When I was pregnant with Aidan I wanted to know as much as I could about pregnancy, labor and birth, so I decided to take a lamaze class.
The teacher, Harriet, was about 75 years old. She was 5 feet tall with jet black hair. In addition to knowing lamaze backward and forward Harriet also had lots of interesting stories about how birth used to be in the city.
She told us about illegal home births in Manhattan and in the outer boroughs where groups of women would gather at the laboring woman's home and all help the baby earthside. She shared with glee the first time a man (gasp!) was in the laboring room with his wife. He handcuffed himself to his wife's bed and refused to give up the key. And then there was that time when they all protested in front of city hall to advocate for a birthing center in Manhattan.
All this went down in the late 60's and early 70's and from what I could gather these acts of civil disobedience brought about a sea-change in maternity care in the city. What started them down this radical path? It was for many reasons, but I think it was primarily because western medicine had overstepped its bounds with regards to birthing.
As I have shared before on this blog, having cancer, in so many ways, is like being pregnant and just as those birth radicals observed and responded to the over-medicalization of birth, so have I seen the tendency toward the over-treatment of cancer, and I am responding.
Don't get me wrong, cancer can kill you, so its best to make sure to treat it until it's gone but continuing to treat after the cancer has been cured? I'm not convinced. Which is why I flew all the way to Philadelphia to speak with Dr. Lawrence Solin after I found an article he wrote about this very topic.
Dr. Solin, it turns out, was the perfect person to see. He told me that every opinion could be supported with the current research which says, yes, no and maybe, someone should receive radiation after a mastectomy, depending on the specifics of their situation.
After he said this he want to on talk to me about my cancer and my treatment and about what makes my situation a-typical: I had chemotherapy first.
Rather than go though the details of all the relevant studies and the specifics about my cancer and course of treatment like Dr. Solin did for me, I share with you an excerpt from the paper which helped me make my decision about radiation:
"Similarly, in 102 patients undergoing mastectomy with clinically positive nodes before neoadjuvant chemotherapy and pathologically negative nodes afterward, the risk of chest wall and regional nodal recurrence was between 0% and 10.8%. These locoregional recurrence rates fit into a low-risk category of patients who are unlikely to experience improved overall survival from radiotherapy."
Translation into English: when a gal with Stage 2 cancer has chemo first and it cures her cancer, like completely cures it, like on a cellular level, her risk of recurrence is between 0% and 10.8% and radiation can't make it any lower, because there is nothing lower than zero.
Whereas the short and long-term side-effects from radiation are pretty significant and the risk of getting at least some of those side-effects is pretty high, way higher than 10.8%.
So, thanks Radiation Oncologist, but, I think I'll pass and stick to getting my radiation the old fashioned ways: from space or from a tanning bed.
