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Wednesday, April 21, 2010

Meeting with the team of oncologists -- DAMN! IT WAS LONG!

So today was the big "C" day, which stands for "conference" or it could stand for "cancer" or just "chaotic" because all three sort've categorized my various meetings. I'm going to summarize in this second paragraph so that anyone who is just skimming or stopping by to get the take-home message can skip the details that will follow from the second paragraph.

The most important person I met with was Dr. Keith Amos, the surgeon who will be doing the 3 procedures on me Friday at 9:30am (and I should be awake and ready to go home by 3pm), which are:
1) left breast lumpectomy to remove the 2 tumors--the largest of which is 2.5 centimeters
2) left breast lymph node sentinel biopsy -- to determine whether the cancer has infiltrated my left lymph system.
3) right breast excise biopsy to remove the calcification points that the cancer team is concerned about because they are of indeterminate status.
I will get the results of the lymph node and right breast biopsy on Thursday, April 29, and after I get the results I will be able to figure out a treatment plan. At minimum, I will be on tomoxifen (cancer drug) for the next 5 years. In the best case scenario (which means no cancer in right breast or left lymph nodes) I would only need to have radiation and not chemo in addition to the tomoxifen, and no other surgical procedure.

Ok, so that's the bare bones of it. Here's a bit more detail for anyone interested.

So, as I noted above, the best case scenario is that the only cancer I have is the two tumors in my left breast, which are relatively small. The next best scenario would be that the right breast has malignancies that are contained within the duct (what's called "in situ") because that means that there's no chance of them spreading to my lymph system. If the cancer is no "in situ" and is invasive (meaning it went outside the duct and into the breast tissue) then I'll need to do a lymph node sentinel biopsy of my right lymph nodes.

The biopsy results are really key to figuring out my treatment options. But at this point, there probably won't be any more surgery (aside from another sentinel biopsy depending on the results of the right excise biopsy). Whether I do chemotherapy vs. radiation or a combination of chemotherapy and radiation (and it would happen in that order if I had an aggressive or late stage cancer, with 4-6 months of chemo and a 3 week break before 4-6 weeks of radiation) depends entirely on whether the cancer is in my lymph nodes and how widely it has spread there. And whether or not I need or should have a masectomy will also depend on the biopsy results--but the good news is that a lumpectomy with radiation has equal rates of survival as masectomy with chemotherapy--the key difference is rates of recurrence (there are virtually none with masectomy since you get rid of all the breast tissue). Anyway, it seems like I won't have to make that kind of a decision until well after the treatments.

In terms of treatments, radiation, as I noted above, lasts 4-6 weeks and I would have to go in everyday for 5 days a week (basically M-F). The actual radiation procedure lasts 5 minutes but the visit itself takes about half an hour (you know, the gowning, the waiting, etc...). They didn't go into detail with me about chemotherapy because I wasn't scheduled with a medical oncologist--which I suppose means that they are so hopeful/positive about my cancer that they didn't think I needed to see a medical oncologist (who is basically the person who would handle my medication/chemo treatment if I needed it).

I probably saw about 10 different medical professionals, all of whom seemed to know the basic facts about who I am, what I do, where my cancer is, what my prognosis seems to be, and the fact that I'm getting married at the end of May--because they all wished me congratulations and then proceeded to go into details about their particular interest or knowledge about my case. This is one of the benefits of being seen at a cancer hospital--that they have a whole team of people who review all cases and weigh in on them, and then they come visit you one by one to talk to you about your case.

Anyway, there's a lot more I could say about the visit, but I think this is a long enough post and has the most relevant information in terms of my overall health outcomes. Everyone I met with seemed very hopeful and my surgeon seemed really confident about everything--which is exactly what I want from my surgeon.

Finally, I will end with sharing part of why this blog is called "No Fucking Pink Ribbons."

I was given a huge folder full of information related to cancer care, particularly my kind of cancer. And inside is this thick booklet, with the following image plastered on the front and back as well as inside the pages of the booklet:

I have no idea why this woman is throwing back her head and throwing back her hands--unless she is a gymnast who has just finished landing a triple somersault backflip off of a balancing beams (thanks to Jordynn for astutely noting that this is exactly what she looks like!). But the whole theme of "My Health, My Journey" is ridiculous! I mean, the whole booklet describes breast cancer as a "journey"--WTF???!!! It doesn't even work as a metaphor. I DO NOT feel like I am preparing for a trip. To the hospital? To the clinic? Cancer isn't a "path" -- it's a disease that reproduces in your body and will kill you if you don't do something about it. What, exactly, is journey-like about that???!!!

Anyway, I took out my disgust and frustration on the oversized bookmark they included in the back of the booklet (although I should note that Ashley says that it's way too big to be a bookmark and appears to be more a door hanging except who the hell wants to hang this thing on their door???):

Finally, Beth decided to be really cheeky and send me a box of items from the "Pink Ribbon Shop," including this great thermal mug that has a built in tea infuser for me to make tea! I decided to do some decorating of the pink mug that was more in keeping with my personal motto:

If you've read this far, you're a champ! And thanks to Jordynn for the flowers, to Ashley for dropping off dinner tonight, to the English & Comp Lit department for sending flowers over the weekend, to Laura for putting a sign on my door announcing the end of my office hours, to Rebecca for being such a champ and being with me through my onslaught of appointments starting at 10:30am, to Mai and Jane for being part of my support team of funneling communication, to my Mom for being my nurse-sounding board, to all of you reading this for all your messages and phone calls of love and encouragement, and especially to Matthew for being a rock and pillar for me--as well as being a source of unconditional love and support who is also OK with me being one angry woman because having cancer just sucks and it pisses me off.


  1. FYI... I always thought that the "pink ribbon" thing was cheezy (my preferred spelling, which evokes EZ-cheese) and Polyanna-ish. I've never admitted it before, but your "NFPR" campaign encouraged me to speak freely. Maybe fighting breast cancer doesn't need to be a "pink" or ribbon-inspiring endeavor. As a mild tangent, in the military, I always thought that ribbons were ridiculous, especially when they were offered as rewards. /Animal Farm/, anyone? PH

  2. I am absolutely with you on the anti-pink-ribbons sentiment. The way it's exploited as a commercial enterprise is disgusting - I mean yes, great, excellent, it's a well-recognized symbol that basically screams "DONATE HERE" and yes, let's do fundraisers and beat the crap out of this thing - butbutbut there are also plenty of companies who'll simply slap the symbol on their products and sell them as-is. People buy them with the expectation that some of the proceeds go toward breast cancer research, but that's not necessarily or even usually true.