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 1^st 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 19^th:

• ·      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. ;)