Here we go...

Time and date is set. I will have surgery November 8 to implant my port. Then I will start chemo on November 9. They said the chemo will take about 2 hours, 1 hour for each drug. I am only taking the taxotere and cytoxan. I will do 4 rounds, 1 every 3 weeks. Hopefully, it won't be too bad. However, the onco does say I will more than likely lose my hair. So, I'm gong to try chemaid and see if it works anyway. It can't hurt.

Also, I had an echocardiogram Friday. It came back ok. Nothing major. Just a little mitral valve regurgitation. I've been all through that. My daughter has it.

So, I will post when I know more.

Our decision

Well, we've made our decision. I told Tim and Kati that I realize this decision basically rests with me, but I couldn't make it myself. I needed my family to help me by giving me their input and desire. As I said before, Kati decided 80% isn't acceptable. So, needless to say, she wants me to have the chemo. Tim and I were undecided until Friday.

I called my onco to see where I fall in the intermediate range. If it's closer to low or closer to high. We felt that would help us with our decision. I found out my number in the Oncotype test is 25. 1-18 is low, 18-31 is intermediate, and 31 and above is high. That really helped. Not. 25 falls almost perfectly in the middle. Except for it's 1 unit closer to high.

So, I called Tim to tell him what my number is and as we talked we made our decision. We realized the thought of it reappearing in the next 10 years was frightening. Especially since it can come back in a different organ. We also realized our first grandbaby would be less than 10 years old if it happened. Not to mention I will probably have another 1 or 2 by then. The thought of something even worse happening that could possibly kill me and I have to leave not only my husband and children, but grandchildren as well pushed it over the edge.

I absolutely cannot wait until Avalyn arrives. That baby has no idea how much she is loved already. Her grandma and grandpa are positively giddy with excitement.

So, with all of the variables involved, we decided I needed to do everything in my power to survive. If it does reappear in the next 10 years I can safely say I did what I could. I will have no guilt and I won't be kicking myself.

Tim said when you really look at the grand scheme of things, worrying about the side effects is stupid. He didn't like the word stupid, but it really fits. Is being fatigued and possibly losing my hair really worth risking the beast coming back to haunt me in a few years? No, it's not. And, unfortunately, it wouldn't be the breast beast. I could handle that. I don't want to even think about it getting to my brain.

I'm calling my onco in the morning to give him our decision. He wants to start treatment in the next two weeks. So, I'll be having surgery to implant my port and then start chemo very quickly.

2nd Opinion

We got our 2nd opinion today. He was really sharp, very knowledgeable. We liked him real well. He gave us an indepth analysis of what's going on and my options. I have several things in my favor:
1) My lymph node was negative for cancer
2) My tissue that was sent for testing showed "intermediate risk" for recurrence in 10 years. That's in my favor because it wasn't high risk.
3) My estrogen receptors are positive

Things that are not in my favor:
1) My tumor was grade 3 - meaning more aggressive
2) My growth rate was fast

One things that can be considered good or bad is the size of the tumor - 2.1 CM. That is considered medium. But anything over 1cm typically requires chemo.

If I do radiation on top of my surgery, that gives me an 80% cure rate. 20% chance of it coming back. Of course, "coming back" is not really the proper term. He said that not only can cancer move through your lymph system, it can also move through your blood. So, if even one small cancer cell broke off and moved through my blood stream, it's possible for it to show up again in another part of my body. Such as, liver, uterus, bones, lungs, brain, etc. Not good.

He made it clear that it's a no brainer to have radiation. Without it, he can't even tell me what my chances of cure are. But, they're low. WITH radiation, I have 3 options:

1) Chemo only - that brings my percentage up to 88%
2) Tamoxifen only - that brings my percentage up to 83%
3) both - that brings my percentage up to 90%

We did ask him about the heart damage issue. He said it can be an issue with adriamycin usage, but he wouldn't even consider giving me that drug with my "great" prognosis. He said heart damage occurred in about 2% of patients using that drug.

I would have to get a port surgically installed, then have chemo every 3 weeks for 3 months. A total of 4 times. Side effects can be:

nausea/vomiting
weight gain (yeah, I really need that)
weak and tired
hair loss
sores in mouth
muscle aches and pains
funny looking nails
excessive eye watering
neuropathy (not reversible)
leukemia (<1%)
allergic reactions (that can be controlled with other medication)
increase in the risk of serious infections such as pneumonia.

He said he would support us in whatever decision we make, but he thinks chemo, radiation, and tamoxifen would be the best course because I'm so young. He told us to take this weekend and think about it, then call him Monday to let him know what we want to do. Typically, they want to start some form of treatment within 2 months of surgery. I'm 2 weeks away from that anniversary.

For the first time since this whole thing started, I'm really scared. Not of the treatment, of the recurrence. It showing it's ugly head again in a few years somewhere else in my body gives me chills. I just have no idea what I'm going to do. Kati wants me to do it. She says 80% isn't good enough. I just want God to point me in the right direction.

All prayers are requested and appreciated.

Waiting

Well, it seems like forever since I posted. I've had calls from concerned friends, so I thought I would give some kind of update. We decided on a second opinion. I have an appointment with him on October 25. I still don't have the test results for my possibility of recurrence. And after reading some recent studies, I really don't think we're going to go the chemo route. It has been determined that chemo can weaken the heart and even lead to heart disease. Well, heart disease RUNS in my family. My dad died of it, my mom has congestive heart failure complete with a handy dandy pacemaker. So, no. With all of that, I don't really think chemo is an option. It would give me that extra 5%, but what would it take away? I could die of heart disease in 10 years because I had chemo. My husband and I have discussed this over and over. We'll talk to the new onco about it and see what he thinks. But, don't count on my hair falling out any time soon.

No more info

Well, I don't really know any more now than I did before I had my date with the oncologist. He pretty much told us the same thing my surgeon did. It was borderline stage II and they typically like to do chemo. However, he is having the hospital send off a sample from my tumor to California to have it tested for the liklihood of reccurence within the next 10 years. If it's a low chance, then chemo isn't really necessary. If it's an intermediate chance, his guess is as good as mine. If it's a high chance, chemo is a must. I have heard from several people that my chemo wouldn't be very strong or devastating. He said everyone gets the same chemo no matter what. Then when I told him I had had a PETscan, he wanted to know why?! I said, "to see if the cancer had spread to other organs." Duh. It really worries me that an ONCOLOGIST doesn't know the significance of a PETscan. He also said, he didn't think the surgeon took out enough tissue. He wants to take out A LOT more. I'm not sure I understand that since all of the tissue surrounding the tumor that was taken out proved negative for cancer cells. He said he was going to call my surgeon to discuss it with her. And I think I'M going to call my surgeon to discuss it with her as well.

Anyway, I have an appointment October 4 to get an echocardiogram to make sure my heart is healthy to have chemo. He's going to see what the test result is that he sent off t0 California then we'll discuss more options. If I do have to have chemo, it will be before radiation treatment. Pretty crappy. However, I'm more concerned with living than anything else.

Date with the oncologist

They have set me up an appointment with the oncologist Wednesday, September 19 at 2:45PM. He works at the Integris Cancer Center, so he's probably pretty good. We can hope. I'll post after my appointment.

Final results!

Cancer is gone! All tests came back negative for cancer, the node and the tumor. However, due to the size of my tumor, that puts me borderline stage II. I will for sure have to have radiation, but it will be for the oncologist, me and Tim to work out the chemo. The surgeon said that when you're that close to stage II, they like to do chemo. It decreases the chance of reoccurrance by 5% more than radiation alone. And due to my young age (below 50), 5% is a lot. So, who knows what will happen with that. She's going to make an appointment for me in about a week because he can't start radiation until one month out of surgery.

Also, I will take the drug Tamoxifen for five years. Joy of joys. It will send me into menopause. My daughter, Kati, is thanking heaven above that she no longer lives with me. She had always hoped she would be out before I went through menopause.

I can never take a birth control pill again that contains estrogen or any other drug containing estrogen for that matter. She told me it is really better for me to have a gynecologist instead of having my family doctor take care of the female stuff. She will take care of future mammograms and other necessary tests to make sure it's not coming back. Not that I trust mammograms too much now.

According to the surgeon, I have had breast cancer for probably 8-9 months. I had a mammogram last September and paid the extra to have it digitally read. That was supposed to find what the mammogram itself wouldn't plus the potential for anything to arise. So much for that idea.

She said my incisions looked real good even though I think the one under my arm looks hideous. I don't have to wear bandages anymore, but i'm going to wear a small piece of gauze with tape only around the edges so my wound can breathe. When I put my arm down, it's skin on skin. That don't feel good at all!

And here's something that's going to drive me crazy. Because she took out the tumor and tissue, there's an empty cavity there. It will fill up with fluid and blood. As a matter of fact, already has. When I walk I can hear fluid moving around! She said it's probably from under my arm too. They had to go in about 2-3 inches into my armpit to get to the node. So, they had to push muscle and other inhabitants of the armpit to the side to get down there. Ew. So that left a cavity that has to fill in as well. Of course, the node is only about the size of a thumbnail, but they had to dig their way down and the cavity will fill up with fluid until everything falls back into place.

All in all, I'm doing great. I feel good. I'm going back to work tomorrow. I really miss my students. I can't wait to dig into english lit. William Faulkner is waiting.