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Monday, July 9, 2012

Stepping Out of the Unknown

After an extraordinarily long office visit – by that I mean that I was told to expect 45 to 60 minutes for this first visit, but spent nearly 4 hours – with Dr. Toma, my oncologist (chemo doctor), I feel a lot better. I think, for me, the hardest part of any crisis is the not knowing – the drawn-out wait for more information. It was the same with my divorce 12 years ago, for the house fire 3 years ago, and, really, for anytime I’ve dated anyone - ever. Yet, as soon as I know the next step and can make a plan, the sooner I feel better. It’s like picking up nuggets of certainty to hang on to during a storm of not knowing anything. But when I think about it, what do I ever know for sure anyways? Life is one big un-knowing-ness. I only have the illusion of certainty. And at a time of crisis, that illusion is shattered, and here I am – being smacked up side the head with the fact that nothing is certain, nothing is for sure.

Pardon me, while I try hold on to my illusion just a little longer. I do like knowing things. I’m a teacher – and as much as I love teaching things, I love learning them too.

Here is what I know… er, think I know, for sure…

1 out of 8 women will get breast cancer. :(

Breast Cancer comes in 4 Stages:
  • ·      Stage 1 = caught early, less than 2 cm in size (that’s mine)
  • ·      Stage 2
  • ·      Stage 3
  • ·      Stage 4 = advanced, metastasized into other parts of the body

Because my little bit of cancer was small 1.4 cm, it counts for Stage One. That made me eligible for a lumpectomy (removing a portion) rather than a mastectomy (removing the entire breast). The good news is, that lumpectomy + radiation = the same survival rate as a radical mastectomy (5 to 7% chance of not surviving). Because I chose lumpectomy, that means I also chose radiation.  The surgery with the radiation counts for the primary treatment of my little bit of cancer.

Breast Cancer comes in 3 Grades:
  • ·      Grade 1
  • ·      Grade 2 (what my biopsy indicated)
  • ·      Grade 3 (what pathology of my tumor revealed)

Each grade indicates the likelihood of the cancer returning, of a cell escaping during surgery and finding a new place to grow in my body – metastasizing. The higher the grade, the greater likelihood of the cancer spreading elsewhere. So, the secondary treatment is to make sure we’ve killed any cell that might have escaped from the tumor. So the next part of my treatment involves poisoning all fast growing cells – which include hair follicles (yes, I plan to lose my hair sometime during the 1st week of August, or soon thereafter), cells lining my GI tract/system (which causes the nausea – but they’ve got great drugs to fix all that), and my blood cells (red blood cells, white blood cells, and platelets), and the possible/maybe cancer cells that might have escaped from the tumor.

Since my cancer cells are He 2 positive, and negative in the other possible areas of receptors, Dr. Toma recommends 4 chemo treatments and a year of herceptin. The worst of the side effects will happen within a 3 month span. I will go for a chemo treatment every 21 days, until the 4 treatments are complete. During that time I will receive the following: Taxotere and Cytoxan. I will take a dose of Herceptin, with each Chemo visit and weekly, in between visits. While in rare cases heart damage could occur, the side effects are minimal. I will be monitored closely, to be sure my heart is safe. My hair will grow back and the fatigue from chemo will subside. Until 2007, herceptin was used only in Advanced stages of cancer. But now, it’s proven highly effective in preventing the spread and return of cancer. That means, I’m going to live a long, long time. J

I have procedures to schedule before my first chemo treatment on July 19th:
  • ·      PET Scan
  • ·      MRI of lower back/lumbar area
  • ·      RNVG scan to check how well my heart is functioning
  • ·      Day Surgery – Dr. Talbert will be inserting a port underneath the skin on the left side of my chest. I will have to keep it in throughout the chemo treatments. Not sure if I’ll need it for the remaining treatments of herceptin. That’s a question for my new list of questions to ask.

The Cancer Center was a place filled with patients reclining in big leather chairs and a very kind staff. The ladies there, ahead of me in my treatment, gave me lots of advise about wigs and scarves and where to find them. The Cancer Treatment Center gave me my first scarf – pictures to follow. The American Cancer Society may provide 2 free wigs. I have to check with my insurance to see if they will cover one, as well. So I’m hoping to find some really cool colors and cuts – to go with different moods on different days. There’s a workshop on how to style my profile while undergoing all this icky stuff….

I could write a lot more stuff … that I think I know, but if you’ve read up to this point, you might be feeling almost as overwhelmed as me. So this is a good place to pause.

In summary: I’ll be done with the worst before Halloween. In a year I’ll be finished with the rest.

Strangely, I do feel better. Even if it’s all an illusion of some maybe-kind-of certainty, it feels good to have a plan.

Thanks for your prayers, positive thoughts, and good light.

Life is good!

P.S. In the meantime, I'm going to archive my present hair and prepare for my hairlessness. So excited about the scarves and hats and cool new looks. ;)


  1. Your diagnosis is very similar to mine. However, my tumors were very large and I needed a mastectomy. I had four courses of chemo with the same drugs, and a year of Herceptin (but we didn't start Herceptin until a month after I finished chemo). There is a terrific book (and a pretty goof Lifetime movie) on the development of Herceptin--I have it at home and can send you the title if you like. It's worth a look--that drug is truly revolutionary and saves lives.

    I didn't wear wigs during treatment. It was summer and just too hot. However, I was in the very small group whose hair doesn't grow back fully and have taken to wearing them now. Also during treatment I had to have Neulasta shots to help with the production of white (I think) blood cells. I also had to do iron treatments, and still do every so often.

    I was never nauseous, but food lost its flavor. The only things that tasted good to me were chocolate milk and Chick-fil-a chicken. Bread was particularly nasty, but everyone is different. The drugs I had to take pre chemo included steroids so I was hungry but unsatisfied on days when I didn't have my chocolate milk and Chick-fil-a.

    You will do well. It's a good prognosis and we are living in a time when medicine can do so much for us. You have a great attitude! : )

  2. Ramona, yes - send me those titles. My addiction yearns to be fed. :) Thanks for sharing your experience. It really helps to know the stories of those who've journeyed before me. Dr. Toma talked about those shots and other treatments as needed. She didn't warn of losing my taste nor of the permanent hair loss. She did mention the possibility of permanent neurapathy. And it was exciting to hear of all the progress made in the history of breast research and treatment. It sounds like you continued working thoughout your treatments with little disruption? (She asked, hopefully)

  3. I have neurapathy under my arm--but they removed five of my lymph nodes. Because one already had cancer, I had to go through the extra four sets of chemo. Also, no hair grows under that arm. I got back all my hair, I guess, (the gray came in first), but my eyelashes and eyebrows are thinner. So is the hair on my legs. So, you get a little good with the bad. You will do fine, Shelly. You have a great attitude. In one year, it will just seem like a bad dream. And school will actually help take your mind off it.

  4. I'm kinda looking forward to not having to shave for awhile. And a brazilian to boot! ;) Did you lose your eyelashes and eyebrows? For some reason I didn't even think eyebrows until the other day. Just now am considering bald eyelids. So funny looking I will be. :) I am looking forward to school. Have you thought anymore about subbing for me, maybe 2-3 days each for my remaining chemo? I'll call you later about that. Just keep thinking and talking to Jerry. If you cannot, it'll be okay. I really shouldn't miss that much.