A typical morning: Up before 7, dressed and out the door by 7:15. A short drive to Maine Medical Center’s radiation clinic, use the keypass to get into the little radiation parking lot. Down one flight to the clinic, into the johnny, ready for a 7:30 appointment. Things run close to on time that early in the morning. Into the treatment room, assume the awkward position, arm bent strangely over head. The machine moves into position, aligning to marks in the skin set weeks ago. A few words from the technician, ready, aim…
Home a little after 8. Maybe stop for coffee on the way and plunge right into the day. Maybe, in the later weeks, go right back to bed, absord another hit, reboot in an hour or so. Serious moisturizer on the treatment area, enough to soak through clothes. Soon the day is in full swing, so close to normal, so close.
Mary Rose began her radiation treatments on Monday, August 11. After the weeks of anxiety and suspense while she healed from surgery, it was an immense relief when this last stage of treatment finally began, just as the ideal window to commence was starting to close. The purpose of radiation was twofold: to destroy any possible, undetected cancer cells in the local area and to make the point of origin for the cancer an inhospitable place for any possible return. Smoke the enemy out of his hiding place, kill him, burn his village to the ground. It would take 28 treatments over almost 6 weeks to accomplish this.
For all the fear and visceral reaction it naturally conjures up, on a day-to-day basis radiation is an almost subtle treatment. There is no pain during the procedure, and the side effects can take weeks to emerge. The greatest concerns were damage to the skin to a degree that would inhibit future reconstruction and debilatating fatigue. I’m pleased to report that, like with her entire course of treatment to date, Mary Rose’s reactions were on the positive end of the spectrum. Her skin held up well, the fatigue was mild and late in coming, the prospects for more reconstruction are good. Mostly, it was just a drag; the early rising, the discomfort, being locked into treatment 5 days a week. She stayed home while I took the kids to the Hamptons for a few days at the end of August and then brought Brendan to college on Long Island. She made good use of the time, but a very lovely beach seemed very empty without her.
She kept very active and healthy throughout the 6 weeks. Most days she would show up at my office door at some point in sneakers and shorts and ask (in that way for which there is only one answer) if I wanted to go walking with her. I would dutifully stop pushing pixels and comply. Still on medical leave, she could attempt to catch up on tasks and projects that months and years ago seemed impossible. The long awaited, seemingly mythic yard sale may yet happen after all. Many right-wing and easily manipulated media outlets will no doubt celebrate the day she returns to work and no longer has as much time to launch verbal fullisades across their digital bows.
With radiation as a manageable routine with a fixed terminus, we started to see around the next corner. This will end. What began in unspeakable fear and horror will end in a mild burning sensation, the journey between chronicled in scars. What next? The killer has been beaten back. How to keep him from returning? We met with Dr Gerburg Wulf at Beth Israel in Boston on August 22 to discuss the long term prospects. She outlined the options for multi-year hormone therapy, recommending Tamoxifen to block the effects of estrogen until menopause sets in, followed by aromatase inhibitors to suppress estogen production; a course of low-level treatment lasting five years, all aimed at dramatically reducing the chances of recurrence. And what are those chances? I could catalog how every aspect of Mary Rose’s treatment, temperment, spirit and determination affect that possibility, but I think instead I will simply quote Dr Wulf when she said, “The odds are overwhelmingly in your favor.” I’ll take those odds any day.
On September 6, with a new season and a new school year for the kids underway, we went for a follow-up visit with Dr Ana Niegowska, Mary Rose’s oncologist at Mercy Hospital. Dr Niegowska was very pleased with the course of radiation to date and with Mary Rose’s overall condition. There were many questions about hormone therapy, possible side effects, prospects for the future. I had a question about language. Radiation would soon be complete. How then would we describe Mary Rose? In remission? A breast cancer patient with no detectable breast cancer? In a 5 year limbo without definition? What would be the appropriate terminology? Dr Niegowska seemed almost puzzled by the question at first, and then simply said, “As far as I’m concerned she is cured.”
Cured.
The word used to seem impossibly remote, presumptious to even wish for or utter, all determination aside, and yet here we were. We knew the course of treatment was curative all along, we knew she was progressing towards this, but it was the first time a doctor said it. Cured, meaning there is no more detectable cancer and they are going to do their best to keep it that way. Cured, meaning that breast cancer can be spoken of in the past tense. Had, not have. Cured, meaning welcome to the other side of all that. She was poisoned, cut and burned, she walked through fire to get here, she is not the same but she is still herself, and she is here.
Welcome.
