Frankly I don't know. I just accepted what the oncologist said. I had
radiation on one breast only but think it was from two sides. It was ten
years ago and my memory isn't what it was - it never has been :-)

It's certainly not my place to advise because I have no experience (I think)
of fallout radiation but you can't be the only woman (or man) who's had
breast or other cancer treatment following such exposure. Don't you know
anyone? I mean, if the fallout radiation caused a huge increased risk of
breast or other cancers then you must know someone, I know lots of people
who've had breast and prostate cancers without experiencing fallout
radiation.

Percentage increases in risk following fall out radiation aren't necessarily
significant, Tim can explain more about that.

Percentage increases or decreases in risk of not having or having radiation
therapy aren't necessarily significant either.

My approach was to put myself in the hands of the experts who were dealing
with the situation on a daily basis and do what they said. I wasn't always
happy at the time but so far (ten years later) they've been right :-)

At 69 I'm very happy. And unlike people from USA I had no choice in the
people I had to trust.

By the way, a fellow cancer patient, who lives close to me but we didn't
meet until we were in the ward together, refused to take hormone medication.
She's still doing well too - but one swallow doesn't make a summer.

I just don't know, sorry ...

Mary

Mary

Can you put words on your anxiety? What do you think is going to
happen?

You still can.

Notice I'm /not/ saying or implying you should, I'm saying that you
still have options: Treatment and recovery is a process, you are still
working through it.

I opted for a mastectomy (against my oncologists advice), thinking I
would be getting a  re-consruction right about now.

I'm actually not thinking about reconstruction at this time - perhaps
in the future I will. I'm fine with my mastectomy. It's the part of
treatment I have recovered the best and quickest from, by far.

I look good in my clothes. I feel so comfortable wearing my breast
form that I forget it's there. My husband is fine with the way I look.
He'll support me if I go for reconstruction, but has made it crystal
clear that if I do, it will be for me, not for him. At this point I
just can't /choose/ more pain and misery for myself. I just want to
enjoy life while I can.

I have found good info here: http://breastfree.org/

It's possible you did, but even so, that's not automatically a reason
not to get /radiation treatment/.

No, but why is PBR less terrifying?

Remember, Les, no woman ever died from the tumor in her breast. It's
the mets that kill you. Cancer cells left in your breast can send mets
to your bones, brain, liver. That's why lumpectomy is only as safe as
mastectomy /combined with radiation/.You really need to discuss this
with a radiation oncologist before you decide. We are not doctors
here.

You're /not/ a wuss, you have been hit by a terrible disease and some
truly lousy options :-(

Ixia

Please consider this.  The local radiation limit to a particular tissue
is about real measurable tissue damage, things like burning, scarring,
hardening and loss of function of the tissue.  Clinical signs. It has
little or no connection to total radiation body dose, which is mostly
about cancer risks and cannot be physically measured in the body after
the fact.  Obviously radiotherapy does add a significant whack to your
total body dose, but as it is confined to one particular area, it is
only slightly increasing the (long term) cancer risk around that area,
while drastically reducing the short term very significant cancer risk
from the tumour residues.

So separate the two parts and balance them off. You can ignore the
effect of environmental radiation on your local radiotherapy limit, it's
a tiny fraction of what your are going to get zapped with.  It's not
like downwinders get a sunburn or anything from the fallout: it takes a
physicist or a statistician to even know it's there.

The additional long term cancer risk from radiotherapy as far as I can
see should be simply additive to the background level. So the additional
risk you are facing is the same additional risk as everyone else is
facing taking this treatment, it's just that you start with a higher
base risk, that you are already living with.

So basically the risk-benefit analysis only differs in this - the
average life expectancy for downwinders may be a little lower than for
the population at large, so do the analysis for a woman 5 years or so
older than you are, and you've got it covered.  I doubt it would ever
make a difference to the prescription, age isn't a big factor in the
radiation decision.

This is not about a rational decision about risks and benefits, this is
about fear of radiation in general, engendered by your previous
exposure.  Like you say, a phobia.  The thing to address is overcoming
the fear, then you can examine the clinical issues rationally, and see
that actually, there aren't any clinical issues.  Hence the doctor's
blank look - they tend to go that way when faced with psychological
problems.

I'm not belittling your problem, I do understand how these things can
get under your skin, but the answer is still to divide and conquer:
break up the problem into bite-sized pieces and 'defeat it in detail'.
Like Ixia said:

Go through it slowly step by step.  What do you think the radiation is
going to do to you, and what do you think it is going to do different
from what it would do to an unexposed person.

Tim

Les, I've been thinking about you a lot. Please don't take this question as
advocacy, but I wanted to ask: Has anyone suggested double mastectomy to
you? I am genuinely wondering.

In your shoes, I would be very very afraid to do radiation. Heck, I was
afraid anyway. I did have mastectomy and...well, it's not perfect but....