Definitely! I have a feeling there will be some times in months ahead when I just might have to have someone help me get where I need to go. That is already difficult for me to imagine. So now, while I am perfectly capable I did not feel I needed anyone with me. This wasn't quite so easy to explain to my very caring friend.
I wanted to have a serious one on one talk with Dr. P so I knew beyond a shadow of a doubt that she was the very best person for me to be and work with. Here is the synopsis I sent to my chosen family members after my meeting.
I am glad that I went to my appointment with Dr. P on my own today. There were some things I needed to say and I came with my questions in hand. We had a really good conversation and I can honestly say I feel comfortable...she even likes me! You'll just have to trust me on that. It's a feeling that I have and I get a lot from a person, their face, and their eyes. ;-)
I also read three different books since last Thursday, so some things actually made more sense to me this time, THANK GOODNESS! So here is how things went:
She explained that my pictures were shared at a review board meeting that just happened to take place on this day this month and was attended by radiologists, oncologists, and surgeons...nice and knowledgable combination for my kinda thing! LOL This was why I have been scheduled for another mammography (yes, I know it is my 3rd with an MRI in the mix too...such a complicated woman I am).
The radiologists all agreed that further pictures were necessary to ELIMINATE the idea that the little "specks" floating about in my left breast are cancerous calcifications. That could change things regarding treatment and my choices IF they are so they want to get some facts on those little guys right away. They now have my old films from WA so they have something to compare to and don't think they have changed but they want to be as sure as they can be.
IF more calcifications are discovered in the mammogram next week, another stereotactic biopsy like I've already had can be performed to remove and/or pinpoint them for removal as well. She really doesn't think we'll have to go there.
The results from the May 4 Biopsy & the basics:
My cancer is Invasive (or Infiltrating) ductal carcinoma, which about 80% of the breast cancers are. My mass is relatively small, so until they do the Sentinel Node procedure, they tentatively consider me at Stage 1
The hormone receptor test has been done which was POSITIVE and that is good.
But you know me, I like to give people a little bit of a challenge so...
The HER2 test is also POSITIVE, which is not good. This is a protein in my breast cancer the can make the cancer cells grow. About 25% of breast tumors have too much of this protein...guess who fell into that category? Lucky me!
They have discovered these so-called Herceptin tumors, even though they are small, tend to show up other places if they are not destroyed. Even though they are small, you still have to treat them. Several years ago, chemotherapy was ineffective against this type of tumor. Within the past few years, they have discovered that chemotherapy drugs and Herceptin can stop these cancer cells from growing and they have had wonderful results. I like the sound of that! So I would undergo what they refer to as Herceptin Therapy...surgery, then chemotherapy, then radiation...what a cocktail!!!
I have a copy of my pathology report...I have read it, we went over it together, and I checked the information.
We discussed talking to my primary care doctor about all this. She also suggested talking to her about who to get a second opinion from and to suggest names of oncologists I could talk to.
She suggested oncologists too and I can talk to them now if I want. Dr. Petty and the book from the ACS agree that they are more helpful after the sentinel node biopsy because then I have been "staged" (Stage 1, 2, 3 etc) and their treatment plan can be more specific and also speak to what side effects I may have to deal with.
She mentioned others but pointed out Dr. A and Dr. B, who I had already looked up on my insurance plan...younger doctors, both nice, and interested in quality of life things too.
Since we do not know at this point whether or not the cancer has already spread we discussed that today too. Here is how she explained where we go from here:
Lumpectomy/Sentinel Node Biopsy:
The radiologist will give an injection of a radioactive substance around the tumor. Dr. Petty will inject a blue dye and use a geiger counter to determine where to make the incision. The lymphatic fluid in that area will carry the radioactive substance and/or dye to the first node(s) in its path and help the surgeon locate the sentinel node(s). Once it's identified, the surgeon removes just those particular node(s). The pathologist will take a close look and see if the cancer has spread there. IF none are found, the surgeon can assume that the other nodes are free of cancer as well .
In my mind, that's where it will end so keep your focus on that. I don't want to lose any more lymph nodes! ;-)
With a lumpectomy, she will just remove the small mass and the immediate "margin" area. We are doing breast conservation so there is a treatment process to follow.
After Surgery:
Procedure: Herceptin treatment is close to a year. Because I have this "herceptin thing" as we called it, it flips my treatment plan around. Most go Radiation then Chemo, I do the opposite to make sure there isn't anything else there.
Surgery (explained above)
Chemotherapy: Everyone is different. Some will have problems, some won't. Not like 20 years ago. They have meds for the nausea, meds to keep your white blood cell count up to help fight infections, things are way better now. Likely to have hair loss, but she deferred and suggested I speak to the oncologist for specifics.
Radiation: With breast conservation and herceptin therapy, you must have radiation as part of your treatment too. This program will follow chemotherapy and consist of treatments for 5-6 weeks, 5 days a week, 10-15 minutes daily.
Personal Notes/comments from Dr. P:
"You were discussed at the tumor conference and they said "as long as she doesn't have any other calcifications she is a good candidate for a lumpectomy and yes she will need chemo." You were discussed by all the oncologists and they all agreed. That's why Dr. H, a radiologist, called and requested that I get the additional mammography, just to be certain on the calcifications."
"Ok, Dr. P, I have my questions and I've done my homework." "You've done an exceptional job. You are also calmer than most people. Some are so wound up that they can't think of anything. They can only focus on the word itself. It's hard to get them to be positive or to think about the next step. You're not like that, I don't have any issue."
"Are you thinking of the lumpectomy? I would, really. Your situation is good for it. I am going to tentatively set you up for surgery at Hackley and try for the first week in June, since that's your preference. It will take 7-10 days anyway. I have better luck at Hackley with sentinel nodes and localizations. After Memorial Day weekend will be fine."
So that is where I am right now. Yes, I made light of some things but I know this won't be easy, there will be some lousy times, but my mind has to stay in the brightest, sunniest, best place possible while I deal with the reality of it all.
No comments:
Post a Comment