Rad.

Rad.

I had my consultation with my radiation oncologist yesterday which went well. Dr. Tsuji spent well over an hour with me taking my history and explaining the process and side effects of radiation therapy. It’s always extra comforting when a physician comes in having already reviewed your chart and having an individualized plan in mind.

Although I had an excellent response to chemo and the post-surgical pathology shows that there was no residual cancer in the tumor bed or the lymph nodes, radiation is important with breast-conserving surgeries to get rid of any cancer cells that may remain in other areas of the breast that weren’t removed (as they would have been in a mastectomy). So, Dr. Tsuji recommends 4 weeks of whole-breast radiation (no axillary radiation since nodes were clear) with a boost to the tumor bed. After everything’s been set up, I’ll go for radiation 5 days per week, likely starting the 2nd or 3rd week of January.

Birthday stay-cation! Thankful to have many options to “get away” in Honolulu!

The side effects of radiation therapy are fatigue, which generally increases as the treatment progresses, and skin irritation which is basically like a bad sun burn. With radiation to the breast, the radiation oncologist takes as much precaution as possible to minimize radiation to the lungs and the heart. One way to protect them is to perform a breath hold during the treatment to raise the breast tissue away from the organs as the lungs expand and so we may see how that goes when I do my simulation in a few weeks.

I also need to be sure my left arm range of motion improves before I can start radiation since I’ll likely be positioned lying on my back with my hands behind my head. I can get there now, but it’s not at all comfortable due to the cording. My PT did work on it last week and it got significantly better after just one treatment, but it’s not quite there yet so I have some goals in the next few weeks!

I’ll see my oncologist on Thursday for a post-surgical follow up and planning and will see my surgeon after that to have my bandages removed from my port surgery. Thankfully, all is going well and everything is healing up nicely. Overall, I’m feeling well but definitely looking forward to being able to be more active again. I’m thankful to be on the last stretch of treatment and starting the new year cancer free!

Aloha ❤

Cancer & Pelvic Pain Conditions

Cancer & Pelvic Pain Conditions

On today’s blog, I wanted to bring attention to female pelvic pain and dyspareunia (pain with intercourse) secondary to cancer treatments.

Often, when a woman is put on adjuvant hormonal treatments, chemotherapy, or fertility-saving drugs during active treatment, the body goes into a state of menopause or “chemopause” as it’s commonly referred to in the cancer world.

Low estrogen levels during chemopause can cause symptoms like:

  • Amenorrhea (loss of menstrual cycle)
  • Low libido
  • Vaginal dryness or atrophy
  • Hot flashes
  • Mood changes
  • Joint aches and pains

In particular, vaginal dryness or atrophy can have a huge impact on sexual health, emotional health, and relationships post-cancer. If the pelvic floor muscles are compromised by treatment, it can result in pelvic pain (like pain from overactive or tight pelvic floor muscles, pain in the tailbone, lower abdominal pain, or pain around post-surgical scars), bladder/bowel changes, or painful sex.

Thankfully, a pelvic floor physical therapist with specialized training in examination and treatment of the pelvic floor muscles can treat these conditions and are an amazing asset to oncology patients on their road to recovery. Some PT treatments for pelvic pain and dyspareunia may involve:

  • Pelvic floor muscle strengthening or relaxation exercises with or without biofeedback training (computer or ultrasound-based pelvic floor training technology)
  • Stretches for tight muscles around the abdomen, pelvis or hips
  • Manual therapy including general massage, pelvic floor muscle release techniques, or scar tissue mobilization
  • Education and lifestyle strategies surrounding posture, nutrition, bowel and bladder habits, and lubrication options during intercourse
  • Education in the use of vaginal dilators to reduce pain that occurs with tampon insertion, gynecological exams, or sex
  • Encouragement around body image and sexual health (this could include referral to a sex therapist or psychologist when appropriate)

If you’re reading this, and you feel like you could benefit from pelvic floor physical therapy during or after cancer treatment, you can find a qualified pelvic floor PT in your area here or here. Ask your doctor for a referral today!

And a quick reminder for all of us…
The path to recovery from cancer involves a whole host of treatments including chemo, hormonal treatments, surgery, and radiation just to name a few. Each of these treatments can come with significant side effects or long-lasting comorbidities. Just because someone is “cured” from cancer doesn’t always mean they are living without long-term effects from treatment. Keep this in mind, and be kind!

*This blog is part 2 of Pink October’s Pelvic Floor Series, a way to raise awareness of pelvic floor problems during cancer treatment and discuss sex & intimacy after a cancer diagnosis.

Aloha ❤