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Posts Tagged ‘radiology’

I can be very stubborn. (I can hear the laughs and see the nods of agreement!) But I will listen, particularly when someone is using terms like “survival rate,” and it’s hard to argue with statistics.

Mom and I both went into this morning’s meeting with the radiation oncologists at Dana-Farber inclined to “just say no.” I was fairly sure I knew what the rates they’d quote would be, based on our initial discussion many months ago. What I didn’t realize was how much things changed when my specific details were factored in post-surgery. Everything from (you guessed it) my “young” age and the size of my tumor to the fact that it had spread to my lymph nodes and there was lymphovascular invasion (LVI) influence the recommended treatment.

So what convinced me? The numbers. The fact that right now my chance of recurrence is approximately 15% and by doing the radiation it brings down the chance of recurrence to 5-7% . That’s a lot more than the 3% improvement I was expecting. I can say no to a 3% improvement – but 7-10%? Even as much as I want this all to just be done, I can’t ignore that.

Tuesday is my last chemo session. But it’s not the end I wanted. It’s like the end of the last chemo session – it’s just the conclusion of another chapter in this never-ending saga. In the next week I will have to go to Dr. H and have him partially deflate my left tissue expander so it won’t get in the way of the radiation. Then the Thursday after Thanksgiving I’ll go in for the radiation planning session where they’ll tattoo marks on me to make sure they radiate the right area each day.

Yes, each day. Monday through Friday for five weeks – 25 sessions. Luckily they will only be a few minutes each time, so I will be able to continue to work through it. The biggest side effects are continued fatigue, redness and soreness. And, since my lymph nodes were removed, the increased risk that the radiation could trigger lymphedema. (I will be praying about that one – really don’t want that!)

And the biggest bummer of it all for me? Postponing the surgery I was supposed to have on January 2. I thought I’d start 2013 with surgery and pretty much be done, but now I’ll be doing radiation and have to wait six more months to switch out the tissue expanders for implants. Then a few months after that will be the nipple surgery and then a few months after that will be the tattooing. Oh – and then the five years of tamoxifen. It really is the never-ending saga…

But it’s worth it. To do everything I can to be cancer free. To fight every step of the way. To not have to look back and wonder, “if only I…” because I have, in fact, done everything within my power to get rid of it and prevent it from coming back. So I can continue to wake up each morning, breathe in and breathe out, and thank God for another day.

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I know I’m not going to do this entry justice – there was just so much to learn and absorb on my first day at Dana Farber! So I’ll try to share, but please know that medical stuff is not my forte! I never wanted anything to do with the medical field (left that to my mom, Mark, Heather, Tina, Tara, Steven, etc.) and still would rather not. But now I don’t have a choice. Ugh. Bottom line: this certainly is not that medically accurate, rather my interpretation and transcription of the notes I took throughout the day…

Tuesday, March 27: Five doctors in eight hours. And barely a minute to breathe (or eat) between sessions. You really should be given a certificate or something after to show you made it through the day! Luckily, many of them said the same thing, just in a different way, so that by the end of the day we thought we pretty much got it – at least mom and Mark did. I was (am) still in shock. (Not quite sure that will ever really go away.) But I have to say – they were pretty much all great (with a minor exception that I’ll get into in a later entry) and I really appreciated being able to see them all in one day. I’d much rather jump in then drag this out!

We saw:

  • Breast surgeon
  • Medical oncologist
  • Genetic counselor
  • Radiation oncologist
  • Reconstructive plastic surgeon

I don’t think I’ve ever undressed, got examined and redressed so many times in such a short span of time. Luckily it was one thing I anticipated so I dressed for it and was down to less than a minute by the end (although to be honest we didn’t time it but I’m pretty sure). For the most part (other than the genetic counselor), it was: say hello, undress, examine me, get dressed, talk about my situation, draw a picture (doc- not me, thank goodness as I’d fail that test), explain options, ask questions and leave me to mull over my options on the way to see the next doc. (At least the reconstructive surgeon threw in a video, too – but no popcorn.)

So basically:

  • Invasive ductal carcinoma in two places in my right breast
  • Grade 1 – slow growing on the aggressive scale
  • Stage 2A – size (because one of them is more than 2 centimeters. One is about 2.3 centemeters and one is 1/2 centimeter)
  • They won’t know if it’s spread until they do surgery and get into my lymph nodes (breast cancer tends to like liver and bones)
  • My cancer may not react to chemo – sent away for a test to see for sure. So I may get to keep my hair, which would be a plus. And I’ve heard how horrid it is; it would be a blessing to be spared of at least that…
  • Strong positive for estrogen and progesterone so will need to be on antihormone therapy for five years after – so no chance of any more children until I’m at least 43. (I hope none of you keeled over hearing that statement from me. I know I’ve pretty much said I was done but I don’t like my options being taken away!)

Options are:

  • Lumpectomy where they will cut both masses out, as well as some around it to be sure they got it all. Day surgery with about two weeks recovery time.  Then radiation every day Monday through Friday for six weeks. You can’t have any reconstructive or plastic surgery with this one. (No spackle to fill in the hole, as the doctor said one patient asked.) So there will just be a big dent/hole, and the radiation will shrink my breast, too.  The chance of it coming back ranges somewhere between 6 and 10% depending whose stats you go with. Could do this in a week or two.
  • Mastectomy where they will take the entire breast and build me a new one. (Multiple types of reconstructions – another decision to be made if this is the winner.) About five days in the hospital, with 5-6 weeks recovery time. May be able to get away with no chemo or radiation. Approximately 3% chance it could come back. (Better odds but not as much of a clear winner as I’d heard.) Could do in three or so weeks.

Then there’s the genetics stuff. The question is, why did I get breast cancer when I’m ‘so young’ (at least for this) and no close family history (my mom’s cousins only)? So there’s a chance I could have what some call the breast cancer gene. BRCA1 or 2. Basically, if I have it, I should have a double mastectomy because there’s more than 50% chance I’ll get it in my left breast too. And up to 40% chance I’ll get ovarian cancer (oh yay). And worst of all, a good chance my future granddaughters or nieces will have the same gene. (I can’t even think of that.) So the test has been ordered and we should find out by the end of next week or so. (It takes up to 14 days at some place in Utah.)

So much to think about. I was completely fried at the end of the day, as were mom and Mark, although they seemed to be in better shape than me. They dropped me off, I called dad and Maggie so they wouldn’t worry, and then I went to dinner with Tina and Mike so I could explain it all to both of them at once rather than rehashing multiple times. That definitely helped because they got me out of the bitchy mood I was falling into as I really hated my options. They made me smile and laugh and somewhat forget about things for a while – and then when we did get into it, they asked the right questions, made me think and even convinced me it would be ok no matter what I choose…

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