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The roller coaster ride never ends. I thought everything was set. Until we decided to see a second radiation oncologist for an opinion on me and mammosite radiation. I made an appointment with the radiation oncologist I used for NHL, a wonderful, fantastic woman. While I am really glad I did, it made my decision about treatment much harder.

Of course I had to work my way through the multi-level gate keepers before I saw the Doctor. Receptionist, aide, nurse and finally doctor. All of them were kind, competent and professional. I especially liked the nurse. She took the time to ask about both my emotional and physical states. When I told her I was really depressed this time, she said that was common. She cited a study which showed that patients diagnosed with cancer the second time are much more likely to be depressed then they were the first time. That knowledge really helped. I couldn't really understand why I was so depressed. I was afraid I would die the first time. This time I don't have that fear at all. I just don't want to go through treatment again. The good news is I am seeing a therapist tonight to start to understand and deal with my depression.

The radiation oncologist also had concerns for me with with mammosite radiation. She stated that the original study was based on a very broad range of patients, many of them may not have actually needed radiation. Of course the inclusion of those patients may skew the data. So she has concerns that the data showing no difference in three year recurrence rates between mammosite radiation on whole breast radiation may be overstated for women like me.

She is also concerned that the mammosite evidence does not specifically address Her2/Neu positive cancers which is an aggressive cancer. She did say that those concerns were somewhat alleviated because of the ability of Herceptin to treat aggressive forms of cancer.

She is also concerned that I had a second smaller tumor near the first tumor and that the surgeon stated that he may need to take so much tissue that my breast won't match after surgery. A larger cavity makes it more difficult to treat the cancer.

Finally she said she tends to be very conservative and the other doctor is a bit less so. Those differences tend to mostly be a matter of style.

Finally she said if the cancer did come back I would need a mastectomy but another cancer would not necessarily be a death sentence.

Right now I don 't know what I am going to do. Al and I need time to think and to talk about it. The idea of 5 days of radiation compared to 33 days is appealing, very appealing. But at the same time I don't want to go though this whole process again.

On a different note, for those of you who get this far, Al and I made a pledge to have sex every night until surgery. We started talking about it after reading an article about a couple from Baltimore who committed to having sex every night for 101 night and wrote a book about it. I was the one who suggest it to Al. It was to be his gift for being so wonderful and supportive. Surprisingly I am finding it to be a gift to me too.