February 10, 2010
As I’ve discussed here, I suspect radiation played a role in the onset of my breast cancer. How big of a role? I’ll never know. But between the ages of 12 and 14, I regularly received blasts of radiation for the monitoring of scoliosis. I don’t know exactly how many x-rays came my way in total, but I do know that protecting my breasts was never mentioned.
Later, as a health writer, I grew increasingly wary of medicine’s willy-nilly use of radiation. My concern escalated in 2008 when I wrote a piece for Time Magazine about the potential hazards of CT scans, especially for children. The basis of the story was two studies indicating an increased cancer risk associated with multiple CT scans. I was blown away to learn that each CT scan packs as much radiation as up to 500 conventional x-rays. Of course, CT scans can be a life-saving diagnostic tool and should absolutely be used when necessary, but my reporting found that they are widely overused.
Not to mention, the operator-error factor. One of the most disturbing tidbits I uncovered in reporting that story was from a CT technician who admitted that even though newer scanners can be adjusted to give children up to 50% less radiation (a standard recommendation), many technicians simply forget to reset the machine.
Needless-to-say, I was thrilled to see the New York Times tackle the issue of radiation safety these past couple of weeks, and I want to help them spread the word. What first grabbed my attention was this article about the lack of radiation safeguards. The people most often in harm’s way? Cancer patients.
Thousands of radiation errors are made every year, many of which are never reported to the FDA. Here are just a few of the most egregious examples from the NYT’s coverage, When Medical Radiation Goes Awry:
- Patient A had just completed treatment for a brain tumor and received additional radiation intended for Patient B, who had breast cancer.
- A 31-year-old woman with vaginal cancer was overdosed because of confusion over the method of measuring the strength of radioactive seeds…causing an overdose of radiation to her rectum and vagina.
- A doctor implanted radioactive seeds in the wrong location in a patient with prostate cancer. The radiation oncologist then failed to promptly interpret a post-implant CT scan, which would have revealed the error.
- A patient with breast cancer received a 50% overdose for 10 treatments because a wedge (a gadget used to shape the radiation beam) was mistakenly left out.
- Another breast cancer patient, 32 years old, received 27 days of radiation overdoses (three times the prescribed amount).
Thankfully, I’m not the only person who was flabbergasted by the magnitude of these medical errors. The NYT’s coverage culminated today in the news that the FDA is finally going to “take steps to more stringently regulate three of the most potent forms of medical radiation, including increasingly popular CT scans.” I’m not a big fan of the FDA. I think the agency is spread too thin and given too little resources to get the job done. But, at the very least, maybe, someone is finally paying attention.
March 19, 2009
The bad news: the surgery hurt like hell (again).
The good news: the surgeon’s office called late this afternoon with the latest pathology report. The tissue margins were clear (aka the surgeon did not slice into the tumor as feared), and the tumor was smaller than anticipated, less than 1 centimeter.
Time for a margarita.
March 16, 2009
Mary and I are up before the sun, preparing for another long drive to Indy. Pre-op arrival time is 10:30; surgery is at 12:30; they tell us we’ll be home in time for dinner. I am hopeful. For reasons too lengthy and complicated to explain at this early hour, I am headed back to the same surgeon. I’m giving him the chance to correct his error. I trust his technical ability 100 percent. I believe his error was one of oversight. With his reputation on the line, I know he’ll bring his A-game (too bad he didn’t bring it the first time).
These past few days have been a blur. I found a new therapist; I call her my “cancer shrink.” She helped me to diffuse my emotions–a good thing. I visited family and friends in Louisville and gained much strength from their love. And I read, re-read, and deeply appreciated every email and blog post. Thank you all for feeling angry, sad, and frustrated for me. While, I am still all of those things, I did find a place of emotional equilibrium to usher me through today–or at least to the doors of the operating room.
Meanwhile, Mary’s got my back. For those of you who don’t know Mary, she is amazing. (So much so that she deserves her own post, which is on its way.) But, for now, just know that even with her crazy-making academic career, Mary has been by my side at every appointment, held my hand through every procedure, and asked the tough questions when I was overwhelmed.
Since today’s questions are tougher than ever, we’ve called in reinforcements. Our generous, smart, fearless friend, Z, is coming along to support Mary in her quest for answers. The three of us motoring up to Indy to kick ass and take names is quite the picture.
Wish us luck!
March 12, 2009
He missed the tumor.
I’m headed back to surgery on Monday.
I can’t believe this is happening.
I was thrilled to get the drains out yesterday. Finally, I felt almost-human again. Reflexively, my hand went to where the tumor had been. Of my body’s typography, this is a location I know intimately. Which is why I was disturbed to feel a lump. Albeit, a smaller lump (more of a button than a broach) but still very much a lump. I pointed this out to the surgeon. He said it was probably “fatty tissue.” I made him feel it. “Nothing to worry about,” he assured me. I assured him–I’m a worrier. I need to know what this thing is. He tsk-tsk’ed and sent me downstairs for an ultrasound. His nurse smiled brightly.
Slowly, things began to unravel. The ultrasound confirmed the lump was solid–a huge calcification at its core. But was it a new lump or the same lump? A biopsy was ordered. But before they could plunge a needle into my aching chest, Mary remembered the lump was tagged. During my biopsy in January, the radiologist inserted a tiny metal tag next to the mass. She explained that it acts like a beacon shining brightly on future mammograms to help techs sort new lumps from old. At the time, I felt like an animal tagged and released back into the wild, but yesterday that tag made all the difference.
Alerted to the tag, the radiologist switched course and ordered a mammogram (yup, a mammogram. don’t ask). Afterward she and I stared at the display in disbelief. There was my tumor in black-and-white. Metal tag still firmly in place. Shining brightly. Illuminating the spot where–without a shadow of a doubt–the cancer still lies.
So many questions.
So much sorrow.
So much disbelief.
So much anger.
Forgive me if I don’t post for awhile, but I don’t have words to describe how I’m feeling.