. Bone metastases can be painful. In some cases, a metastases to the spinal bones may result in paralysis.

During the past couple of weeks, I have witnessed a sad parade of cancer patients using wheelchairs and walkers. I have heard women say that headaches or sudden issues with mobility had led them to discover that the breast cancer cells had spread to their brain.

“You are receiving the best treatment available. You need to take that into consideration … living your life in fear is not the way,” said Takita. “You can worry about metastases if it becomes an issue … now go on and be happy. Have some fun.”

To help me with the fear, I plan to visit the director of the Courtelis Center for Psychosocial Oncology, Dr. Maria B. Currier, with regularity. During a recent session, she asked me what I had learned about myself during the treatment.

“I learned that I was stronger than I thought I was,” I said. And then I began to cry. I thought about the suffering I had experienced since the Aug. 1, diagnosis, and the sacrifices that I have had to make. And although I felt like damaged goods, I knew I had emerged with glimmery inner beauty. My external appearance would be aided by a plastic surgeon, a nutritionist, a physical therapist, and some fashionable female trickery.

“You are one tough resilient cookie,” Currier said. We talked about my decision to have my ovaries removed when I have the reconstruction surgery. We talked about my love for children, and how difficult it has been for me to be around them lately. I stare at them with sadness.

“The dream. The idea of a family has shifted. You are still mourning the loss,” said Currier. “It’s a process … there will come a day when you will be ready to see the many options that are available to you — from adoption to having a surrogate mother.”

But that is not in my near future. I now have to focus on the next stage of my treatment: Tamoxifen, a drug that blocks the estrogen, which the cancer cells in my primary tumor fed on.

To protect my quality of life, I have to deal with possible complications. Physiatrist Dr. Tamar Ference recently checked my arm for signs of lymph edema, a condition of localized fluid retention. About 10 to 15 percent of women who undergo the removal of underarm lymph tissue and the breast develop the condition.

“You have to wear the compression sleeve even if it’s just for an hour a day,” said Ference. She had prescribed the sleeve a few weeks ago, but I didn’t want the thick fabric near my burns. The friction was extremely painful. “You can put it on and lift your arm away from your body for about an hour a day.”

Ference, who is a breast cancer survivor, was excited about my progress. She smiled, raised her arms and said, “You did it!’’

I really hope so. I don’t want my mom to suffer on my behalf. There is a pertinacious woman in me who refuses to give up on her dreams. I want more time to do the things I love. I want to be a mother one day. I want to meet more friends from different cultures. I want to continue to travel the world.

I need and want to believe that a cure is possible, so I have a meeting next week with a man who said that in my case it is.


Part 1: At age 33, I’m dealing with breast cancer

Part 2: Cancer treatment complicates dreams of pregnancy

Part 3: Hanging in when chemotherapy gets rough

Part 4: Tough surgery choices: Mastectomy vs. Lumpectomy

Part 5: Silicone implans are not the only way to go in breast reconstruction

Part 6: Rebuilding the breast from body tissue

Part 7: Body fat can be used to build breast

Part 8: Facing my fears after mastectomy

Part 9: Taking control of the fear that comes with breast cancer

Part 10: Doctor knows about being a breast cancer survivor

Part 11: Radiation therapy gives her hope

Part 12: Finding strength from others

Part 13: Facebook, medication help breast cancer patient deal with depression

Part 14: A new outlook on 2012

Part 15: Breast cancer patient faces genetic mystery

Part 16: Using diversion to cope with harsh reality