First things first gang, the PET scan showed NO spreading which means this is a localized cancer…YEAH!!! This is good, the surgeon classified this as a stage 1 cancer, and the oncologist this morning classified this as a stage 1, borderline stage 2 cancer.
A few details:
It is a grade III cancer, which makes it the most aggressive form of cancer. However, this is a stage 1 cancer which I mentioned which means that its early, which of course is great! It is an invasive cancer which means that it has broken out of the either lobule or duct (lobules are where milk is made and ducts are what carry it to the nipple) and it had small patches of “in-situ” cancer, which are small areas of the total tumor that have not broken out of their “containers”. By classifying it as a stage 1, that means that there is no sign of it having broken into the lymph system, which is how it would progress into other areas of the body. To be frank, that does not guarantee that it is not in a few lymph nodes. The PET scan can only really pick up tumors that are 1cm or larger. HOWEVER, be not discouraged by this! The mammogram and ultrasound showed nothing anywhere else, the pathology (via the biopsy) showed nothing anywhere else. More on this later.
Here’s what happens next – she has an appt with the plastic surgeon on Monday at 10:30am to begin the discussion with him as to what the options are for reconstruction. The reason that is important is because we are leaning toward a unilateral mastectomy. That means that she will have the entire of the breast tissue removed on the right side only. We have not decided that for sure, but in our discussions with the oncologist, the surgeon, the nurse navigator, and Santa Clause I think was there, that felt like the best overall option. Of course no woman wants to lose her breast, but the tumor is just large enough that to do a lumpectomy only might leave a divot in the poor girl’s boobie. Yes…I said boobie. Say it again…boobie! In that case, what will happen is that she will have a reconstruction done using muscle and skin tissue from the latissimus (sp?) muscle, which is the one that comes vertically down your side under the arm toward the back. Ish. Because of the location of the tumor in relation to the nipple, she will probably lose the whole of the nipple in the process and they will have to recreate it and tattoo it in color to match the other one. Apparently getting daffy duck tattooed there instead is an option. Our surgeon fancies himself a comedian. During the surgery, they will do what is called a “sentinel-node biopsy”. This is a process in which they inject the boobie with a radioactive dye that will in turn enter the lymph system thereby showing them the path that the cancer would also take. Whichever node stains first is the “sentinel” and will be removed along with the next 1-2 nodes. Those will be sent for biopsy right away and if cancer is present in any of those nodes, she will do local radiation to eradicate the cancer in the lymph system.
We are also looking at surgery first, followed by chemo. They are feeling that chemo is going to be necessary due in great part to her age. She has a lot of years to live and they want to give her the best shot possible at many many MANY years of healthy, cancer free living. I concur doc, I concur. Here’s the sucky thing – this tumor is a hormonally-fed tumor, which means that it is living on a Golden Corrall style buffet of estrogen and progesterone. As far as breast cancer goes, that is the best kind to have. However, we reeeeeeeally want to have kids and one option that many women consider and choose to do is to have their eggs harvested because chemo essentially sends women into menopause. In roughly 80% of women, they come back out of that menopause and are then fertile again and able to conceive. We worry about being in the 20%. To have one’s eggs harvested though, she will have to stimulate her ovaries into overproduction with injections of highly concentrated hormones…fertility treatments…which also happens to be what that damn tumor eats. A catch-22 of monuMENTAL proportions. The surgeon essentially said he wouldn’t let us do the hormone stimulation for egg harvesting because of the aggressive nature of the tumor and the fact that the tumor feeds on that same cocktail of hormones that are used in the fertility treatments.
What we at this point believe is the best option is to do surgery, chemo shortly after and then to fervently pray that we will be able to make babies after this is all over. The danger to our baby-making chances are scary but it just isn’t worth taking the risk of fertility treatments without the cancer gone first.
Another thing, chemo will begin 2-4 weeks after surgery, depending on how her recovery from surgery/reconstruction goes
Put all THAT in your pipe and smoke it.
Here are all the details:
Important Dates:
1) Monday the 15th – Plastic Surgeon, 10:30am
Initial consult, this will help us determine the pros/cons of lumpectomy vs mastectomy from a reconstruction and cosmetic perspective
2) The next week to week and a half (specific date yet to be decided)
Next appt with surgeon to finalize what type of surgery we are going to do from a cure perspective. (lumpectomy vs mastectomy)
3) Tuesday, October 30th – *tentative* Date of breast surgery to remove tumor.
This depends on the availability of both the surgeon and the plastic surgeon, as they would both need to be in the OR at the same time and the tumor removal and the reconstruction would happen at the same time. This would also involve a couple nights in the hospital.
Prayer Requests:
1) Just be in conversation with the Lord with thanksgiving…this is a VERY curable type of cancer, this type puts her right in with 85% of the other cases of breast cancer out there, it is most likely stage 1 maybe on the border of stage 2…this will be cured and she will go on to live a normal, long, cancer free life. She will fight this bastard and we will beat it!
2) Lift up our sleeping and rest. She is exhausted and has been wrestling with anxiety throughout all this…duh. Learning today that the cancer hasn’t spread was a massive weight off; again thank God.
3) We have many appts, and many days of worry and wonder ahead. A request I will ask of you for many months to come is for endurance and patience and focus. Focus on each other, focus on care and nutrition and sleep etc. We will need to continue to laugh and rest and relax and enjoy in the midst of continuing to fight and persevere.
4) Lift up our doctors; (Surgeon, Dickinson – Oncologist, Stroh – Plastic Surgeon, Boustred) for the many MAs, Pas, nurses. Lift up the second and third opinions we are seeking from 2 other sources.
5) Financial – we don’t know yet what will be covered, what we will need to pay etc. There is the potential we may get to access assistance programs and perhaps some grants. Nothing is guaranteed yet of course and after seeing the bill for the PET scan alone ($2100), we have realized that this could get pricey. However, we KNOW the Lord will provide. We believe that and trust that!
6) In 7-10 days she will also get results on a genetic test that will determine if she has the mutated gene that predisposes her to breast and ovarian cancer. If she has this, is makes her 40-80% more likely than the general population without the gene to get it again, and 20-40% more likely than the general population without the gene to get ovarian cancer. This will have bearing on whether or not she decides to at some point get a mastectomy done on the other breast in the future and whether she will have her ovaries taken out. Both the other breast and the ovaries would be preventative and done AFTER we make some little Jeydriennes!
7) On that note, pray that we will be able to conceive after this is all over.
8) Lift up Neela and Richard – they are a couple we met while waiting for the CDs of the PET images. They are a couple in their 60s who while here from Missouri for the birth of their first grandchild discovered that he has lung cancer after he started coughing up blood. My darling wife was the one who decided we should wait an extra minute for her to get off the phone so we could ask their names and pray for them. She does that.
Needs:
1) We would really appreciate it if someone would take the position of coordinating meals. We don’t need that immediately but those would be so nice to have during and after the surgery in a few weeks. She will be in the hospital for a few days and out of commission completely for about 2 weeks. During that time we would love for some help with food. I will be in touch in the coming days and weeks as we nail down a date of surgery for sure. Thanks to those who have already sent meals and food and pleasantries…that’s just been so nice!
2) Keep checking in with us. We keep coming home to flowers on the door step and notes and cards and I can’t tell you what that means. Like I said before, don’t be offended if you don’t get a response, but it makes a world of difference when we get notes and texts and things that let us know that we aren’t alone. Every time she gets a note or text she just gets a beautiful little smile on her face…I’m telling you she loves it. You all are so wonderful, and its humbling and flattering the support we have gotten. So thank you.
3) If SOMEONE can find a friggin pink ribbon pin somewhere on God’s green earth will you please buy a few for us? We will more than happily reimburse you. We cannot for the life of us find those dumb things. In October of all months too…its Breast Cancer Awareness Month! Ridiculous.
I think I covered it for the most part. We decided that everyone in the surgeon’s office must be on speed or something because they all talk so stinkin’ fast. There was a lot to digest and learn and process. We really need help in the discernment process, in not getting overwhelmed and in making the right decisions. Either way, we walk into this weekend confident, relieved and in much need of relaxation. It sucks that she has cancer. Given that, we have much reason to believe and know that she will come through to the other side the delightful, whole and beautiful woman that we’ve all come to dearly love.
We’ve discovered a few things about life. One, there are a lot of things that just don’t matter. There are a lot of worries that no longer are. She had someone at the store last Tuesday, so the day after the diagnosis tell her to have a good day…we have an entirely different perspective on that phrase now. It actually means something and we have a new desperation to actually do that. Hug your wife. Hug your kids. And for heaven’s sake if you are a woman, CHECK YOUR BREASTS REGULARLY! If you’re married to a woman…you can help with this too…if ya know what I’m sayin’. Remind your mom. Remind your sister. Don’t get so pissed off at the things that otherwise have no real bearing on your life. It’s short, precious and worth living well.
Signing off with an abundance of love and an overflowing cup,
Jeydrienne
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