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!