How Cancer Treatment Is Like Cleaning Up After Thanksgiving

I sat in yet another paper gown, undressed from the waist up, waiting for yet another doctor in the parade I had seen over the past 10 months. My breast cancer diagnosis had given me cause to be grateful that innumerable cardiology visits since my first heart surgery at 11 days old had previously eradicated any claim to modesty I may have ever possessed, so at least I felt zero discomfort with the incessant poking, prodding, and inspection of my breasts, or, rather, the region where my breasts had once resided.

The radiation oncologist immediately honed in on the college bandana covering my still bald scalp and we spent 20 minutes animatedly discussing “dream” schools and the change in admissions since “our days,” before we began to talk about the part of treatment I found the most intimidating: radiation.

Slowing from her previous high energy, rapid-fire chat style, Dr. T looked at me and said, “So. You had surgery. You had chemo. I’m like the Lysol spraying everything down and getting the invisible things the other treatments missed.”

For me, this was a powerful explanation of why I should agree to 25 radiation treatments on top of the other treatments I had already endured, and an analogy of cleaning up after Thanksgiving dinner and cancer treatment emerged.

In my case, the first treatment I experienced was a double mastectomy to remove the cancer.

Surgery is like putting away the leftovers. You take the visible cancer and remove it. You separate it from the kitchen. This is the first step in returning the kitchen to its pristine, pre-Thanksgiving status.

However, like most Thanksgiving cooks, I do not maintain a spotless kitchen as I cook. Putting away leftovers still leaves a kitchen full of dirty pots, pans, and unidentifiable splotches.

I next must roll up my sleeves and scrub turkey drippings off the bottom of the roasting pan and clean gravy that had bubbled over off the stove. My efforts to clean the dishes include wiping down places I didn’t even mean to end up with food: the back splash, the fridge door, the faucet handle. My efforts to restore cleanliness range throughout my entire kitchen, they are not limited to the pots that contained food.

This washing phase is akin to chemotherapy. Once the drugs enter the system, they do not restrict themselves to treating breast tissue. They seek fast growing cells throughout the body and eradicate them. Just as I might scrub so hard to remove crusted food from a pan that I damage its finish, so chemo doesn’t discriminate between the healthy blood and stomach lining cells patients wish to retain and the cancer cells it is designed to destroy.

Celebrating Radiation 25 with my Family and Team

Having restored my kitchen to its previous sparkling status, I reach into the cabinet to the left of the sink and grab the disinfectant spray, squirting it liberally across my primary prep areas and giving them a final swipe with a clean towel.

The kitchen looks perfectly clean before this last step, but on the not-zero chance there are any invisible germs making themselves at home on my counter, I use the spray.

This is radiation. It doesn’t look around the body for dirt as chemo does. It strictly treats the area in which it is applied. The area we know was invaded by cancer.

Do I use antibacterial spray for every meal? No. Perhaps the meal is merely a quick salad and doesn’t involve raw proteins likely to spread bacteria. Perhaps my meal prep was very clearly contained to a single bowl that I already washed.

Similarly, radiation may not be necessary because of the characteristics of an individual’s cancer. Perhaps the cancer is less likely to shed dangerous cells or is known to have been limited to a removed area.

The vast majority of cancer doctors, whether surgeons, oncologists, or radiation oncologists, are deeply committed, caring humans who passionately want to make their patients as close to whole as they can. However, they are constantly walking the tightrope of what information to provide and how to provide it. Too much information can create confusion and fear. Too little information can create confusion and fear. The wrong timing, tone, order . . . all can create rather than relieve confusion and fear. And the amount of information and style of delivery that is correct is different for each patient.

Fortunately, on that day, Dr. T knew exactly how to give me a strong visual and the right amount of information to help me understand the value in accepting radiation as the next step in my treatment and roll my sleeves up the next step in the process of purging cancer from my body.

They told me I could hit the gong as hard as I wanted to when I was done!