Bill Murray, Chemo Mascot

     Round 5 is under my belt as of this morning.  Fistbumps all around!  I slept through almost the entire thing, putting headphones on not only to jam out but to drown out all the noise.  If you were wondering where everyone in town was this morning, well, I think they were all in the Drug Den.  Who knew I was sharing this side of town with so many cancer peeps?  The place was packed!  The nurses had to make an announcement (very pleasant and nice) that family and friends of patients had to vacate the cushy seats they were sitting in next to "their" patients so that arriving patients could find a place to sit for treatment.  It was crazy busy.  I came home by 2 p.m., ate some lunch, and went right to sleep until 6 p.m.  And I feel like I could go right back to sleep in a few minutes.  So I'll just bang this out before I begin the post-chemo hibernation.
     John and I went to a consult with a radiation oncologist last week.  We were  very impressed with her--great communication skills, answered all our questions, did a lot of referencing answers back to my PET scan images to talk about how radiation would go for me.  (And she's darn cute and a snappy dresser!  She was wearing some fierce peep-toe pumps, I might add.  So both the oncology doctors are really attractive and well-dressed women--maybe that counts for a little extra somethin' somethin' in fighting my cancer?)
     Anywho, this is what I learned:

·        Regardless of what the final PET shows, the radiation oncologist recommends radiation treatment, specifically because the PET can show baseline numbers on the tumor and the lymph nodes but, because this is a systemic cancer, radiation is used to put the final nail in the coffin of the stem cells in the bone marrow that are manufacturing the cancerous blood cells that started it all.

·        I also fit the protocol for radiation because my tumor was considered “bulky”—bulky means how big, and although mine was only 9 cm and bulky is usually 10cm+, it is also defined by how much of my chest cavity the tumor was taking up.  I now know that my chest cavity is 22 cm wide, so if the tumor takes up more than 1/3 of that, it fits the bulky category.

·        Both the radiation oncologist and my hematology oncologist stated vehemently that there should be no surgery whatsoever.  In fact, my primary oncologist said if someone mentions surgery with lymphoma, it’s a lawsuit.  Apparently surgery used to be standard in the old days—now with what they know about lymphomas, it is too high a risk that surgery would shake something loose to travel through lymphatic or circulatory system to start up elsewhere.  She said if surgeons are operating and see a lymphatic tumor (apparently ones with experience can tell what they look like), they will just close you right back up, end of story.  So the scar tissue mass that will be left after my treatment is done stays there no matter what.  A permanent cancer souvenir for me.

·        Her recommended course of radiation is 5x a week for 4 weeks.  This is a short program of radiation, because lymphomas are (luckily) very sensitive to radiation.  It is also a low strength of radiation, less than half of what someone being treated for breast cancer would receive.

·        Radiation would start about 4 weeks after my last chemo.

·        As far as immediate side effects:  Nothing first few weeks, then skin burn in radiation zone, possible internal burn inside esophagus (then you have an excuse to have milkshakes), fatigue (but not anything worse than with chemo, and possibly better).  She said she had a patient compete in Ironman while doing radiation treatment--so although you will not be seeing me in an Ironman or any other triathlon or marathon, I'm looking forward to the idea that I can actually start to see a possibly slow but steady upward trend in my stamina that doesn't keep getting interrupted and bumped down to square one with chemo treatments. 

·        Radiation zone:  North and South:  from neck to about the top of my heart—so the zone does include a small slice of my heart.  East and West:  a margin that includes part of my esophagus to a margin slightly outside the final tumor/scar tissue mass area (not the original size).  This will be determined by the PET scan 4 weeks after my last chemo when I've processed all the drugs out of my body.

·        Possible long term effects:  Possible lung effects could be treated with steroids and would not be a chronic problem.  Possible heart effect could also be treated and managed.  However, this oncologist said the odds are very slim, and she has personally never had a patient come down with the heart condition associated with radiation.  The risk of damage to my heart from the chemotherapy drugs exceeds the risk from this proposed level of radiation.  Cancer is ironically a possible side effect. So that’s a roll of the dice.  If I come up with cancer in the radiation zone in less than 10 years, blame it on radiation. If it is more than 10 years or outside the radiation zone, that’s just my bad luck.  (John thinks I may have mixed the cancer side effect info up--it will give me more questions to ask another oncologist, I guess!)  If I have a recurrence of lymphoma, well, if it popped up in the same area I suppose we’d argue about it.

·        Both oncologists are of the opinion that the possibility for side effects is far outweighed by the opportunity to add some percentage points to the cure/survival rate.

**Sorry the font went all wonky...techno dinosaur doesn't know how to fix it! 

So this gives me things to think about.  I definitely feel less apprehension about radiation than  I did before.  I do want to hear another radiation oncologist's take on how he or she would proceed with my case, just to add another voice to the mix and not have my emotional response to it overshadowing the facts. 

And now you probably want to know about Bill Murray.  Well, this is the mystery of the Decor in the Drug Den.  Hanging high on the walls are four large framed prints of...well...it's hard to describe.  They look like photos that have been manipulated with filters to have this sort of overexposed, slightly washed out color palette.  And they have either an empty background or some graphic effect.  And these are the subjects:

1. A giraffe head
2. A roller skate--old school style.
3. Three quarters of a Buddha statue head.
4. A headshot of Bill Murray.

Yep, that's what I said.  Bill Murray.  A much  younger Bill Murray, maybe around the Ghostbusters/Scrooged era.  And I think, unless I'm imagining this right now, that he's pointing in a kind of, "Hey there, Tiger!" way?  The very first day of chemo I thought: What the hell is a picture of Bill Murray doing here?  And no offense to Bill Murray.  I like Bill Murray. I enjoy his movies, especially some of the movies he's done very recently.  Good stuff.  I suppose he's there to evoke comedy?  As a Buddha statue is to evoke...peaceful Zen Buddhist thinking?  As a giraffe is to evoke...giraffes?  I'm a little baffled by the grouping, I  must say.  I tried to take a photo of Bill today in the Drug Den...and my phone made the shutter click sound, but then when I got home the photo wasn't there!  Paranormal explanation?  Maybe.  I will try again on the day of the final chemo to capture Bill, Chemo Mascot, in celebration of finishing round six.  And I will share it with you.  I wonder if  Bill Murray knows he's been selected to raise the spirits of people undergoing cancer treatment?  Someone should tell him--he might like that.
This just in:  John has identified the manipulated photo of Bill Murray.  It's actually the Stripes Bill Murray.  So you don't even have to wait for it--imagine this in an overexposed and faded presentation:

Hey, you, Cancer!  Get outta here!  That's a fact, Jack!

Why did the chicken cross the road?

To get from the left to the right.

He stepped out of rank, got hit by a tank.

He ain't no chicken no more.

-Stripes