TRUTHS

When you get right down to it, the truth is that perky breasts, loosing my hair, and the fact that I might miss out on many things over the next few months aren't that important to me. What I want more than anything is to be around for the future. I want to watch my son graduate from college and find a career he is passionate about. I want to be there when he says his vows "to love you in sickness and in health" and to hold my grandchildren. I want to climb big mountains in Italy with Mark, drink margaritas with him while my toes play in the sand, take long walks along the American River with our dog and watch the hawks fly high. I want to share morning cups of coffee and discuss the world news. I want to continue to be there as my nephews and nieces grow up. I want to be there to help my Mom and in-laws as they grow old. I want to go to family reunions in Yosemite and hang out at Donner Lake. I want to celebrate your 80th Birthdays with each of you! I think you get my drift.

And that is what the next phase is all about. It's about keeping the cancer from returning. We met with the Medical Oncologist, Dr. Rohatgi on Thursday. He asked me tons of questions about my health. He was so very patient with both Mark and I as we asked for clarification on just about everything he said. And he even had a sense of humor. Lucky us to have found another doctor we really like! Without too much detail I will try to give you a summary of our meeting. Without doing any further treatments I have about a 25% chance of the cancer reoccurring somewhere else in my body. If I take the chemo pill, Tamoxifen, for 5 years that brings the rate down to about 16%. If I take a course of chemotherapy - four treatments, three weeks apart then it can bring the chance for reoccurance down to around 10-11%. He said that no one every gets it lower than about 5%. So, going from 25% to about 11% sounds really good to me. All these statistics come from a database called Adjuvant. The scientists have been studying the tumors and keeping stats since the 80s. (Yes, I think they keep all those breast tumors stored somewhere indefinitely so they can continue to do different studies on them.) One thing to keep in mind is that the chemo "cocktails" have improved a lot since then so in reality the chances for the cancer returning might be even lower. (Do you think it's fair to describe chemo as a "cocktail"?) And the other silver lining... the side effects are not as bad as they used to be. Yes, he told me I would loose my hair. But most don't feel the nausea and other things so much. I have recently spoken with two friends who have just finished chemo and didn't have such a hard time with it. (Maybe they were lying like my frisbee/tupperware friends.. but I don't think so.) 

So I think that I will be starting chemo in about 3 weeks. BUT there is one more test that the doctor just ordered on my tumors. It is a fairly new test called Onocotype DX. In a nutshell, this test identifies which types of breast cancers benefit from chemo treatment. This test looks at a group of 21 genes of my tumor and based on that gives my tumor a reoccurance score which determines if I will benefit from chemo. If you are curious and want to know more please go to this website. I can't say that I clearly understand it. I do know that you can't have lymph node involvement and need to be estrogen-receptor-positive in order to qualify for the test. I know is that it takes two weeks to get the results back. So, we wait again. But they wouldn't start chemo right now anyway as I still get more time to recover from my surgery.

http://www.oncotypedx.com/PatientCaregiver/OncoOverview.aspx?Sid=1 (This is the page with the overview.)

We also met with the Radiation Oncologist on Wednesday. A friend from my ski club who has recently finished her breast cancer treatments was a patient of Dr. Ryu and told me all about her before our first meeting. Needless to say, we thought she was great. She is also a big skier so we have much in common. She says I am in a bit of a "grey area" when it comes to radiation treatment. I don't fit into any neat little box that says yes or no. Radiation is done to make sure that all the cancer cells were removed from the area during surgery. I had that tumor that grew into the muscle, but they got clean margins. I had another tumor and a "mass of stuff" in between. There could be a few cells floating around in there. Basically she said that she tends to be conservative when ordering radiation. Doesn't do it unless she feels strongly about it. However, she said she would be "offering  me radiation". I said "offering? is that like offering me a cookie or a piece of cheesecake?". She laughed. But she will be "offering" me radiation and I will most likely "accept her offer". It wouldn't happen until after chemo is done. And then it would be every weekday for 5 weeks in a row. No skipping! It doesn't take long to get the zap of radiation. But you have to go every day. Doesn't that sound fun? 

It's a lot to take in. And even though I try to make my blog upbeat, I do cry. And when Mark asks what he can do I say "Please make it go away". And of course that probably makes him feel worse as this one is out of his control. 

I am blessed for the following reasons: 

I have wonderful family and group of FINS!

Modern medicine can do so much for me.

I have such an incredible team of doctors and nurses on my side.

I am healthy (except for this cancer stuff).

I will recover and put this behind me. 

I could go on and on...

By the way, two friends answered my rhetorical question. I am now a Breast Cancer Survivor... over three weeks now. Those two friends are also Breast Cancer Survivors. Get your mammograms!