A New Reality

Wednesday, April 1, 2009

9:15am: Arrived at the surgeon's office for a more thorough take on the results of the biopsy. "Cancer," though a loaded word and obviously pejorative, is not in itself all that telling. If anything, the diagnosis inspired even more unanswered questions. What's next? How bad is it? Am I going to get better?

9:30am: The surgeon comes in to speak with me, my mom, my dad, and Joe. He presents me with the surgical options, but is completely clear that the ultimate call on treatment schedule should come from my oncologist. At this point, I had an appointment with the oncologist later in the afternoon, so again...more questions that would have to wait.

So, at this point my options...pending a lot of things...were lumpectomy, mastectomy, or bi-lateral mastectomy. For those of you who don't know, a lumpectomy is the removal of just the mass, a mastectomy is the removal of the whole breast and a bi-lateral would be the removal of both breasts. Now, the concept of mastectomies seems brutal, but there are some really good reasons for it. For one, if I were to carry the gene that predisposed me to breast cancer and associated cancers, my likelihood of having another mass would be significantly increased. For some women, the lifelong fear is just not worth it, so they opt for the mastectomy or bi-lateral mastectomy. Unfortunately, it really comes down to a numbers game. Percentages and chances all resting on whether I carry the breast cancer gene. That fact is still to be determined. I'm waiting on the genetic testing results as we speak.

1:30pm: Meeting with the oncologist. Again, I have my entourage in tow. He was matter-of-fact and direct, but compassionate at the same time. The staff seemed very competent and caring. It helped a lot to finally have a little confidence.

So, we sat down to discuss treatment options (surgery is a part of this, but treatment is much more about the drugs + the surgery + the emotional treatment). The oncologist recommended chemo first with surgery to come later. From what I understand, this is gaining in popularity because there's some amount of research that shows that cutting into a tumor can potentially spread cancer cells into the surrounding tissue, possibly increasing your chances of cancers later on. This way, they kill all the precancerous cells that are floating around in there, shrink the tumor, and you're already deep into treatment before they cut into anything.

My doctor and I will sit down every two weeks and reevaluate how the tumor is responding and when surgery might be an option. Initially, he thought surgery wouldn't happen until after the fourth of eight treatments, but I'm staying hopeful that this thing will be out of there as soon as possible.

Treatment Verdict: Eight chemo treatments over the course of 16 weeks. The first four treatments will be a mix of two chemo drugs and a third will be added in by the fifth treatment. I will be tired all the time, sick most of the time, my hair will fall out about 14-17 days after the first treatment, and it will be a rough 16 weeks. But at the end...both the surgeon and oncologist agree, there is every reason to believe that I will be healthy and cancer-free! About five tough months from finding the tumor to being cancer-free! I can totally do this!

2:30pm: They shuffle me off to have blood drawn for your typical blood work stuff as well as to be sent off for the genetic testing. I then get a full tour of the facility and a little walk through of how the chemo treatments will go. Little scary, but I'm ready to get started.

4:00pm: Time to head home after a very long day. Just as I suspected: a new month brings new promise for better outcomes. My day ends on an optimistic note with about 20,000 new tests scheduled between now and my first treatment on Monday April 6. Here we go!