The Big Reveal

Here is what I looked like this past Friday, November 28th, 2014:

Me & Bryce at Trey show, Aragon Ballroom

And here is what I looked like the very next day...

Notice anything different? That's right, for the first time in 18 years, I have short hair! Here's another angle:

And the back:

In anticipation of losing my hair, I cut it so we could start adjusting to seeing it short. But it's not going to waste. I'm donating this much to Locks of Love, which makes wigs for children with cancer.

11 inches!

My friends Krysten and Erin were there providing moral support during the haircut...thanks again ladies!! Then Beth and Kristi joined us for lunch and drinks to celebrate my new look and toast to a healthy future. Hugs to you all!

Bizarro Pregnancy

Going through cancer treatment is a lot like being pregnant, except that everything is turned on its head—bizarro pregnancy, if you will. How so? Let me count the ways:

LIKE PREGNANCY, everyone is focused on something inside of me.

I as an individual cease to be the protagonist of my own life, and everything revolves around the thing inside of my body.

BUT, instead of this growth inside of me being awaited and celebrated, it is feared and loathed, a thing to be gotten rid of and destroyed instead of a thing to be welcomed and cherished.

LIKE PREGNANCY, I am in doctors' offices all the time.

BUT, instead of receiving smiles, knowing glances, and perhaps even a look of envy at my swollen belly, I am looked upon with pity and surprise. I am no longer surrounded in the waiting room by women in my age group; I am always the youngest person there. And when the elderly are pitying you, you know something is seriously wrong.

LIKE PREGNANCY, people feel they have license to tell you anything and everything about their experience or the experience of anyone they have ever known, whether you want their input or not. In this area, there is actually little difference between pregnancy and cancer treatment. The degree of scientific backing for peoples' suggestions is exceedingly low in both situations; unverified internet information, old wives' tales, and personal experience (which by its nature is unique to every individual) suddenly become medical fact in the mind of the person talking to you. They undoubtedly know what you must/shouldn't/can't/had better do.

BUT, the content is of course different. Instead of "Oh, you're carrying high so it must be a girl," the prognosis is instead something like "Keep you body alkaline!" Or was it acidic? I can't remember now what the woman at the spa said when I hadn't asked for her advice...and besides, don't our bodies maintain a necessary pH level that isn't impacted by short-term changes to the hydrochloric acid in our stomachs? Soooo....

LIKE PREGNANCY, I am taking about six months off of work. And the entire ordeal will likely be 9-12 months.

BUT, there is nothing cute and cuddly at the end that I can walk around the office with.

What I hope for most is this:
LIKE PREGNANCY, cancer treatment will last for a defined amount of time and then end. Be over. There will be permanent, lasting changes—such is the nature of living in a body. And they will be unpredictable and personalized, a reminder that your body has gone through a significant challenge. But over time those changes become a part of who you are; they don't preclude feeling or looking good, or being normal.

BUT, it is a phase to be endured, and reaching that end calls for a drink.

Getting a Second Opinion

Today we met with Dr. William Gradishar at Northwestern Memorial to get a second opinion on my course of treatment. By all accounts, he's the leading breast cancer specialist in the Chicago area and one of the top breast oncologists in the nation (just check out this publications list). My oncologist recommended I see him simply because my case is such a borderline situation. So it isn't that I don't trust or agree with my oncologist; he's smart enough to recognize the value of additional input and referred me to bigwig in the field (part of why I like this guy).

Anyway, Dr. Gradishar agreed with our treatment plan and said he would recommend the exact same thing: chemo with a 4-round course of TC, radiation, and Tamoxifen (hormone therapy since the tumor was hormone responsive). This was very reassuring, obviously! On the one hand, it's good to hear from the top expert in your particular health issue that he/she would do the same thing you're planning. It's also nice to not have the waters muddied, so to speak, by that person recommending something else or casting doubt on the course of treatment. All in all, I was hoping for confirmation from this meeting, and that's exactly what I got!

Another bright spot was that the word "cured" was used in the conversation, and it's a relief just to hear it. According to the doctor, for all intents and purposes I am "cured" right now since the tumor was removed cleanly and entirely, and my lymph nodes were negative. Of course, systemic treatment is still crucial to prevent any microscopic cells anywhere in the body from growing, but he said I'm at "the good end" of the scale, and this is likely "a bump in the road." Always a nice thing to hear!

Cancer Update!

OK, so this is a way for me to keep everyone up to date on the latest cancer news. Please feel free to comment (I get notifications), but if you'd rather text, call, send a carrier pigeon, whatever, that's fine too. My apologies to those of you who know some/all of this info...skip whatever you already know!

Where things stand right now: I am done with surgery and will be starting chemotherapy the second week of December. My lumpectomy was a success, they biopsied three lymph nodes, which were all negative for cancer cells, and radiation will come later on. Many of you know I was on the fence about chemo, but in light of my latest test results I feel it's safest to just do it.

What changed? Well, my Oncotype score was "intermediate" risk for recurrence, but very close to the "low" risk part of the scale. Needless to say, it was inconclusive. So my oncologist ordered a MammaPrint test, which is a more comprehensive test of genes from the tumor tissue. That test only has "high" and "low" risk of recurrence. My results were high-risk, but just on the line between low and high. Literally. On the line.

My surgeon's response: "You've gotta be kidding me."

Unfortunately these results are rather inconclusive too. However, if that high-risk categorization is accurate (and the testing company itself says it's got >10%  chance of being wrong), then I would benefit notably from chemotherapy. Basically chemo will substantially help prevent cancer cells from recurring in another organ. Of course, the cancer could still pop up in another organ even with chemo, but the treatment will lower that risk in a numerically significant way.

So, I'm going to suck it up and do a chemo regimen for three months. I'm concerned that if it recurred in my liver, kidneys, what have you, in a few years and I hadn't done chemo now, I wouldn't be able to live with myself. I feel I need to do everything I can to beat this NOW and ensure my best chances for long-term survival. If it does come back in a different organ in a few years, at least I'll know that I did all I could. I'll get four infusions of two chemo drugs (cytoxan and taxotere for those of you keeping score at home), on a three-week cycle. This is set to begin 12/8, with the last one around mid-February.

Once I've had a few weeks to recover from that, I'll start radiation. What is the point of that, you ask? Radiation is to kill any latent cancer cells in the breast tissue itself. Since I didn't have a mastectomy we need to blast the shit out of the breast with radiation. That will be about two months but less intense side effects than chemo (i.e., a bad sunburn and fatigue). In total, this crap is going to be about six months.

On the bright side! Bryce and I are taking a much-needed, much-deserved vacation to the Dominican Republic to celebrate our 10-year wedding anniversary! We'll be spending five days at an all-inclusive resort where Umphrey's McGee is playing a music festival exclusively for resort guests. We've been planning this for months and are so relieved that the cancer didn't ruin the trip (it seemed that it would at a couple points). Then I have my first chemo infusion less than 12 hours after we're back.

You may wonder how I'm handling things, and that answer changes hour to hour. I feel satisfied with my choice to have a lumpectomy and radiation (the survival rate for women choosing that option is exactly the same as it is for women who choose a mastectomy). If a breast tumor comes back, mastectomy is still a tool in the toolbox. I am at peace with the decision to do chemotherapy. I'm terrified, angry, saddened, and all those other things that come with a cancer diagnosis. I'm grateful I have amazing doctors and a good prognosis. I'm relieved I have quality health insurance. I am paranoid it will come back. I am human.

What's next? We're meeting with another oncologist on Monday to get a second opinion. I doubt he's going to say much of anything different, given the latest test results, but he's a breast cancer specialist and I'm looking forward to getting confirmation that I'm taking the right path, or to hear of some amazing new study that could brighten my outlook. I'll post again with an update from that meeting...stay tuned!