Dang I am a complicated person...and no comments from the peanut gallery! LOL One last treatment change but, as Professor Higgins once said, "I think we've got it!"
Met with my Medical Oncologist, Dr. Alguire, today to determine my final treatment plan. She did her homework, as did I, and we had a very fine discussion. I truly appreciate the way she listens, feel completely confident in her judgment, sincerely respect her medical expertise and appreciate greatly her patience with my questions...and I had a few.
There was a notation in my Mayo path report that "Angiolymphatic invasion was present" and on looking that up on line, I discovered: Angiolymphatic invasion means that the pathologist was able to see cancer cells in the middle of blood vessels. Chemotherapy is used to treat any cancer cells that may have left the tumor to settle somewhere else.
We discussed chemotherapy and after she clarified a few points, I was completely satisfied and comfortable, both in regards to HER2 1+ status, the possibility of floating hidden cancer cells elsewhere and what is best for them, and with her general explanation of what she felt would be in my best interest.
Because of my high levels of estrogen for one thing, the chemo could possibly be more harmful to me at this point than be of help, even to the point of increasing my risk of cancer reoccurence. Didn't take a rocket scientist to figure out what to do after that point was made! We completely agreed that the "four hits of chemo" that had been recommended before and discussed previously were out!
On Friday at 10:00 am, I have my first consultation with Dr. Tate, who will be my Radiation Oncologist. I told Lindsey, the check out receptionist, that I needed to arrange this. She went to Radiation, rather than wait on the phone, and got me the earliest they had so I could get started. This takes place right there at the Center. It was wonderful to have that scheduled AND she even got an appointment with Mercy Hospital Imagining department to have my Bone Density tests done next Tuesday. I LOVE "one stop shopping!"
The consultation specifics: The documentation for my consultation visit at JFCCC is very thorough. My family and I will be escorted into an examination room by my radiation oncology nurse. She will discuss health history, do a head to toe assessment, discuss what to expect during the visit and will show a patient teaching DVD so we will be better informed regarding radiation treatment prior to meeting my physician. While the nursing visit is underway, my Radiation Oncologist, Dr. Tate, will be reviewing my X-rays (have fun, Dr. T, there are quite a few!) and chart information. When it is his turn, he'll introduce himself to all of us, perform a physical exam, and give his recommendation as to my treatment plan, along with the benefits and associated risks. Questions are encouraged and welcomed. They encourage my family to accompany me during this visit which will consist of 1 1/2-2 hours.
I have bone density tests to be done next Tuesday morning at Mercy Hospital, but I can do that very well on my own.
My understanding at this time is several weeks of radiation, five days a week, number of weeks will be determined during this consultation on Friday. IF I need company, some of you have already offered to drive or be with me and I will definitely be calling you without hesitation if it becomes difficult for me...promise!
Dr. Alguire suggests I take an Aromatase Inhibitor, Arimidex, for the next 5 years. That's a totally different one from Dr. Batts (Tamoxifen) and Dr. Goetz (Letrozol/Femara). I had been concerned with what I had read regarding Tamoxifen,that it would not be as effective for me. Tamoxifen is best for women who have NOT already gone through menopause and Dr. A agreed. The Letrozol would be the second option for me IF I can not, for some reason, tolerate Arimidex. Arimidex is one AI that Dr. Alguire has had a lot of success with and has a lot of patients currently on this regimen, which is comforting in itself. Hard as it might be to believe with all the research I did, it is the one medication I DID NOT read up on. Leaves me with something else to find out about and I have time before I start it anyway.
Radiation isn't going to be a piece of cake, I know that already and I am sure you will hear about it here. But after that is over, I will be taking a daily pill for the next 5 years. As she said, "Basically Donalee, from all outside appearances, no one will even know that you have cancer or are under current treatment for it."
From chemo/radiation/tamoxifen to heart challenging Herceptin & chemo/radiation/tamoxifen/AI to radiation/AI...I've have walked a very, very long and sometimes stressful road! I've dropped from being a highly aggressive HER2 3+ positive to a milder but still present HER2 1+ and I can definitely live with that! No matter what you do, there is always a chance for reoccurance, but right now, I couldn't have a better prognosis.
It's been 3 very, very long months...but I came out ahead for it all in the end. It was worth the trip to Mayo and all the studying, crying, babbling, and frustration to finally reach this point. I am humbly grateful to my family and sincerely thank all my friends for supporting and encouraging me to do what I felt I had to do.
Even though it is a pill, it will still be an adventure. Through the radiation and along this road awhile, there will be more to say I am sure. There are bridges yet to cross and experience. This journey is far from over.
But I see what Ann meant by "feeling lucky"...and I am feeling incredibly lucky right now!
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