Christ Hospital is a tough drive.  The traffic, combined with the hills, curves, and many lane changes in the Mt. Auburn area, is very stressful for Cathy.  The driving made a hard day even harder.  Today we met with a radiation oncologist who we liked very much, but her location at Christ might eliminate her from being part of the treatment.  I think Cathy can handle a trip or two to Christ for surgery or other sparsely timed events, but the regimen of radiation will be too stressful.  Unfortunately, I think Cathy has been the victim of one or two too many traffic accidents that weren't her fault.

The appointment itself was also tough.  While the doctor was extremely knowledgable, had a nice personality, and good bedside manner, the information was difficult to digest.  The doctor felt with 85% certainty that Cathy would need to have radiation.  She also felt that radiation would be a good course of action regardless of the lymph node biopsy outcome.  Because of the triple negative cancer type, the high rate of proliferation, and Cathy's young age, the doctor felt that radiation would give her the best chance of not having a recurrence.  The downside is that having the BRCA1 gene mutation makes Cathy's cell reparation process flawed, increasing her chances for some other kind of cancer that is the result of all the radiation exposure.  I think the percentage is somewhere in the neighborhood of 1-2% as opposed to <1% for BRCA-, but I'm not sure my percentages are accurate (it was a lot of information to process, I know I missed some).

Developing another type of cancer seems to be a common thread in the possible side effects of cancer treatment.  I guess when you're using nasty methods to treat a nasty disease you have to face some other nasty outcomes.  I remember that my nuclear medicine doctor warned me of a 1% chance of leukemia as a side effect of radioactive iodine therapy.  That's was a risk I was willing to take to treat 100% certain thyroid cancer.

We have lots of research to read and we need to get some further opinions before we decide on this one - before Cathy decides on this one.  I feel pretty certain, though, that Cathy won't want to go to Christ five days a week for five weeks, as would be the treatment protocol.  It's obvious, though, that the treatment options and protocols for radiation present a lot more variables than with surgery or chemo.  This makes the decisions much more difficult.

On the brighter side of things, Cathy made an appointment with a plastic surgeon.  The initial contact has been favorable and Cathy is excited (at least as excited as you get when you are lining up for surgery).  The peripheral neuropathy has diminished over the last few days, as well.  Thank you for the flood of prayers.  Hopefully, it will stay mild after this next chemo cycle.

Cathy is tough, but not superhuman.  We're praying for clarity, confidence, and comfort.