Kansas Snapshots by Gloria Freeland - August 19, 2022

I received my diploma!

As husband Art and I approached the medical building, I almost did a little jig. I was to get the last dose of my 16-day radiation treatment for breast cancer, and I was excited to be done.

My "journey" began in late January, when Art discovered a lump in my left breast near the sternum. I had a mammogram the previous September and it was normal. So while I knew they weren't foolproof, I was surprised.

In early February, I met with my primary care physician, who then referred me to the Women's Imaging Center to have a diagnostic mammogram. It looked suspicious. The next step was a biopsy, which showed cancer � a lump with a diameter a little smaller than two M&Ms side by side.

I was referred to surgeon Dr. Henry "Hank" Doering, who performed a lumpectomy on March 9. He also removed a couple of "sentinel" lymph nodes from under my left shoulder - a routine procedure to check if the cancer had spread. I wrote about that surgery in my March 18, 2022 column, "Knockers Up!"

Little did I know that I would undergo two more "excisions" - one on March 30 and another on April 8 � to take additional tissue from the margins of where the lump had been removed. DCIS � ductal carcinoma in situ, a sort of pre-cancerous condition - had been found. One in five women require the second surgery, but only one in 25 will require a third. Sometimes it isn't good to be special!

Thankfully, the third time was the charm! And the lymph nodes removed during the first surgery were also clear - more good news meaning the likelihood the cancer had spread to other parts of the body was less than one in 20.

Chemotherapy was not called for because the cancer had been discovered early, it apparently hadn't spread and there were no other signs it would be of any benefit. The likelihood I would later die of breast cancer was now the same as any other woman my age. But there were post-surgery options that would reduce the likelihood of a reoccurrence.

We spoke with Doering and learned there was no problem with going ahead with our planned early-May trip to Germany to visit our "adopted" German kids Nadja and Tim and their families and a subsequent late-May-early-June trip to Wales with our daughters and spouses and, later on, Art's daughter and granddaughter. While overseas, I ALMOST forgot I had more decisions ahead.

Five days after returning, Art and I met with radiation oncologist Dr. Martin Bell, who suggested a 20-day regimen of Monday-Friday radiation treatments. That same day, we spoke with medical oncologist Dr. Travis Koeneke, who said hormone treatments could be considered after radiation was completed.

On July 1, I had a Computerized Tomography (CT) scan to "map" the upper part of my body and receive four alignment dot tattoos. Along with three lasers, they allowed me to be precisely positioned on the therapy table. The first treatment was on July 18 and took about an hour followed by a question-and-answer chat with Bell and Physician�s Assistant Brenda Avery.

I then marked "R" on my daily planner for the subsequent 10:15 a.m. Monday-Friday appointments.

The daily treatments were pretty routine. Typically, I checked in via a card with my individual bar code ID on it, waited a few minutes in the lobby until called, followed by changing into a hospital gown. Then I lay face down on the "patient table," where the radiation therapists adjusted my position based on the dots and lasers. Once properly positioned to target my left breast, I had to lie totally still for the few-minute duration of the treatment. Then it was back to the dressing room, where I applied lotion to my left breast, dressed and left to go about my day.

Mondays were the exception. After the treatment, there was a meeting with Bell and Avery. Art went to all of these and also accompanied me on some of the other days. The treatments weren't painful and everyone from Bell to the receptionists were all extremely helpful and friendly.

Art's support has been important to me, too. His insatiable curiosity and scientific bent have meant he has done research on many aspects of breast cancer and treatment options. He also has kept family members and friends informed by writing a series of 11 detailed updates. One friend told me he learned more about me than he had ever known before. I laughed and said, "Probably more than you wanted to know!"

Other than a minor daily inconvenience, the only effects have been feeling a bit more tired than usual and my left breast being more sensitive than normal - both common effects of radiation.

The plan had been a 16-day radiation regimen for the whole left breast followed by four "boost" radiations targeting the location where the lump had been removed. I opted not to do the boosts as research showed they reduced the likelihood of a reoccurrence by less than one percent.

When I told Bell of my decision, he smiled and said, "I think that's a perfectly good decision, and I wouldn't lose any sleep over it."

And I haven't.

On August 10, I stood next to my therapists at the Central Kansas Cancer Center and rang a bell indicating I had finished my radiation treatments. I also received a diploma tied with a purple ribbon. As a long-time teacher, at first I laughed as I had done nothing more than show up. But a diploma can be any sort of official document, typically signed by the conferring parties as this one was. Maybe I should frame it for my office. I'm not as proud of it as I am of the others, but I am certainly happy to have it.

Top row (l-r): Recovering from the third-time-is-the-charm surgery; three of the four positioning tatoo dots; patient table. During radiation, patient lies face down. Note gap in table for the breast to hang through. Bottom-left: about to receive CT scan. Center: on the patient table with the radiation source positioned to radiate the left side of the breast. Center-bottom: all treatments completed. Gloria holds her diploma and the bell chord. Bottom-right: diploma.

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