Treatment #2: Radiotherapy?

Supposed to post this earlier but I got lazy hahaha zzz now I have a backlog of updates:

Thursday, 29th January 2015

I had an appointment with Dr Lim to discuss the results of my PET scan done a few days before. This scan was done after 6 chemotherapy sessions, and was supposed to check on any signs of mass/cancer activity left in my body.

My scan showed that the mass has decreased — what's left measures 4.7 x 2.8cm (compared to the previous scan, 6.2 x 4.2cm). But there's a concern over the activity part, because it INCREASED from SUV3.6 to 7.0. This can mean two things:

1. The PET scan is very sensitive, and it may pick up activity from scarred tissue that will slowly go down given more time

2. There's still some disease left which means that radiotherapy is needed to zap it off

They've arranged for another PET scan after CNY on the 23rd Feb to try to make sense of things. But for now, my doctor is more keen on radiotherapy to get rid of the cancer totally. He says he rather 'overtreat' than miss out on something which can be worse.

But on the brighter side of things... I'm off my (blood thinner) injections and PICC line!!!!!! Major hallelujah! I have been injecting myself twice a day for the last 4 months my stomach got pretty badly bruised. I got used to the PICC line but yes, really really glad to get these two out of the way.

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Wednesday, 4th February 2015

Dr Lim discussed my case with other specialists (radiologists, radiation oncologists...) last Friday and he helped to arrange for me to meet Dr Yeoh, a senior consultant in radiation oncology today. I think the consultation was around an hour?! He explained radiotherapy thoroughly — the history, side-effects, my case... 

Honestly I wasn't keen on radiotherapy AT ALL. (HELLO... I WON'T SIGN UP FOR ANOTHER CANCER TO HAPPEN IN THE FUTURE!) I've always thought it was a really bad type of treatment (must be all the horrible stories of old technology radiotherapy). Ok la, then again, chemotherapy is equally horrible!!!! Scientists should find even better cures for cancers ASAP. But I can understand where the doctors are coming from, pros vs cons. Like what Dr Yeoh said, there can only be so much scans I can do. Plus, most of the time, he says that patients who keep doing scans, the results are hot-cold-hot-hotter... In other words, time is of the essence. We wouldn't want to wait and only find out one day that the cancer has deteriorated. *touch wood*

Because I started off with a HUGE tumour (12.6 by 6.5cm), chemotherapy can only do so much to shrink it. Most lymphoma patients will still have abit of cancer cells left because of the tendency that our tumours are naturally larger in the first place. Dr Yeoh described chemotherapy as a systematic type of treatment (i.e. it goes through the whole body), while radiotherapy is localized. 

With modern technology, radiologists are able to blast the radiation at precise locations that only hit the affected cancer cells. But every treatment comes with side-effects and risks right? Since my mass is at the chest area...

Short-term side effects:

- Redness of the skin ("You mean like sunburn?" "No, for sunburn there's peeling. But for this... It's like spending 2 hours walking at the beach")

- Dry cough

- Fatigue

Long-term side effects (20 years down the road):

- Secondary cancers: Skin, bone, lung, breast

- Heart and lung problems 

Dr Yeoh assured us that these secondary cancers only occur to a reallyyyyy small percentage of people. As we grow older, risk of cancer goes up anyway. I ran into Dr Lim at the entrance, so nice of him to say hi and check on me. After balancing the pros and cons, the doctors agree that getting rid of my current tumour entirely is the safest option, and an option that will give me a peace of mind, rather than playing the waiting game.

And since there's a pre-treatment session for radiotherapy for the doctors to decide on how they are going to carry out the treatment (e.g. how to localize the radiation such that it has minimum effect on my vital organs)... I have an appointment booked next week on the 11th. The real treatment begins on 29th Feb (if I decide to go through with it, after my PET scan on the 23rd Feb). It will last for 3 weeks every day (????!!!!), and 15 minutes each time. 

Gah.... why can't SGH be in the east?!