TO SURVIVE IS OUR STARTING POINT...
TO THRIVE IS OUR ORIGINAL DESIGN....
-Beverly Vote
 |
 |
| Customize a scrapbook design |
If there was any good news, it was that the Lobular form of Breast Cancer is usually slow growing and also ER/PR and HER2- which, thankfully, my tumor was. The bad news is that this form of Breast Cancer is also referred to as "the sneaky stuff". Only a year before I had a Mammogram that was "unremarkable". My tumor was estimated to be about 2-3cm in size. My surgeon had performed his own Ultrasound and punch biopsy confirming the suspicions of the radiologist. I was scheduled for an MRI to further define the area of the tumor and the size. The tumor was very clear on the Ultrasound, but both the Mammogram and MRI were marginal at best in showing the tumor and the size.
In October of 2009 I went in for a scheduled Lumpectomy along with a Sentinel Node Biopsy. Waking up from the surgery there was the Hospital's Breast Cancer coordinator handing me a huge pink teddy bear. Welcome to the world of pink, I was formally inducted into "the club". She had also accompanied me for the preparation for the SNB, as they inject a radioactive dye into your breast which lights up the lymphatic path showing the connection between the lymph node and the tumor. This is how they minimize the number of lymph nodes that are removed to determine if the cancer has metastisized. I remember how scary our discussion was while we waited for the dye to disperse in my system. She asked "do you have a good support system"? Not really knowing her, I responded with what I thought she wanted to hear. I really just wanted to be left alone.
The next day after the surgery, my Dr. called stating that the tumor margins were not clear, he needed to go back in. They call this a resection - I call it a do over. Basically, they had determined that the cancer was what is called Multi-focal. The breast is looked at as having 4 quadrants, my tumor had very thin branches that had spread to other quadrants of the breast. Think of it like a daddy long legs... when they remove the tumor they have to have a section of tissue that is clear around it. Because of my little spider growing inside, it was difficult to get the clear margin. We decided to name the tumor George - George was there, sneaking around inside of me and George had to go!
After the surgery, the Tumor board reviewed my case. The tumor board consists of the Surgeon, the Radiologis, the Breast Cancer Coordinator and the Oncology doctor. They determine the best course of therapy to address the cancer. In my case, there was no question chemotherapy was required. Then there was the choice of Radiation or Mastectomy to take as the next course of action. This is where things start to really get mind boggling. I understand the methodolgy of the shared decision making approach, but damn it, I wasn't the skilled physician - I just wanted somebody to agree. The surgeon wanted Radiation, the Radiologist thought Mastectomy, the Oncologist thought either was a sane approach. I wanted to just SCREAM. For the radiation, I would need 6 weeks of daily treatment. I just wanted to be cancer free and move on with getting back to a "normal" life. HA! Little did I know, life never returns to "normal", it is long gone from my vocabulary.
I began my chemotherapy the week following Thanksgiving. My treatment was 4 cycles of AC every 2 weeks as long as my cell counts were not too low. The drill was, a blood test for cell counts, then treatment, then the metal taste in your mouth for a week and then just when you feel like you can eat again it is time for the next treatment. The A part of the treatment is a wonderful OLD drug known as Adriamycin (doxorubicin). You can only have it once in your life as it is really hard on the veins and your heart. In some cases they even test your heart before they start treatment with it. This drug has been given the name "red devil" by Sistahs that have had therapy with it. The freaky part is that when they give this drug to you, it is not given through the IV like the other part of your "cocktail" (doesn't that sound like fun - a "cocktail") is. The Adriamycin is given with a HUGE needle as a "push". This means that the slowly (very slowly) inject the drug by hand a small amount at a time. They keep a sharp eye out for any reaction or indication that the vein is leaking as this drug immediately will destroy tissue if it leaks from the injection site. You are made very aware that you have to let them know if you feel ANYTHING! Seeing them come at me with this drug and their safety gear was definitely eye opening. The first treatment was hell, I woke up the next day feeling like I was going to die, my husband didn't know what to do with me, I felt like my head was ready to explode. We called the doctor and his response was "it is the drugs"... hmmmmmm no shit! He called in something for the headache and nausea and told me that the next treatment they could make adjustments to compensate for the reaction. They did and treatments 2 and 3 were not bad at all.
By the 4th cycle, the chemo was doing its' thing. The theory behind chemo is that after the surgery it takes care of any remaining cancer cells that can still be produced in your system. The reason they give it over a period of time in the cycles is that the hope is that it catches the cells when they are actively reproducing. The tough part is that there is no way for the drugs to distinguish good cells from cancerous ones - which is why other cells (like hair follicles, white blood cells, red blood cells, brain cells) are also affected. The last cycle my white count was low-low-low. I had gotten the dreaded mouth soars and had to get the magic mouth wash to dull the pain. Because of the low cell count, chemo was delayed an extra week to give the cells time to build back to the level they need them to be for another round of treatment. At the end of January I finished cocktail hours (4 to be close). Chemo was now behind me.
During this phase of the treatment, I spoke with the other doctors and determined the route that I would take post-chemo. We agreed that for this cancer, a uni-lateral mastectomy would be a solid approach with immediate reconstruction. I went to Dartmouth/Hitchcock to consult with another surgeon and a plastic surgeon to schedule this surgery.
