Surgery is on for Wednesday morning at 9 a.m.
Should last about 3 hours. X-ray immediately after to make sure they don't puncture my lung.
Hope to be home snoozing in my own bed, doped up on narcotics by 3 p.m.
Chemo starts March 8th.
Keeping my chin up.
Tuesday, February 27, 2007
Saturday, February 24, 2007
The Survivor Movie
I wish I could say I wrote this, but I didn't. Get your box of tissues and visit www.TheSurvivorMovie.Com
I have cancer…
But cancer does not have me.
Cancer is not who I am.
It is only a bend in the road that is my life’s journey…
An unexpected detour on my path.
It is a lesson in the cosmic schoolroom that is human existence.
So I will pause to rest…And heal…And study the lesson…
Before I move on to my life beyond cancer.
I will not give in to fear,
And I will not be discouraged by setbacks.
Setbacks are only opportunities to review the lesson.
I will not be ashamed of my scars
My scars are the brushstrokes in the masterpiece that is my life.
I will be thankful for the many blessings cancer has brought into my life:
People I never would have known,
Love that I had never been still or quiet enough to witness,
Humility I needed,
Strength I thought I had lost,
Courage I never knew I had.
I will remember that I can still have fun
And that it’s okay- even healthy!- to be silly.
I will remember that to find the joy in rainbows
I must endure the rain.
And I will remember always that…
While I may have cancer…
Cancer does not have me
I have cancer…
But cancer does not have me.
Cancer is not who I am.
It is only a bend in the road that is my life’s journey…
An unexpected detour on my path.
It is a lesson in the cosmic schoolroom that is human existence.
So I will pause to rest…And heal…And study the lesson…
Before I move on to my life beyond cancer.
I will not give in to fear,
And I will not be discouraged by setbacks.
Setbacks are only opportunities to review the lesson.
I will not be ashamed of my scars
My scars are the brushstrokes in the masterpiece that is my life.
I will be thankful for the many blessings cancer has brought into my life:
People I never would have known,
Love that I had never been still or quiet enough to witness,
Humility I needed,
Strength I thought I had lost,
Courage I never knew I had.
I will remember that I can still have fun
And that it’s okay- even healthy!- to be silly.
I will remember that to find the joy in rainbows
I must endure the rain.
And I will remember always that…
While I may have cancer…
Cancer does not have me
Friday, February 23, 2007
The Risk Factors
So you may be wondering what sort of voodoo-wielding gypsy I pissed off to end up with two major medical diagnoses in one calendar year (the other being inflammatory bowel disease - annoying, but not life-threatening).
The following is a list of the most common risk factors associated with breast cancer according to the American Cancer Society. I don't meet many of them.... do you? (For the full explanations, click here).
Risk Factors You Cannot Change
Gender: Simply being a woman is the main risk factor for developing breast cancer. This disease is about 100 times more common among women than men.
Aging: Your risk of developing breast cancer increases as you get older. About 17% of invasive breast cancer diagnoses are among women in their 40s, while about 78% of women with invasive breast cancer are age 50 or older when they are diagnosed.
Genetic risk factors: Recent studies have shown that about 5% to 10% of breast cancer cases are hereditary as a result of gene changes (called mutations). The most common mutations are those of the BRCA1 and BRCA2 genes. (More on this later. I'm going to be tested for the BRCA genes in March).
Family history of breast cancer: Breast cancer risk is higher among women whose close blood relatives have this disease. (My father's mother was about 54 when she had breast cancer).
Your risk of developing breast cancer is increased if:
You have 2 or more relatives with breast or ovarian cancer.
Breast cancer occurs before age 50 in a relative (mother, sister, grandmother or aunt) on either side of the family. The risk is higher if your mother or sister has a history of breast cancer.
You have relatives with both breast and ovarian cancer.
You have 1 or more relatives with two cancers (breast and ovarian, or 2 different breast cancers).
You have a male relative (or relatives) with breast cancer.
You have a family history of breast or ovarian cancer and Ashkenazi Jewish heritage.
Your family history includes a history of diseases associated with hereditary breast cancer such as Li-Fraumeni or Cowden Syndrome.
Having 1 first-degree relative (mother, sister, or daughter) with breast cancer approximately doubles a woman's risk. Having 2, first-degree relatives increases her risk 5-fold. Although the exact risk is not known, women with a family history of breast cancer in a father or brother also have an increased risk of breast cancer. Altogether, about 20% to 30% of women with breast cancer have a family member with this disease.
Personal history of breast cancer: A woman with cancer in one breast has a 3- to 4-fold increased risk of developing a new cancer in the other breast or in another part of the same breast. This is different from a recurrence (return) of the first cancer.
Race: White women are slightly more likely to develop breast cancer than are African-American women. Asian, Hispanic, and Native-American women have a lower risk of developing and dying from breast cancer.
Abnormal breast biopsy: Some types of benign breast conditions are more closely linked to breast cancer risk than others.
Previous chest radiation: Women who as children or young adults had radiation therapy to the chest area as treatment for another cancer (such as Hodgkin disease or non-Hodgkin lymphoma) are at significantly increased risk for breast cancer.
Menstrual periods: Women who started menstruating at an early age (before age 12) or who went through menopause at a late age (after age 55) have a slightly higher risk of breast cancer.
Diethylstilbestrol (DES): In the 1940s through the 1960s some pregnant women were given diethylstilbestrol because it was thought to lower their chances of miscarriage. Recent studies have shown that these women have a slightly increased risk of developing breast cancer. Recent findings have also suggested that women whose mothers took DES during pregnancy may have a higher risk for breast cancer than women not exposed to the drug in utero.
Lifestyle-Related Factors and Breast Cancer Risk
Not having children: Women who have had no children or who had their first child after age 30 have a slightly higher breast cancer risk. Having multiple pregnancies and becoming pregnant at an early age reduces breast cancer risk. (Chalk one up for teen pregnancy).
Oral contraceptive use: It is still not certain what part oral contraceptives (birth control pills) might play in breast cancer risk. Studies have suggested that women now using oral contraceptives have a slightly greater risk of breast cancer than women who have never used them.
Postmenopausal hormone therapy (also known as hormone replacement therapy, or HRT): It has become clear that long-term use (several years or more) of postmenopausal hormone therapy (PHT), particularly estrogen and progesterone combined, increases your risk of breast cancer.
Breast-feeding and pregnancy: Some studies suggest that breast-feeding may slightly lower breast cancer risk, especially if breast-feeding is continued for 1.5 to 2 years. Other studies found no impact on breast cancer risk.
One study concluded that having more children and breast-feeding longer could reduce the risk of breast cancer by half. (Nathan weaned me at 8 months. God knows I tried to have more children).
Alcohol: Use of alcohol is clearly linked to an increased risk of developing breast cancer. (But you have to drink a Hell of alot more than my one drink every two months for it to matter).
Obesity and high-fat diets: Obesity has been found to be a breast cancer risk in all studies, especially for women after menopause. Studies of fat in the diet have not clearly shown that this is a breast cancer risk factor. Most studies found that breast cancer is less common in countries where the typical diet is low in total fat, low in polyunsaturated fat, and low in saturated fat. On the other hand, many studies of women in the United States have not found breast cancer risk to be related to dietary fat intake. (Have we met?)
Physical activity: Evidence is growing that physical activity in the form of exercise reduces breast cancer risk. (See Obesity. I have two little kids. Enough said).
The following is a list of the most common risk factors associated with breast cancer according to the American Cancer Society. I don't meet many of them.... do you? (For the full explanations, click here).
Risk Factors You Cannot Change
Gender: Simply being a woman is the main risk factor for developing breast cancer. This disease is about 100 times more common among women than men.
Aging: Your risk of developing breast cancer increases as you get older. About 17% of invasive breast cancer diagnoses are among women in their 40s, while about 78% of women with invasive breast cancer are age 50 or older when they are diagnosed.
Genetic risk factors: Recent studies have shown that about 5% to 10% of breast cancer cases are hereditary as a result of gene changes (called mutations). The most common mutations are those of the BRCA1 and BRCA2 genes. (More on this later. I'm going to be tested for the BRCA genes in March).
Family history of breast cancer: Breast cancer risk is higher among women whose close blood relatives have this disease. (My father's mother was about 54 when she had breast cancer).
Your risk of developing breast cancer is increased if:
You have 2 or more relatives with breast or ovarian cancer.
Breast cancer occurs before age 50 in a relative (mother, sister, grandmother or aunt) on either side of the family. The risk is higher if your mother or sister has a history of breast cancer.
You have relatives with both breast and ovarian cancer.
You have 1 or more relatives with two cancers (breast and ovarian, or 2 different breast cancers).
You have a male relative (or relatives) with breast cancer.
You have a family history of breast or ovarian cancer and Ashkenazi Jewish heritage.
Your family history includes a history of diseases associated with hereditary breast cancer such as Li-Fraumeni or Cowden Syndrome.
Having 1 first-degree relative (mother, sister, or daughter) with breast cancer approximately doubles a woman's risk. Having 2, first-degree relatives increases her risk 5-fold. Although the exact risk is not known, women with a family history of breast cancer in a father or brother also have an increased risk of breast cancer. Altogether, about 20% to 30% of women with breast cancer have a family member with this disease.
Personal history of breast cancer: A woman with cancer in one breast has a 3- to 4-fold increased risk of developing a new cancer in the other breast or in another part of the same breast. This is different from a recurrence (return) of the first cancer.
Race: White women are slightly more likely to develop breast cancer than are African-American women. Asian, Hispanic, and Native-American women have a lower risk of developing and dying from breast cancer.
Abnormal breast biopsy: Some types of benign breast conditions are more closely linked to breast cancer risk than others.
Previous chest radiation: Women who as children or young adults had radiation therapy to the chest area as treatment for another cancer (such as Hodgkin disease or non-Hodgkin lymphoma) are at significantly increased risk for breast cancer.
Menstrual periods: Women who started menstruating at an early age (before age 12) or who went through menopause at a late age (after age 55) have a slightly higher risk of breast cancer.
Diethylstilbestrol (DES): In the 1940s through the 1960s some pregnant women were given diethylstilbestrol because it was thought to lower their chances of miscarriage. Recent studies have shown that these women have a slightly increased risk of developing breast cancer. Recent findings have also suggested that women whose mothers took DES during pregnancy may have a higher risk for breast cancer than women not exposed to the drug in utero.
Lifestyle-Related Factors and Breast Cancer Risk
Not having children: Women who have had no children or who had their first child after age 30 have a slightly higher breast cancer risk. Having multiple pregnancies and becoming pregnant at an early age reduces breast cancer risk. (Chalk one up for teen pregnancy).
Oral contraceptive use: It is still not certain what part oral contraceptives (birth control pills) might play in breast cancer risk. Studies have suggested that women now using oral contraceptives have a slightly greater risk of breast cancer than women who have never used them.
Postmenopausal hormone therapy (also known as hormone replacement therapy, or HRT): It has become clear that long-term use (several years or more) of postmenopausal hormone therapy (PHT), particularly estrogen and progesterone combined, increases your risk of breast cancer.
Breast-feeding and pregnancy: Some studies suggest that breast-feeding may slightly lower breast cancer risk, especially if breast-feeding is continued for 1.5 to 2 years. Other studies found no impact on breast cancer risk.
One study concluded that having more children and breast-feeding longer could reduce the risk of breast cancer by half. (Nathan weaned me at 8 months. God knows I tried to have more children).
Alcohol: Use of alcohol is clearly linked to an increased risk of developing breast cancer. (But you have to drink a Hell of alot more than my one drink every two months for it to matter).
Obesity and high-fat diets: Obesity has been found to be a breast cancer risk in all studies, especially for women after menopause. Studies of fat in the diet have not clearly shown that this is a breast cancer risk factor. Most studies found that breast cancer is less common in countries where the typical diet is low in total fat, low in polyunsaturated fat, and low in saturated fat. On the other hand, many studies of women in the United States have not found breast cancer risk to be related to dietary fat intake. (Have we met?)
Physical activity: Evidence is growing that physical activity in the form of exercise reduces breast cancer risk. (See Obesity. I have two little kids. Enough said).
Tuesday, February 20, 2007
The Right Thing To Say
One person on an online support group for cancer survivors recently posted her frustrations with the reactions of several people to her diagnosis. She said she could see from the looks on their faces that they had already written her off, already were thinking, "oh her poor husband will have to raise those kids alone."
Her post made me think. It made me think ALOT. It made me think about my own reactions to the things people say - and don't say. I, too, have grown weary of people's reactions to my diagnosis: the stricken look on their faces, the holding back of tears, the hand that covers the mouth instinctively to avoid saying the wrong thing. Subtle shaking of the head.... sometimes I can hear my euology being mentally dictated. It is one of the reasons I stopped telling people and started this blog - I simply could not continue to inflict this pain on others, or myself. I would not continue to be the person who consoled others and said, "It'll be ok."
At the other extreme are the people who say nothing - those who have not even acknowledged that I am going through this. And I don't mean the average joe at the supermarket... it is nice to go out and NOT be the woman with cancer..... but I mean my close friends and family who haven't even dropped an e-mail, or a card.
I realize that many people may carry their own baggage related to cancer, and they just cannot deal with me being sick. Some are from the era where cancer was a death sentence. Many people who have been touched by the disease in the past have equated it with death. This, of course, is no longer always the case. It is much more treatable now than it was even 20 years ago. Even more than five years ago.
On the other hand, I also think we have come so far in treating cancer that a lot of people (especially people my age and younger) think, "oh, it's just breast cancer, she'll be fine." How fortunate we are to live in an era where so many people survive cancer and die of old age instead. I am here to tell you, though, that it doesn't suck any less to actually go through it. I firmly believe I will come out of this whole, and possibly a better person. But I would rather not go through it at all.
So you may be wondering..... WHAT is the right thing to say? As you can see, you run the risk of pissing me off either way. ;) I guess my point is.... think before you talk.... but do not fail to talk altogether. Don't tell me your list of everyone you know who has had cancer, unless they are alive and well! Don't introduce me as your friend with breast cancer, and don't blow me off. When you see me, give me a hug. Not because it may be your last chance, but because you love me.
Soooooo many people are really coming through for me in this crisis - they are bringing food, emailing me encouragement, sending cards, babysitting my kids, driving me to the doctor, holding my hand, praying. One friend has brought me two pairs of new jammies so I can look fabulous while I recover from surgery. Don't for one minute think I don't have lots of support, because I do. But if you are struggling with the right thing to say, consider clicking on the circle of cancer link on the right, or I will mail you a copy of the book "What to do when your friend has cancer." One thoughtful friend sent me six copies.
A few weeks ago I received the most wonderful email from a friend of mine from high school. She said:
"The Japanese believe that if you make 1000 origami cranes your heart's desire will be granted. I'm at 54 for this week, each one is for you. I may even mail them to you."
Today she emailed me that she is up to 99.
This was the right thing to say.
Her post made me think. It made me think ALOT. It made me think about my own reactions to the things people say - and don't say. I, too, have grown weary of people's reactions to my diagnosis: the stricken look on their faces, the holding back of tears, the hand that covers the mouth instinctively to avoid saying the wrong thing. Subtle shaking of the head.... sometimes I can hear my euology being mentally dictated. It is one of the reasons I stopped telling people and started this blog - I simply could not continue to inflict this pain on others, or myself. I would not continue to be the person who consoled others and said, "It'll be ok."
At the other extreme are the people who say nothing - those who have not even acknowledged that I am going through this. And I don't mean the average joe at the supermarket... it is nice to go out and NOT be the woman with cancer..... but I mean my close friends and family who haven't even dropped an e-mail, or a card.
I realize that many people may carry their own baggage related to cancer, and they just cannot deal with me being sick. Some are from the era where cancer was a death sentence. Many people who have been touched by the disease in the past have equated it with death. This, of course, is no longer always the case. It is much more treatable now than it was even 20 years ago. Even more than five years ago.
On the other hand, I also think we have come so far in treating cancer that a lot of people (especially people my age and younger) think, "oh, it's just breast cancer, she'll be fine." How fortunate we are to live in an era where so many people survive cancer and die of old age instead. I am here to tell you, though, that it doesn't suck any less to actually go through it. I firmly believe I will come out of this whole, and possibly a better person. But I would rather not go through it at all.
So you may be wondering..... WHAT is the right thing to say? As you can see, you run the risk of pissing me off either way. ;) I guess my point is.... think before you talk.... but do not fail to talk altogether. Don't tell me your list of everyone you know who has had cancer, unless they are alive and well! Don't introduce me as your friend with breast cancer, and don't blow me off. When you see me, give me a hug. Not because it may be your last chance, but because you love me.
Soooooo many people are really coming through for me in this crisis - they are bringing food, emailing me encouragement, sending cards, babysitting my kids, driving me to the doctor, holding my hand, praying. One friend has brought me two pairs of new jammies so I can look fabulous while I recover from surgery. Don't for one minute think I don't have lots of support, because I do. But if you are struggling with the right thing to say, consider clicking on the circle of cancer link on the right, or I will mail you a copy of the book "What to do when your friend has cancer." One thoughtful friend sent me six copies.
A few weeks ago I received the most wonderful email from a friend of mine from high school. She said:
"The Japanese believe that if you make 1000 origami cranes your heart's desire will be granted. I'm at 54 for this week, each one is for you. I may even mail them to you."
Today she emailed me that she is up to 99.
This was the right thing to say.
Monday, February 19, 2007
Surgery Rescheduled - Again
It' not even worth explaining what all happened.... but surgery has been rescheduled until Wednesday, February 28, 2007 at 9 a.m. I was scheduled for the 23rd at 3pm (the last of my surgeon's FIVE surgeries on a Friday.... no thanks) and had the opportunity to reschedule, and I think this will work out better for MANY reasons (not the least of which that my surgeon will be fresh in the morning, and not exhausted at the end of the week). Todd's sister gets here on Monday the 26th to help with the kids, so it's all working out.
Thursday, February 15, 2007
Random Thoughts
Shall we talk about something other than cancer?
Many thanks to the person who posted the wig link in the comments.... I needed a good laugh. If you haven't clicked here yet..... do so. I may take a poll to find out which one you think I should order.
And I've gotten more than one email poking fun at the reference to the "CCAI Snowbabies Yahoo Group" mentioned in another comment..... allow me to explain. CCAI is short for "Chinese Children Adoption International," the fabulous adoption agency we used to adopt Anika. (See link on the right). While waiting to travel to China (over 20 months from start to finish) I spent a lot of time talking to other adoptive parents (mostly moms) on the Yahoo boards.... one board dubbed itself the "snowbabies" because we expected to get our babies in the winter of 2005-06. As it turned out.... we didn't get our hands on the little darlings until August 2006 - traveling to the heat of Hunan to do so. It has been suggested that a better name for the group might have been "Lava Babies of August." I would have to agree.
I cut my hair today. Also had my wig trimmed more to my liking. Stan said I was the third client in this week to get a wig trimmed.... weird.
Although I'm bummed to delay treatment, I must say I still have my cold, and am glad I'm not also getting over surgery today. I'm enjoying my "free time" with this unexpected week "off" of cancer treatment before the fun really begins.... trying to get a little work done (telecommuting) and finishing a few projects around the house.... all the while enjoying the kids. It sucks right after surgery not to be able to pick them up for about a week.
So I started out not talking about cancer... but as you can see.... it permeates everything.
Many thanks to the person who posted the wig link in the comments.... I needed a good laugh. If you haven't clicked here yet..... do so. I may take a poll to find out which one you think I should order.
And I've gotten more than one email poking fun at the reference to the "CCAI Snowbabies Yahoo Group" mentioned in another comment..... allow me to explain. CCAI is short for "Chinese Children Adoption International," the fabulous adoption agency we used to adopt Anika. (See link on the right). While waiting to travel to China (over 20 months from start to finish) I spent a lot of time talking to other adoptive parents (mostly moms) on the Yahoo boards.... one board dubbed itself the "snowbabies" because we expected to get our babies in the winter of 2005-06. As it turned out.... we didn't get our hands on the little darlings until August 2006 - traveling to the heat of Hunan to do so. It has been suggested that a better name for the group might have been "Lava Babies of August." I would have to agree.
I cut my hair today. Also had my wig trimmed more to my liking. Stan said I was the third client in this week to get a wig trimmed.... weird.
Although I'm bummed to delay treatment, I must say I still have my cold, and am glad I'm not also getting over surgery today. I'm enjoying my "free time" with this unexpected week "off" of cancer treatment before the fun really begins.... trying to get a little work done (telecommuting) and finishing a few projects around the house.... all the while enjoying the kids. It sucks right after surgery not to be able to pick them up for about a week.
So I started out not talking about cancer... but as you can see.... it permeates everything.
Tuesday, February 13, 2007
Good News/Annoying News
First the annoying news: Surgery has been rescheduled for Friday, February 23, 2007. I went in to do my pre-op stuff today for tomorrow's surgery, and the doctor took one look at my sore throat and said "no." Apparently my cold and especially my sore throat put me at a higher risk for infection...... so no point in making things WORSE, right? This puts off the installation of the port for another week, and thus pushes the start (and therefore the end) of chemotherapy back another 10 days, but nothing to be done about that.
For those of you who want to be in-tune with my personal calendar.... my "Chemo 101" training with "Zach the chemo nurse" at my oncologist's office is scheduled for March 1st. Chemotherapy schedule to be determined on that date.
BUT NOW THE GOOD NEWS: Last Friday I had a bone scan and a triple cat scan to look for any signs of cancer elsewhere in my body. NADA. Zero, zip. Woohoo. This was to be expected since my lymph nodes were negative back in January.... but still....... nice to have some confirmation. The chemo should kill any pesky little cells that might have escaped. Bastards. Teach them to mess with me.
Anyway, over the weekend we celebrated an early Chinese New Year with other adoptive families, and then went wig shopping. Surreal. Hope you all like my new short hair..... if I even bother to wear the damn thing.
For those of you who want to be in-tune with my personal calendar.... my "Chemo 101" training with "Zach the chemo nurse" at my oncologist's office is scheduled for March 1st. Chemotherapy schedule to be determined on that date.
BUT NOW THE GOOD NEWS: Last Friday I had a bone scan and a triple cat scan to look for any signs of cancer elsewhere in my body. NADA. Zero, zip. Woohoo. This was to be expected since my lymph nodes were negative back in January.... but still....... nice to have some confirmation. The chemo should kill any pesky little cells that might have escaped. Bastards. Teach them to mess with me.
Anyway, over the weekend we celebrated an early Chinese New Year with other adoptive families, and then went wig shopping. Surreal. Hope you all like my new short hair..... if I even bother to wear the damn thing.
Friday, February 9, 2007
The Plan
As some of you know, I've been struggling with the decision regarding what to do next. After the second surgery, while I was getting my bandages off, my doctor called the pathologist to make sure everything looked OK. The pathologist indicated that there are still a few stray cancer cells in there, and it was suggested that I should consider a mastectomy. Having had no doubt that the second surgery would "get it," this came as a shock.
A third small surgery (a "wider excission") was offered, but my surgeon said (having just gotten this news herself) that a third attempt to get cancer usually is not worth it, and a mastectomy is usually performed at this point. She told us to go home and think about it..... I have done nothing but think about it for days and days. Todd and I consulted two plastic surgeons to discuss reconstruction options.
I lost sleep over this decision, wondering if a third surgery was worth it if it would fail. Wondering if it was time to just accept. I weighed options, considered pros and cons of both options (there are many that I will not go into here), polled close friends, and took a lot of drugs to help me sleep at night. In the morning I would enjoy the blissful 15 seconds of forgetting I have cancer, then remember.
Then we met with the oncologist, and she confirmed that chemotherapy is necessary. The prospect of major surgery AND chemotherapy completely overwhelmed me. The circular arguments in my head were driving me crazy, leading to no result that I felt I could stand, no decision I was prepared to make.
Finally I just let it go. I asked God for an answer, because no answer was coming to me that I could live with. Of course, the answer arrived, and now it seems so obvious.
After extensive consultation with both my surgeon and my plastic surgeon yesterday, we have decided to do a third surgery (a "wider excission") to try and get the remaining cancer. In most cases, if you don't get it the second time a mastectomy is required. However, in this case, given all the details that I won't bore you with, my surgeon and I have decided that it is worth a try. I was so pleased when both my surgeon and plastic surgeon agreed that it is a good plan. (I have to go under anesthesia soon anyway to have a port installed before chemotherapy. More on this later. So it's not really even an "extra surgery.")
If the pathology comes back "good," I won't need any more surgery. After chemotherapy, I will need radiation and that will be it. If the pathology were to come back "bad," a mastectomy would be unavoidable (but no radiation). However, if it comes to that, I will know that I did everything I could, and I will look back with no regrets, no "should I have....?" The survival rate for lumpectomy plus radiation is the same as for mastectomy alone, so I do not feel (based on all I know) that I am taking an unreasonable risk.
Regardless of how the pathology comes back, I will start chemotherapy soon. If a mastecomy is required, it will wait until after chemo is over, with immediate reconstruction.
I slept very well last night, for the first time in awhile.
P.S. The next surgery is scheduled for Wednesday, February 14, 2007. Yes, Valentine's Day. My choice. The sooner the better.
A third small surgery (a "wider excission") was offered, but my surgeon said (having just gotten this news herself) that a third attempt to get cancer usually is not worth it, and a mastectomy is usually performed at this point. She told us to go home and think about it..... I have done nothing but think about it for days and days. Todd and I consulted two plastic surgeons to discuss reconstruction options.
I lost sleep over this decision, wondering if a third surgery was worth it if it would fail. Wondering if it was time to just accept. I weighed options, considered pros and cons of both options (there are many that I will not go into here), polled close friends, and took a lot of drugs to help me sleep at night. In the morning I would enjoy the blissful 15 seconds of forgetting I have cancer, then remember.
Then we met with the oncologist, and she confirmed that chemotherapy is necessary. The prospect of major surgery AND chemotherapy completely overwhelmed me. The circular arguments in my head were driving me crazy, leading to no result that I felt I could stand, no decision I was prepared to make.
Finally I just let it go. I asked God for an answer, because no answer was coming to me that I could live with. Of course, the answer arrived, and now it seems so obvious.
After extensive consultation with both my surgeon and my plastic surgeon yesterday, we have decided to do a third surgery (a "wider excission") to try and get the remaining cancer. In most cases, if you don't get it the second time a mastectomy is required. However, in this case, given all the details that I won't bore you with, my surgeon and I have decided that it is worth a try. I was so pleased when both my surgeon and plastic surgeon agreed that it is a good plan. (I have to go under anesthesia soon anyway to have a port installed before chemotherapy. More on this later. So it's not really even an "extra surgery.")
If the pathology comes back "good," I won't need any more surgery. After chemotherapy, I will need radiation and that will be it. If the pathology were to come back "bad," a mastectomy would be unavoidable (but no radiation). However, if it comes to that, I will know that I did everything I could, and I will look back with no regrets, no "should I have....?" The survival rate for lumpectomy plus radiation is the same as for mastectomy alone, so I do not feel (based on all I know) that I am taking an unreasonable risk.
Regardless of how the pathology comes back, I will start chemotherapy soon. If a mastecomy is required, it will wait until after chemo is over, with immediate reconstruction.
I slept very well last night, for the first time in awhile.
P.S. The next surgery is scheduled for Wednesday, February 14, 2007. Yes, Valentine's Day. My choice. The sooner the better.
Tuesday, February 6, 2007
Chemotherapy and Politics
So I explained in my previous posting why chemotherapy is necessary... or "advised," in my case. The oncologist looked at us like we were nuts when we said, "Is this really necessary?" She was like, uh, YEAH. Here we thought with negative lymph nodes maybe I was in the clear.... no such luck.
Several people have advised me - or suggested - that I should avoid chemotherapy if at all possible. Well duh. Avoid getting cancer if you can, OK? That's my advice to all of you. Chemotherapy has shitty side affects, including but not limited to hair loss, fingernails falling off, sores in the mouth, and let us not forget the heart problems it can cause. Yes - chemotherapy is bad for your heart. Ironic, no? There are a million other things I don't even want to know about.
But this is how I look at it. Politically I am a pretty liberal (sorry, Dad), "can't-we-all-just-get-along," pray-for-peace kind of gal. But sometimes somebody comes along.... you know the type I'm talking about .... the really bad guys..... and they are not going to hold hands around the fire and sing Kumbaya with the rest of us. They are going to be mean and nasty and eventuallywe just have to say "we're not going to take your crap" and drop a bomb on the SOB. Do I like it? No, frankly, I don't. Do I have a better solution? Again, no. At a loss here.
Such is the case with chemo. Hopefully the collateral damage is worth it.
The good news is I had a MUGA scan of my heart and it came back "normal." So my heart is good and strong and ready to deal with the poison they plan to pump into me. Excellent.
Several people have advised me - or suggested - that I should avoid chemotherapy if at all possible. Well duh. Avoid getting cancer if you can, OK? That's my advice to all of you. Chemotherapy has shitty side affects, including but not limited to hair loss, fingernails falling off, sores in the mouth, and let us not forget the heart problems it can cause. Yes - chemotherapy is bad for your heart. Ironic, no? There are a million other things I don't even want to know about.
But this is how I look at it. Politically I am a pretty liberal (sorry, Dad), "can't-we-all-just-get-along," pray-for-peace kind of gal. But sometimes somebody comes along.... you know the type I'm talking about .... the really bad guys..... and they are not going to hold hands around the fire and sing Kumbaya with the rest of us. They are going to be mean and nasty and eventuallywe just have to say "we're not going to take your crap" and drop a bomb on the SOB. Do I like it? No, frankly, I don't. Do I have a better solution? Again, no. At a loss here.
Such is the case with chemo. Hopefully the collateral damage is worth it.
The good news is I had a MUGA scan of my heart and it came back "normal." So my heart is good and strong and ready to deal with the poison they plan to pump into me. Excellent.
Monday, February 5, 2007
The Facts
Ok, alot of you are getting this news for the first time and are wondering "what the....?" Here are answers to some frequently asked questions, and some of my clinical facts.
My father's mother had breast cancer. Otherwise I have no family history.
I am 36. Routine mammograms do not start until after 40, usually. 36 is young for breast cancer.
Younger women usually get more aggressive breast cancers. I have read it is "easier" to treat in post-menopausal women. I'm not.
I found the lump myself.
They have removed the lump, but the margins around the lump still have cancer cells. That is why they did a second surgery. Cancer cells showed up in the tissue removed in the second surgery, so a third surgery is necessary. The nature of that surgery is yet to be determined.
If they took out the lump, why do I have to have chemotherapy?
The point of chemo in my case is to get any cancer that may be floating around. Although they found no cancer in my lymph nodes, cancer can travel through the blood. The oncologist listed 6 factors relevant to determining if chemo is beneficial:
1. Tumor size - at 1.8 cm it is smallish, but no tumor is a good tumor
2. Lymph nodes - they took 4 lymph nodes and all were negative for cancer. This is good.
3. Histologic grade - tumors come in Grade 1, 2, and 3. Mine was a 3. 3 is the worst. Aggressive and fast-growing.
4. Age - as I mentioned, younger is not better.
5. Hormone receptors - if the tumor is receptive to the hormones estrogen and progesterone, there are other treatment options. Mine are only slightly receptive....so we cannot rely on the hormonal treatment options alone (if at all).
6. Something called Her2.... I don't remember what this is but mine was negative and I think this is good.
So the biggies here are my age and the grade 3 tumor. These are working against me.
Statistics
They can plug all this information into a program and it spits out a graph of how beneficial chemo is for a particular patient.
Based on my information, I have a 30% chance of getting cancer again (a "recurrance") in the next 5 years if I don't do chemotherapy. Anybody want to take those odds? This is reduced to 14% with chemotherapy. Anything more than a 4% improvement is "worth it" in oncology-speak. Clear as mud? Another way to look at it: with chemo I'll have an 85% chance of NOT getting cancer again. And a 91% chance that I'll still be alive in 10 years. That's an A minus. :) Better than some of my grades in law school.
Chemotherapy
The oncologist suggests 16 weeks of weekly Adriamycin (an injection) and daily Cytoxan (a pill), followed by 12 weeks of weekly Taxol (I think this is an IV drug). This may or may not be followed by 5 years of a daily pill called Tamoxifen. I'm telling ya', the fun never ends.
Radiation
Whether or not I have radiation remains to be decided, and if so it would follow AFTER the chemotherapy, approximately 6 weeks for 5 days a week. I'll explain radiation later.
My father's mother had breast cancer. Otherwise I have no family history.
I am 36. Routine mammograms do not start until after 40, usually. 36 is young for breast cancer.
Younger women usually get more aggressive breast cancers. I have read it is "easier" to treat in post-menopausal women. I'm not.
I found the lump myself.
They have removed the lump, but the margins around the lump still have cancer cells. That is why they did a second surgery. Cancer cells showed up in the tissue removed in the second surgery, so a third surgery is necessary. The nature of that surgery is yet to be determined.
If they took out the lump, why do I have to have chemotherapy?
The point of chemo in my case is to get any cancer that may be floating around. Although they found no cancer in my lymph nodes, cancer can travel through the blood. The oncologist listed 6 factors relevant to determining if chemo is beneficial:
1. Tumor size - at 1.8 cm it is smallish, but no tumor is a good tumor
2. Lymph nodes - they took 4 lymph nodes and all were negative for cancer. This is good.
3. Histologic grade - tumors come in Grade 1, 2, and 3. Mine was a 3. 3 is the worst. Aggressive and fast-growing.
4. Age - as I mentioned, younger is not better.
5. Hormone receptors - if the tumor is receptive to the hormones estrogen and progesterone, there are other treatment options. Mine are only slightly receptive....so we cannot rely on the hormonal treatment options alone (if at all).
6. Something called Her2.... I don't remember what this is but mine was negative and I think this is good.
So the biggies here are my age and the grade 3 tumor. These are working against me.
Statistics
They can plug all this information into a program and it spits out a graph of how beneficial chemo is for a particular patient.
Based on my information, I have a 30% chance of getting cancer again (a "recurrance") in the next 5 years if I don't do chemotherapy. Anybody want to take those odds? This is reduced to 14% with chemotherapy. Anything more than a 4% improvement is "worth it" in oncology-speak. Clear as mud? Another way to look at it: with chemo I'll have an 85% chance of NOT getting cancer again. And a 91% chance that I'll still be alive in 10 years. That's an A minus. :) Better than some of my grades in law school.
Chemotherapy
The oncologist suggests 16 weeks of weekly Adriamycin (an injection) and daily Cytoxan (a pill), followed by 12 weeks of weekly Taxol (I think this is an IV drug). This may or may not be followed by 5 years of a daily pill called Tamoxifen. I'm telling ya', the fun never ends.
Radiation
Whether or not I have radiation remains to be decided, and if so it would follow AFTER the chemotherapy, approximately 6 weeks for 5 days a week. I'll explain radiation later.
Thursday, February 1, 2007
The Backstory
Following the discovery of a lump, a mammogram, ultrasound and fine needle biopsy were performed in December 2006. I was diagnosed with invasive ductal carcinoma (breast cancer) on December 20, 2006.
On January 12, 2007, I had surgery to remove the lump. Pathology revealed that surrounding the invasive tumor there were tiny little cancer cells just waiting.... waiting to grow up to be a big tumor like their mentor that was removed. These tiny cells are called ductal carcinoma in situ. (DCIS). My surgeon said they had to be removed. She thought they could get it all with one more surgery.
So one week later, on January 19, 2007, I went into surgery again. More tissue was removed. Pathology revealed that the DCIS was now showing up in other areas. More surgery will be required.
After surgery I will have chemotherapy, possibly for as long as 28 weeks on a weekly basis.
Then I will probably have more surgery to complete reconstruction, if necessary.
I have been keeping those close to me informed via email. It has become too big of a project to keep doing email updates, updating the message boards where I have concerned friends, and fielding telephone calls from all concerned.... so this blog has been formed.
This blog is for me, and if you love me, this blog is for you. I don't promise to be all sun-shiney and optimistic all the time. I don't promise to always see the glass as half full. I don't promise that I won't swear like a sailor, pitch a fit, have a pity party for myself, or seem pathetic at times.
I do promise to fight with every ounce of strength that I have. When I seem to be losing strength, send me some. Pray, send me emails, call me, bring me some cookies, and then pray some more.
On January 12, 2007, I had surgery to remove the lump. Pathology revealed that surrounding the invasive tumor there were tiny little cancer cells just waiting.... waiting to grow up to be a big tumor like their mentor that was removed. These tiny cells are called ductal carcinoma in situ. (DCIS). My surgeon said they had to be removed. She thought they could get it all with one more surgery.
So one week later, on January 19, 2007, I went into surgery again. More tissue was removed. Pathology revealed that the DCIS was now showing up in other areas. More surgery will be required.
After surgery I will have chemotherapy, possibly for as long as 28 weeks on a weekly basis.
Then I will probably have more surgery to complete reconstruction, if necessary.
I have been keeping those close to me informed via email. It has become too big of a project to keep doing email updates, updating the message boards where I have concerned friends, and fielding telephone calls from all concerned.... so this blog has been formed.
This blog is for me, and if you love me, this blog is for you. I don't promise to be all sun-shiney and optimistic all the time. I don't promise to always see the glass as half full. I don't promise that I won't swear like a sailor, pitch a fit, have a pity party for myself, or seem pathetic at times.
I do promise to fight with every ounce of strength that I have. When I seem to be losing strength, send me some. Pray, send me emails, call me, bring me some cookies, and then pray some more.
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