End of active treatment meltdown over missing 1 out of 20 rads

dl1129

I have been relatively 'unflappable' through my treatment for DCIS - lumpectomy and radiation. Perhaps having recently supported a friend through chemo for breast cancer, I had perspective from the start that this was, relatively speaking, no big deal. I will also start a low dose of Tamoxifen within the next 3 months.

I had a 3 week course of whole breast radiation, followed by a 4 day boost (I ended up doing 3 days). The boost was primarily because I had a 1 mm margin at the skin, and the surgeon took all the breast tissue he could possibly take. My RO agreed the boost was likely to be of small added benefit to me.

Everything went pretty swimmingly, all considered. I treated the breast 2x daily with mometasone cream prescribed by the doctor, and had only minor skin side effects. I did feel generally unwell during rads, some days were better than others. I decided to do the boost. Out of the blue, the night before my last treatment I had an irrational meltdown and decided I couldn't do anymore. After I missed it, and removed my stickers (negating the chance to do it later that day), I had a bigger meltdown that somehow this ONE treatment, 25% of my boost, was going to be the consequential one that would determine my long term outcome. I know that's not rational given what my RO said, and I think my reaction is more complicated than that. I think I missed out on having the symbolism of an "official" end of treatment, a clear delineation to tell my mind "we're done!" and thus I feel incomplete.

Yes, I had anxiety before treatment (!) but this came in like a tidal wave out of nowhere... after coping super well throughout. I planned to finish. I don't know what happened and I hate that my mind is now using that missed day to torture me.

I appreciate having a place to vent this.I feel like my mind is an evil mad scientist!

Reader425

dl1129 emotions are complicated! I wonder if you could make a brief appointment with your RO and talk with her about that one missed session? I have a feeling he/she could explain the impact in terms that might put it in perspective.

Just a thought. I loved my RO. I made a random comment once about "the inevitability of heart issues with my left-sided BC." She immediately discussed it and showed me via scans why that was not necessarily true. Very helpful to me.

Salamandra

aww dl1229, I'm sorry it's been tough.

I think speaking to your RO is a great idea. Whatever the reality is, it will be easier to face than the fear of the unknown. I suspect it won't be as bad as you fear - most treatment is pretty conservative.

I'll also say that avoiding treatment or even asking the question reminds me a bit of what my psych described as PTSD symptoms. Like your brain and body just won't cooperate with something that, at some level, triggers the trauma for you. I think cancer can be a very tricky journey mentally and emotionally, and if you do have access to mental health support through your cancer center or otherwise, it would be a great time to use it.

dl1129

Thanks to both of you for your replies. I ended up recovering from this meltdown pretty quickly. After being relatively unflappable from diagnosis til that very last day, it seems I went out with a bang. Apparently I saved up all my anxieties and fears for the grand finale.

I see my RO for my first follow up on 5/20. I already knew from her that she was comfortable with me choosing not to do the boost at all (she expected it would be of small benefit in my case) so I don't expect her to quantify a "risk" associated with not doing 1/4 of it.

Just trying to learn from the experience now... not eager to repeat it! On Thursday (actual last day), I do recall making a conscious choice not to go on Friday. I felt so ill and I also felt confident that that last day was not going to be consequential (i.e., there are unknowns, and there will always be unknowns, whether 19 or 20 sessions). I deeply felt DONE and that I had had enough (in a literal sense, that I'd had enough radiation). But then I forgot all of that by Friday... and went down a rabbit hole of irrationality, as if I had set myself up for it. Our minds can be so darn tricky!

kber

Hey - you've been through a lot and one or two emotional outbursts are totally legit.  I am also pretty steady, but had a spectacular melt down over the automatic blood pressure cuffs my center uses.  You'd have thought using a manual cuff was a life and death issue and my outburst earned me a visit from the phycologist and concerned follow ups from my MO and about half the nursing staff.  Very public and very embarrassing!  

Oh well.  We are fighting monsters and it's OK if the enormity of it all occasionally penetrates the armor we wear every day.  

AliceBastable

I had my meltdown at the beginning of rads. I'd been unflappable and even cheerful through the lumpectomy, re-excision, and another large surgery. But at the rads set-up, I found out I'd have the 33 day course of treatment instead of the 16 days the RO had mentioned as a possibility when I first met him. We snapped and hissed at each other for about ten minutes, then he explained that because I had a micromet and some other changes from the initial pre-pathology assessment, I needed the longer course with a wider field. It made sense, but I was still cranky for a couple of weeks. Part of it was because I was still uncomfortable from the non-breast surgery (robotic radical nephrectomy) and my body and brain were just exhausted at that point. I started feeling better after those first weeks and my attitude really improved. But getting through rads is as much mental and emotional, like a nightmare version of the movie Groundhog Day.