Zip zap zip

My radiation simulation – a kind of dress rehearsal for radiation – involved five technicians hovering around my inert, topless body and taking turns poking and prodding me into position on the un-comfy metal table, while urging me to hold still and lay heavy. Their multicultural combo of accents, the many monitors and hulking high-tech equipment, and the general futuristic vibe made me feel as if I were guest starring on an episode of Star Trek.

I certainly have the hair-do for it.

At one point, a Russian man and a Chinese woman stood on each side of me, both scribbling on my chest with their special medical markers and reciting numbers that seemed nonsensical to me: 84, 23, 17 (I wanted to pipe up, “Hut!”). Now I felt as if I were a disputed Sino-Soviet border territory, perhaps Mongolia or Manchuria, being divvied up.

Simulation involved maintaining a fixed position for a good (or, rather, bad) 45 minutes.

“My neck hurts from tilting my head at this angle,” I complained.

“You need to keep it like that; we don’t want to accidentally irradiate your throat,” a technician said.

Talk about instant motivation to stay stock still. A crick in the neck or months on a feeding tube? I’ll go for Door Number 1.

They try to liven up the experience with Muzak and a Hallmark-worthy mural on the ceiling depicting a verdant nature scene in unnaturally bright colors. Someone with a sense of humor had decorated it with little stickers of monkeys , penguins and other assorted geographically incompatible critters cavorting through the fake woodlands. The radiation-delivery device -- a linear accelerator, which looks like a giant’s dinner plate mounted on a mechanical arm -- was also festooned with little stickers of animals and Disney characters.

The actual radiation session was a lot quicker; I was in the room for less than 15 minutes.

“Jump up; butt here, head here and boob out,” a friendly technician said, patting the metal table. Another one tucked a warm blanket around my lower half.

Once they arrange me to their satisfaction, the techs file out into their control room where they supervise the proceedings on closed-circuit monitors. It looks just like the live-TV control room I’m using to seeing on Academy Award broadcasts.

As I lie on the table, a mechanical arm swings the accelerator into different positions over me. When it’s actually zapping, it emits a high-pitched whine and a sign that says “X-ray in progress” lights up on the wall. The four different zaps take just a few minutes in total.

Including putting on the hospital gown, waiting to be called, getting prodded into position, getting zapped and getting re-dressed, each daily radiation session takes about 30 minutes. My standard night-time exhaustion is now kicking in earlier and earlier, and my chest area is starting to feel tender.

Summoning up the full power of my command of the English language, I would say that in comparison to chemotherapy, radiation sucks less.

Information overload: Pathology report

"Here's your pathology report, which is basically your breast cancer report card," Dr C said as we gazed at the three pages of single-spaced gobblety-gook. Mark and I had come to her office for the post-op visit.

Bottom line: I think I got a C+ or maybe a B-. Everything was sort of mid-range -- "not as good as it could be, but not as bad either," she said.

The tumor's "histologic grade composite (Nottingham)" was "II, tubule formation 3, nuclear grade 2, mitoses 1."

"Of course, you remember mitosis from high school biology," she said.

Mark nodded agreeably while I looked at her slack-jawed. Of course, I don't.

"Mitosis is the process of cell division." She went on to explain about spindle apparatus, chromosone centers, receptive nuclei and skewed arms, while I waited impatiently for the bell to ring so I could get to the cafeteria and strained to hear if that was "Band on the Run" coming in over the loudspeaker before the principal's announcement.

Anyway, my overall grade of II (on a scale of I to III) means that my chromosones are acting a little funky - bent arms, skewed. Grade I would mean they were normal; Grade III is seriously messed up. If I'm getting this right, the rate of cell division is mildly abnormal, and the way they're doing it is wacky.

The docs looked to see if any tumor cells were roaming around elsewhere in my breast and didn't see any, which was good. That was my favorite sentence of the report, and the only one in clear English: "The remainder of the breast is effectively unremarkable." Yay!!!! I'm thrilled to be unremarkable!

There definitely is some ductal carcinoma in situ - which she describes as "itty bitty and not super aggressive" and a tiny bit of additional invasive ductal carcinoma near the skin, so she will do a re-excision when I have the lymph node biopsy to get out every last bad cell.

Both estrogen and progesterone receptors were not just positive, but strongly positive, which means they will be treatable with tamoxifen. She mentioned taking it daily for 5 years.

HER2 status hasn't yet been determined, we should get a report on that soon.

She was totally supportive of my going to UCSF for a second opinion and gave me a referral.

Chemo still unknown based on the Oncotype DX score. But whether I have chemo or not, I definitely must have radiation. It will be every weekday for 6 to 8 weeks. Without radiation, there is a 30% chance that the cancer will return in that breast.

What are my risks for recurrence? They're highest in the first five years, she said, so I will be under "increased surveillance" with more frequent mammograms and at least an annual breast MRI (ugh, claustrophobia alert!).

She thinks I should stop eating soy at least until I'm on tamoxifen which would block its estrogen-like effects.

The lymph node biopsy will be Thursday, Sept. 2.