Surprise Test & Prayers For a Better Tomorrow
I had mentioned that the genome test is being done. I already had been told I might meet that protocol so that one wasn't a surprise. However, when Dr. Wagner's staff called yesterday, I was surprised by the subject. Rather than calling to schedule the surgery which is what I assumed, she was calling to bring me in for a MRI. Mind you, this is not a full body MRI; only the breast area.
Since she had not said anything about that in our meeting, I can only assume she is wanting to cross all the T's and dot all the I's and maybe take a closer look at the lymph nodes just in case. I'm sure my insurance company is not gonna be amused. I am choosing to believe that this is an extra step taken out of caution rather than her second guessing or being worried about the lymph nodes. I will try to find out.
Cancer has this way of creating difficult choices; often weighing one situation against the other and finding the lesser of two evils. It is like when you have two children and you can only choose to save one. Talk about Sophie's Choice. For example, Dr. Wagner has to take lymph nodes for biopsy. She was leaning toward taking very few based on a gut instinct my lymph nodes are cancer-free. If she were to take too many to be on the safe side to protect my life, she might be dooming me to a lifetime of the terrible side effect known as lymphedema. If she is wrong about the lymph node involvement, I will have to have additional treatment get more lymph nodes and in the meantime, giving the cancer more time to grow and spread into more areas and more nodes as well as upping my chemotherapy regiment and possibly the stage of my cancer and/or chance of recurrence. Cancer is all about weighing the risks against the benefits and hoping you make the right choices.
And speaking of chemo ... that is the ultimate tough choice in cancer treatment, especially in the early stages. In the later stages it is an easier call to make because it becomes the only way to treat cancer systemically that has spread. The purpose of chemo in early stage cancer when you have are already having surgery and radiation for the local area where cancer has started is to:
1. Kill off any tiny remnants that are too small to be seen on an X-ray or even a MRI or PET scan (can only be seen under a microscope) that may be anywhere in the local area, the lymph nodes, or anywhere else in your entire body.
2. Reduce the chance of cancer coming back either in the same general location or elsewhere after treatment.
The vast majority of early stage cancers will not recur after surgery and radiation even without chemo (but it is also true that chemo drops the recurrence rate within first 5 years). The reason they are pointing me toward chemo is primarily because I have the triple negative cancer and no hormonal-based therapies are effective against it. If I had ER+, for example, I would get the lumpectomy surgery plus radiation (or a masectomy without radiation like my aunt) plus 5 years of a once-a-day pill with fewer side effects called tamoxifen. No chemo needed.
But even with just the surgery and the radiation treatment, the chance of cancer coming back is less than 15%. You add in chemo and it drops to about 6%. This is about a 9% difference. So do you go through 4 1/2 months of hard core chemo with possible side effects like as heart damage, chemo brain, nausea and diarrhea, complete fatigue, losing all your hair, mouth sores, etc. just for an extra 10%? What's the trade off? What's the lesser of two evils?
I'm undecided with a lot more questions than answers. I AM NOT gonna just be pushed into quickly making these decisions without full confidence that I have all the data and info necessary to make a wise choice. I did learn about something that could help me though: there is a test that is available they could do on the tissue removed during surgery that has proven to be effective in predicting risk factors like recurrence and more. It gives you a score between 1 and 100 with the higher the number, the greater the risk. I want that test. I also want a second opinion on the triple negative diagnosis using the much larger cancer tumor removed rather than the small samples they took during biopsy.
In addition, I have made an appointment with my cardiologist. I had a stress test a while back but no follow-up and nobody has been able to explain why I have an abnormal EKG. I am gonna talk to her about the results and find out if my heart would be at risk of damage from chemo (in other words, I need to find out the reason for my abnormal EKG and get her sign-off that chemo would not unduly stress my heart before I will consider it). Until I have an "all clear" on that front ... NO CHEMO.
I am going in on December 4th for the MRI and that will have to be looked at and processed before any surgery can happen. It's looking more like mid-December now.
And back to the genome testing ... those results will take about two weeks. My sweet dad actually apologized for possibly and unknowingly giving me the gene that may have caused this cancer. It broke my heart because he is not to blame in any way. We knew nothing of this 50 years ago. We are just now barely getting into the technology and the knowledge of what role genetics might play in this. And there are so many other variables like environmental and lifestyle that probably play a much larger role. I would like nothing better than to get a negative (no genetic mutation) back so I can put his mind at ease. Of course, if I do, we will be no closer to solving the puzzle of what role our family history plays. After all, my aunt could still have the mutation she got from her mother and it just either didn't get my dad or my dad is a carrier, but I got that normal gene from my mother as each generation only has a 50/50 chance of getting that specific gene. If I am positive, we can test my daughter and hope she got lucky with her dad's genes. We may never know unless all living relatives are tested including my aunt, my dad, me (well that's done) and my daughter, as well as my son. I think there is just so much more we don't have figured out yet; that we are barely scratching the surface of the family history link as it relates to cancer.
Let's all hope and pray for:
technology and medical science knowledge to expand quickly
for newer and better, more effective tests and treatments
for knowledge on how to change our environment and choices to help lower cancer risks
AND ...
FOR A CURE FOR CANCER
Since she had not said anything about that in our meeting, I can only assume she is wanting to cross all the T's and dot all the I's and maybe take a closer look at the lymph nodes just in case. I'm sure my insurance company is not gonna be amused. I am choosing to believe that this is an extra step taken out of caution rather than her second guessing or being worried about the lymph nodes. I will try to find out.
Cancer has this way of creating difficult choices; often weighing one situation against the other and finding the lesser of two evils. It is like when you have two children and you can only choose to save one. Talk about Sophie's Choice. For example, Dr. Wagner has to take lymph nodes for biopsy. She was leaning toward taking very few based on a gut instinct my lymph nodes are cancer-free. If she were to take too many to be on the safe side to protect my life, she might be dooming me to a lifetime of the terrible side effect known as lymphedema. If she is wrong about the lymph node involvement, I will have to have additional treatment get more lymph nodes and in the meantime, giving the cancer more time to grow and spread into more areas and more nodes as well as upping my chemotherapy regiment and possibly the stage of my cancer and/or chance of recurrence. Cancer is all about weighing the risks against the benefits and hoping you make the right choices.
And speaking of chemo ... that is the ultimate tough choice in cancer treatment, especially in the early stages. In the later stages it is an easier call to make because it becomes the only way to treat cancer systemically that has spread. The purpose of chemo in early stage cancer when you have are already having surgery and radiation for the local area where cancer has started is to:
1. Kill off any tiny remnants that are too small to be seen on an X-ray or even a MRI or PET scan (can only be seen under a microscope) that may be anywhere in the local area, the lymph nodes, or anywhere else in your entire body.
2. Reduce the chance of cancer coming back either in the same general location or elsewhere after treatment.
The vast majority of early stage cancers will not recur after surgery and radiation even without chemo (but it is also true that chemo drops the recurrence rate within first 5 years). The reason they are pointing me toward chemo is primarily because I have the triple negative cancer and no hormonal-based therapies are effective against it. If I had ER+, for example, I would get the lumpectomy surgery plus radiation (or a masectomy without radiation like my aunt) plus 5 years of a once-a-day pill with fewer side effects called tamoxifen. No chemo needed.
But even with just the surgery and the radiation treatment, the chance of cancer coming back is less than 15%. You add in chemo and it drops to about 6%. This is about a 9% difference. So do you go through 4 1/2 months of hard core chemo with possible side effects like as heart damage, chemo brain, nausea and diarrhea, complete fatigue, losing all your hair, mouth sores, etc. just for an extra 10%? What's the trade off? What's the lesser of two evils?
I'm undecided with a lot more questions than answers. I AM NOT gonna just be pushed into quickly making these decisions without full confidence that I have all the data and info necessary to make a wise choice. I did learn about something that could help me though: there is a test that is available they could do on the tissue removed during surgery that has proven to be effective in predicting risk factors like recurrence and more. It gives you a score between 1 and 100 with the higher the number, the greater the risk. I want that test. I also want a second opinion on the triple negative diagnosis using the much larger cancer tumor removed rather than the small samples they took during biopsy.
In addition, I have made an appointment with my cardiologist. I had a stress test a while back but no follow-up and nobody has been able to explain why I have an abnormal EKG. I am gonna talk to her about the results and find out if my heart would be at risk of damage from chemo (in other words, I need to find out the reason for my abnormal EKG and get her sign-off that chemo would not unduly stress my heart before I will consider it). Until I have an "all clear" on that front ... NO CHEMO.
I am going in on December 4th for the MRI and that will have to be looked at and processed before any surgery can happen. It's looking more like mid-December now.
And back to the genome testing ... those results will take about two weeks. My sweet dad actually apologized for possibly and unknowingly giving me the gene that may have caused this cancer. It broke my heart because he is not to blame in any way. We knew nothing of this 50 years ago. We are just now barely getting into the technology and the knowledge of what role genetics might play in this. And there are so many other variables like environmental and lifestyle that probably play a much larger role. I would like nothing better than to get a negative (no genetic mutation) back so I can put his mind at ease. Of course, if I do, we will be no closer to solving the puzzle of what role our family history plays. After all, my aunt could still have the mutation she got from her mother and it just either didn't get my dad or my dad is a carrier, but I got that normal gene from my mother as each generation only has a 50/50 chance of getting that specific gene. If I am positive, we can test my daughter and hope she got lucky with her dad's genes. We may never know unless all living relatives are tested including my aunt, my dad, me (well that's done) and my daughter, as well as my son. I think there is just so much more we don't have figured out yet; that we are barely scratching the surface of the family history link as it relates to cancer.
Let's all hope and pray for:
technology and medical science knowledge to expand quickly
for newer and better, more effective tests and treatments
for knowledge on how to change our environment and choices to help lower cancer risks
AND ...
FOR A CURE FOR CANCER
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