1/2 way done with radiation!

Today i am 1/2 way done!

I have had 14 of 28 radiation treatments for my colorectal cancer. So strange because i feel like it is flying by but also taking forever to complete.

I am doing Intensity Modulated Radiation Therapy (IMRT) which is a high precision radiotherapy that delivers a precise radiation doses to my tumor. IMRT also allows higher doses of radiation focused on the tumor while minimizing the dose to the surrounding normal structures (although it is inevitable that i will be put into menopause because of the location and the fact that my ovaries are right there too- so yay me 😐).

Each treatment lasts 106 seconds (yes, i count each day) and that is it. It is important for me to count each day because i know I’m 106 seconds closer to the finish line (for this part at least). So i have had 1484 seconds of radiation since starting. After today, i have another 1484 seconds to go. Doesn’t seem like a lot of time in the long run.

Also to update everyone, I’m doing ok. I am a bit more tired but that is to be expected. I am enjoying the days where i can sleep in (usually til 7:30 which is late for me) but i also like getting up early and going to Orange Theory to work out before i go to radiation and then work. I’m trying to stay as active as possible because i know that will help my recovery from surgery. I have no radiation burns (yay!) but i do have some pain in my lower back/bum from the radiation but it is manageable. So when i say I’m ok, i am really ok!

Thank you to everyone checking on me and sending me prayers. It is much appreciated. 💙

I waited….you shouldn’t

So i’m going to be honest about my diagnosis, which is really hard to do because this is the thing that crushes me when it comes to my cancer story. But if me being honest helps ONE person, then there is a reason why i am going through this.

I had colorectal cancer symptoms for over two years.

There it is. I shook my head as i wrote that. I also can see people’s eyes when i tell them that. And i hear “Oh Lara….” when i say it. I had symptoms for over two years. And i didn’t go to my doctor about it. Because why would a young, healthy DOCTOR believe she had cancer. I thought i was stressed. I thought i had IBS. Cancer was not a thought in my mind.

I started having blood in my stool (very little) when i was studying for an exam 2.5 years ago. I was stressed out to the max and figured it was that. Then the blood went away once i finished studying and life was normal. See, it was the stress (that’s what i told myself). The blood came back a couple months later but was very little and then it was gone again. I never had constipation or pain and being a physician, we see blood in stool ALL THE TIME. Guess what it usually is? Not cancer. And so my symptoms went on like that for two years, but got a little worse over the past holiday season. So when i saw my PCP this February i told her and she urged me to get a colonoscopy.

I sometimes go down the path of “what if i had gone earlier?” What stage would i be? Or if had gone right when it started, would it just have been a pre-cancerous polyp that was removed? And alternatively, what if i waited even longer? I was (well still am) a busy physician who felt like i didn’t have the time to take TWO days off for a colonoscopy. My life would be so different when i think about all of these things. But i cannot dwell on that part. I cannot change my past and can only control my future. So here i am, battling Stage 3 cancer, for better or for worse.

So i’m once again sharing symptoms because Colorectal cancer (cancer in the colon or rectum) first develops with few, if any, symptoms. Please be proactive and talk to your doctor and don’t wait like i did. If symptoms are present, they may include:

  1. A Change in Bowel Habits, including diarrhea, constipation, a change in the consistency of your stool or finding your stools are narrower than usual
  2. Persistent Abdominal Discomfort, such as cramps, gas, or pain and/or feeling full, bloated or that your bowel does not empty completely
  3. Rectal Bleeding- finding blood (either bright red or very dark) in your stool
  4. Weakness or Fatigue- can also accompany losing weight for no known reason, nausea or vomiting

Additionally, the American Cancer Society recently recommended that adults without a family history should begin colorectal cancer screening at age 45. This is a change as of this year- it use to be 50, so take note!

Thankful

I just wanted to come on here quickly and let y’all know what i am thankful for at this moment.

1st- i’m thankful it is the weekend and i’m getting a break from chemo and radiation. It really is draining and although it is daunting that i am only on radiation 9/28, i know i can make it through this part.

2nd- i’m thankful for people continuing to ask how i am and if i need anything. Right now i don’t need anything except prayers….i’m sure that will change and it will shock y’all when i actually have something that i need someone to do. But for now, i’m ok.

3rd- i’m thankful for my work family at the VA. They give me hugs when they see me, they offer to see patients for me (which i totally am capable of doing but they are trying to make me REST), and they have rallied around me and some are offering to transfer some of their time off to my time off when i have surgery and undergo IV chemo. I’m so humbled by this action and would have never asked for them to do this, but appreciate it more than they know. Oh- and the rumor going around the hospital is that i have PANCREATIC cancer. I laughed when i heard this and said that i was not Alex Trabek and politely told them that i had colorectal cancer. 😉

4th-i’m thankful for my family- my rocks, my support, my steadfast loves. I would not be able to make it on this journey without them.

What are YOU thankful for?

My second post: my cancer story

I found out that I had colorectal cancer on 5/8/19 after a colonoscopy at MUSC here in Charleston.  I had been having some blood in my stool for longer than I want to admit (I know, I know), but it would come and go and get worse with stress and better other times.  I thought as a healthy, in shape 40 year old, that I had IBS and while I joked “maybe it is cancer,” I never thought in a million years it would be.  Again, I am 40.  I am healthy.  I have no risk factors for colorectal cancer.  And the worst thing is that I’m a doctor and I know signs/symptoms, but why would I ever think that I have cancer? And even more frustrating, I get upset when my patients don’t do the things that I tell them…..but more on that later.

So I had my colonoscopy, fully expecting the doctor to explain she didn’t find anything and took biopsies to rule out things like Crohns, Ulcerative Colitis, or Celiac. In recovery the doctor came in and looked like she had seen a ghost.  “It isn’t good, is it?” I asked.  She said “no” and went on to tell me how she found a mass (she said 10 cm in size) and took biopsies and it is likely cancer and I would need to get labs that day and be scheduled for scans and a surgery consult within the next few weeks.  Carson almost fainted.  This was not what we were expecting.

The GI doctor also mentioned that my siblings would need a colonoscopy asap because of family history being a risk factor (so sorry Paul and Leslie) and that my child would have to get a colonoscopy at the age of 30 (10 years prior to the age of my diagnosis- sorry Taylor)

When we left, I called Taylor, my daughter, and I honestly don’t remember what I told her. She was 2 days away from graduating college and had been stressed with a few “life events” (including her dog getting attacked at a pet store), but I don’t remember the call. THEN I immediately called my dad, who called the Chair of the Department of Surgery, within a few hours I had a CT scan and MRI scheduled for that evening (to look for metastatic disease and for staging) and had an appointment with the surgeon the next day. I always said that I live close to my parents so that I can take care of them when they get old, and while that is still true, that day I realized that I live close to them so they can take care of me too.

That night I had my CT scan (and the techs let me look at it and I could see that there were no metastatic lesions in my lungs or liver- yay!) and then had my MRI for staging and went home to get results the next day with the surgeon. I don’t really remember anything else that evening.  I’m pretty sure we called some family and friends but that night is a blur. I was in shock.  I still am in shock.  I feel like life was “normal” up until Wednesday the 8th and then I went into this nightmare/dreamworld alternate universe.  Kind of like Game of Thrones seasons 1-7, and then the nightmare that was season 8. Just kidding about GOT. I do love that show and didn’t actually mind the 8th season. If you want to talk about all things GOT, just text me. 😉

The next day, Carson (my fiancee) and I met with the GI surgeon at MUSC, Dr. George, and his PA Karen.  My dad also showed up for the appointment. I actually went to the appointment fasting in case they wanted to admit me and do the surgery the next day. I wanted this thing OUT. But I wasn’t offered surgery for the next day. We found out that the tumor is Stage 3, T3cN2, meaning that T3= tumor invades through the muscularis propria into pericolorectal tissues and N2= 4-6 lymph nodes are positive. It is also 7cm in size. Not exactly what I wanted to hear.  During the appointment we talked about a treatment plan and because of the stage, no surgery right away, and then I was set up to meet with Oncology and Radiation Oncology the next week. Surgery has been scheduled for 9/3 tentatively. That seems like forever from now. But don’t worry, I will be busy with other treatments.

By the time those two other appointments rolled around, I had read A LOT of information and pretty much knew what I was going to be facing over the next year. On 5/13 we met with the Oncologist and discussed his part. The plan is radiation/chemo for 28 days and then proceed with surgery after a 8 week “rest” period to allow the colon to heal from the radiation.  Then after surgery, I will be on IV Chemotherapy for 6 months, one infusion a week.

We then met with the radiation oncologist on 5/18. Dr Warren at MUSC is amazing and I loved him and his personality and the good bedside manner he has (I also have emailed him a half dozen times over the past week and he has graciously written me back VERY LONG emails explaining things).  At our appointment we discussed the option of short vs long radiation- it was something the surgeon brought up and Tumor Board had discussed. With short radiation, it would just be 5 days of radiation, followed by a rest week, and then surgery.  Long radiation would be 28 days of radiation + oral chemo, then rest 8 weeks, then surgery.  Of course the doctor in me wants this OUT NOW and to get on with surgery and then IV chemo.  And I have been reading studies and the short vs long radiation BOTH have favorable outcomes.  BUT- I have lymph node involvement.  My cancer is complicated. And per Dr Warren, it would be beneficial to be on oral chemo to combat those pesky lymph nodes while doing the radiation.  And while I hate the lengthy drawn out process, I agree with him.  And my good friend Courtney made a point- she said, what if I did the short course radiation (with no chemo) and years down the road the cancer comes back and then I think “if I had done the long course radiation with chemo, would it have come back?”  I want to make sure I do everything I can to prevent this cancer from coming back.

So now we have a oral chemo/radiation plan. I will start this upcoming Tuesday (5/28 ) and my last day will be 7/5. I will be doing chemo and radiation 5 days and week and “rest” on the weekends.

And for those of y’all who are curious, I will be trying to work while doing oral chemo and radiation. I might be a little fatigued and I might have a hard time sitting down (damn radiation pointed right at my butt), but I plan on working as much as I can! I do however, plan to take time off when I have my surgery, so don’t worry, I not trying to push myself too much. 🙂