Oncologist Visit

I had anticipated three outcome choices and I was almost right. I figured today's visit would decide: 1. I would definitely need chemo OR 2. I would definitely not need chemo OR 3. I MIGHT need chemo and they would base it on a test of my excised tumor tissue sample (called Oncotype Dx test). Dr. DaCosta said that I could opt for any of those three choices today--depending on my wishes I could say Yes, No or Maybe-depending on the Oncotype DX test outcome--and he would start the ball rolling in any of those directions.

After he said that I could start radiation first while waiting for the results of the Oncotype Dx Test (takes about 3 weeks), I knew that was the way to go. Tomorrow, I will be setting an appointment with the radiation oncologist, Dr. Cirrone (already met with him in December). During this visit they will place tiny tattoos over certain areas where the beam will be aimed, and then they map out the area, and then possibly send me for pics to see if everything is correct. After all that, I will be scheduling appointments with them, 5 days a week, about 15 minutes each day, for a total of about 6 1/2 weeks. I should be about halfway through treatment when the results of the oncotype test come in.

At least something is starting soon!!!

The Rock

Everyone needs that person in their life who puts things in perspective and sometimes has to put you on the path of clear thinking again. That person in my life is my husband, David. David is my rock. He supports me by listening carefully and reminding me to take it 'one day at a time', to live in the present, not the future of 'what if'.

Sometimes it's easier said than done especially when one is faced with a pretty serious medical condition such as breast cancer. The waiting game is extremely difficult--the waiting for pathology reports to come back, the waiting for the next doctor visit to find out results, or what treatments to expect, the waiting while testing is being done and researched to find out what that best mode of treatment will be. The waiting is the hardest part and sometimes my mind gets so focused on all the different possibile outcomes, it's hard to think straight and to be happy 'in the moment'.

Being an avid reader, I have been doing my research about all different breast cancer options and it has blown my mind that the 'simple' term of breast cancer can mean such a variety of different things. It depends on the size and location of the actual tumor as well as the cell growth rate, whether or not it has escaped the breast into the lymph nodes, the type of receptors the cancer has--estrogen, progesterone, Her2, etc...and of course with all of these different types, comes different treatment options. I happen to be one of those people who falls on the cusp of the chemo/no chemo line. The reason for this is that my tumor was small (only 8mm/ .8cm) and there was no lymph node involvement. This would normally point to a treatment that would include:

* a lumpectomy (already had--took out 7cm x 3 cm x 1.75 cm--and the margins were not clean--went back, not sure how much more they took out, but this time got clean margins)
* radiation to the area.
* Tamoxifen (or something similar) to stop the estrogen from forming in my body, since my cancer is Estrogen/Progesterone Receptor Positive (my cancer likes estrogen and progesterone)

Now the part that is tricky here is that the tumor was on top of the muscle of my chest wall and they found an 'in situ' cancer (waiting to happen), closer to the skin surface (hence the reason they did not get clean margins the first time even taking out all that tissue). After a second surgery and removing some muscle, and inside the skin surface, they got clean tissue margins.

Since the cancer was in two different places, does this now mean I should have chemo? Also, since it was so close to the chest wall that separates the breast tissue from the heart, is it now more dangerous to do radiation, even though they can bend the beam to try to avoid healthy tissue? These are the things that invade my thoughts, and I wish I could just let go of them until the surgeon visit on the 21st and the oncologist visit on the 28th.

This is where Dave comes in and reminds me there is nothing I can do about any of this until we see the doctor. Why not enjoy this time? So, just for today, I will enjoy every minute of not knowing the future. I may have to take it minute by minute, second by second even, but I'll get through the day happier by doing so. I need to turn those negative thoughts into positive ones and focus on the good things life brings.

Clean Margins...YAY!

Margins from the 1/9 surgery were clean! Yippee!!! Now it's off for a follow up surgeon's visit on the 21st and then to the oncologist on the 28th (decide whether chemo would be beneficial, or if I can just have radiation). The waiting game begins again...

2nd surgery

After seeing Dr. Borden and going over the pathology, I went in for a second surgery today. He removed more tissue on the top and bottom margins of the 7cm he took out last time. Those two places did not have clean margins. The surgery was a lot shorter, only an hour. and I was home, feeling really well, at noon. Now, I'm sore, took some percocet an hour ago and am ready for a nap.

I will find out results some time next week and will follow up with the surgeon on January 21st. Then, I have an appt. with an oncologist on January 28th. This time we'll be talking about chemotherapy as an option of treatment. UGH.

Couple of scenarios:
IF...
Margins are all clear then consult with oncologist about chemo to see if it would benefit me.

IF...Margins are not clear, EITHER more tissue removal (may not be possible) OR a full mastectomy and consult with oncologist.

I'm bracing myself for either scenario and reading everything I can get my hands on in the meantime.

The best thing I did was to get an AFLAC cancer policy last JUNE. I did this after watching my sister-in-law Theresa go through her treatments and medication costs. Our district offered it and I jumped on it. I got all the paperwork together to get the ball rolling with them.

My brother-in-law Gary got some awful news about his cancer. He's at Sloans satellite site at Mercy Hospital for about a week now. They gave him a time frame of how long he has left on this earth. I'm at a loss for words--how terrible for him and Kim--I feel helpless.