oncologist

Just When You Start to Hope . . .

Posted on January 9, 2010 at 8:00 am

I got some big news on Friday afternoon and decided to share it with the world (or at least the 20 of you who read this blog and all future google searchers . . .) so forgive me if I repeat information you already know. Also, I may give you more detail than you really want, and I apologize in advance for that.

As a general update: back in early December I met with an oncologist to discuss how necessary it is for me to have chemotherapy. I am a perfect candidate for a new test that looks at cancer tumors at a genetic level and assigns a percentage of likelihood of that cancer recurring in the next 10 years. A low number means a low likelihood, and therefore a poor candidate for chemotherapy. A high number means a strong likelihood of the breast cancer recurring and making it more necessary for chemotherapy.

While waiting for these results, I’ve been taking care of myself and healing from the mastectomy. At this point I can go back ‘any time’ for the 2nd stage of my reconstructive surgery, which involves putting the implant in. This includes a ‘re-excision’ of several more millimeters of tissue from the inside of my breast to give me a clear margin*, which was not 100% successful during the original surgery. Good news: I’m told that the recovery from this operation is days, not weeks; moreover, I should find the implant much more comfortable and the BLO** will look much more like a breast than an object.

On New Year’s Eve, John’s mother was taken to the local hospital in Charlotte in an ambulance, apparently the victim of pneumonia. She did not respond to the medication, and had a sudden decline in her ability to understand things said to her, became unable to recognize family members, then lost her ability to speak. On Monday she was correctly diagnosed as having Bacterial Meningitis. John flew out to see her on Wednesday night, and will be there through Monday. Although she seemed to improve for a day, as of a few hours ago, she had been moved to the ICU unit in the larger hospital in Charleston. We literally have no idea what her condition or prognosis is or will be.

Friday afternoon my oncologist called me. My test results came back and my number is 42 (on a scale of 1-100). That means that I have a 42% chance of a recurrence of breast cancer in the next 10 years. Even with Tamoxifen my likelihood of recurrence is 28% in the next 5 years. I had hoped for a much lower number, but it is clear that chemotherapy will be necessary. I have an appointment to speak with my oncologist on Monday morning.

Chemo for me will be a combination of 2 drugs, and will be four sessions, one every three weeks. A piece of good news is that he does NOT feel I need to start chemo immediately. I have time to take care of some things first.

At the moment, and keeping in mind that all of this can change in a heartbeat (Mr. Toad’s Wild Ride, anyone?) my plan is to have the 2nd surgery within the next few weeks (AFTER Mercury goes direct), giving myself at least 4 weeks to recover before starting chemotherapy. John and I are planning to go to the opening weekend of the OSF in the last week of February. I would start chemo on or after March 2nd, and my last session would be in early May.

As always, your good wishes, prayers, white light, positive vibes, and energy is appreciated and welcomed. I am truly blessed with such good people in my life, and I promise that I don’t hesitate to reach out and ask when I need help.

*the margin is an area from around the cancer tumor that is completely clear of cancer cells. It varies in size based on the size of the tumor. My margins were not 100% ‘clear’ (of cancer cells), so I need to have an additional layer removed.

** breast-like-object

Meeting the Oncologist

Posted on December 9, 2009 at 9:47 am

I continue to be fortunate in that every medical professional I’ve worked with (with a few minor exceptions) are warm, caring, knowledgeable, competent people. My oncologist is one of those. He could see how nervous I was, and one of the first things he did was to start at the beginning and have me tell him about what my cancer journey has been like.

I finished with “and so it was more than a little shocking to be told on Friday that I am a good candidate for chemotherapy.” He immediately said: “I’m not so sure about that. It’s one thing I want to talk with you about.”

It turns out that there is a test (Oncotype DX) that is for a specific population of women with breast cancer. This test provides a very specific answer to the question: does she have a high likelihood of breast cancer recurring (and therefore is a good candidate for chemotherapy)? In reading about it, it looked liked I was a perfect candidate (invasive, Stage I, ER+, lymph node negative). But it is very new (just out of clinical trials in 2007) and I wasn’t sure if my oncologist knew about it, and if I really was a good candidate.

He did, and he thinks I’m a ‘poster child’ for the test. Good thing: they (the lab that does this test is in Sunnyvale, Ca, I believe) examine the tissue already removed. I don’t have to do anything. We’ll get the results in a week or two.

IF I DO have chemotherapy, it would take about 3 months with chemo sessions 1x/3wks. The plan is that I would be in chemo for a day, recovering for a couple of days, and then working like normal for a few weeks. So, disruptive, but not horrid. And fairly brief.

I left that office feeling like I’d been given good news, and it was sort of appalling that I felt that way when really all I’d been told was that I’d be waiting for an answer again.

This is one of the cruelties of cancer, your definition of ‘normal’ becomes skewed. I wonder how long it will take for my definition to right itself?

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