Thursday, March 17, 2016

A plan! A plan! A glorious plan!

Today was a good day.

Okay, so I have cancer. I won't lie to you...that sucks. And I spent two hours in an oncology clinic today. And that kind of sucks. But when compared to the last week, today was a pretty wonderful day.

First and foremost, we were given a plan of action today. Cancer kind of punches you in the stomach and it feels hard to catch your breath at times...until you have a plan. Until today, I felt like I was flailing around aimlessly. The BIG C with no plan in place is pretty damn terrifying. You are helpless and you have no idea how to fight. Today, I have a plan of action to finally--FINALLY!--fight back.

The oncologist spent about an hour just talking to Ruanita and I all about my test results, what the test results mean, and what sorts of treatment would provide our best shot at curing me of cancer.

The pathology was promising. A grade 1 tumor - slow growing, slow spreading. High positive on the estrogen and progesterone tests. This means the tumor may respond quite well to hormonal treatment.  The mammogram and biopsy I had done showed a relatively small tumor of about 2cm in my left breast. Not too bad. Small tumor. Simple enough to remove. A little surgery. A little radiation. Slam, bam, thank you ma'am.

Noooooo problem.

However, upon review of the breast MRI, the story got a little grimmer. The breast MRI showed pretty much rampant cancer in that breast. In addition to the 2cm tumor that showed up on the mammogram, the MRI showed "extensive nodular malignant enhancement involving most of the anterior breast with involvement of all 4 quadrants, in total measuring approximately 10.4 x 8.2 x 5.9 cm." In short, the cancer is everywhere in that breast, extending out toward and (we are pretty sure) including my lymph nodes.

What the hell??

How can a slow growing tumor result in cancer that rampant? Well, I've apparently had this for quite a while. I had a mammogram in April of 2015, but nothing showed up there. I did receive a letter at that time saying that my breast tissue was dense and that dense breast tissue often made it difficult to read a mammogram, but I was young(-ish) and healthy. I thought absolutely nothing of it at the time. And in the mammogram I had last week, the only thing that showed up was a small tumor.  Only the MRI showed the true extent of the cancer. So mammograms, while an important tool, are not always the be-all and end-all we assume they are. this all sounds pretty negative, right? It's okay. It's a little overwhelming for me too. Actually, I think the person who has been most affected to date is Ruanita. Honestly, I haven't even cried since being diagnosed. I feel fairly positive most of the time and the times that I do get upset, it's been more anxiety and nervousness over the unknown that any real sadness or devastation. Ruanita, on the other hand, is in the throes of full-on glacial-sized devastation. Her mood swings have been an unexpected--not to mention refreshing--turn of events. She is either staring at me longingly while I brush my teeth (creepy), crying uncontrollably (awkward), or threatening to start a brawl in the middle of I-94 in rush hour traffic (scary). I feel so bad for her because she seems to be having all the feels at once. And she feels both completely responsible for me and the kids and, at the same time, completely and totally NOT in control of anything. Grave responsibility without control is a pretty shitty emotion. Emotion? Is that an emotion? I don't know. It's shitty for her, regardless. If you ever had any doubt that cancer affects an entire family, and not just the diseased person, try having a conversation with Ruanita without her crying right now. And if you figure out how to do that, please let me in on your secret.

But back to the plan. It looks like we are going to forgo surgery for now and start with chemotherapy. I have appointments next week for a ultrasound biopsy of the lymph nodes (we expect this to come back positive and we've made the rest of this plan with that assumption in mind. If it comes back negative, we will re-evaluate), an echocardiogram (have to make sure the ticker is in good shape before chemo), to have the port-a-cath for chemo put in, and to attend a "chemo class" where I will learn what to expect during chemo, what to bring with me, where to go, etc.

Then Friday of next week, Ruanita and I will be heading to Kentucky for a week for the kids' Spring Break. We have already told the kids that we would not be going on this trip. We assumed we would want to atart chemo immediately. They were extremely disappointed, to say the least. I think we all need a get-away right now. However, after discussing it in probably unnecessarily lengthy detail with the oncologist today, we have decided that the benefits of going ahead and taking this trip (taking into consideration the pathology of my cancer) outweigh any possible (and highly improbable) negative outcomes of beginning chemotherapy exactly one week later than we normally would have begun. As my doctor said, it appears that I have had this cancer for quite some time. One more week will likely not have any effect on treatment outcomes. And we really are in need of an oasis in the midst of this storm. This trip will provide exactly the relaxing time with family that we desperately need right now. Plus, I'll get to squeeze on my brother's new baby. That has to be therapeutic, right?

So, I will be on vacation with my port-a-cath all ready to go (maybe I can get away with telling Ruanita that she'll have to get in the pool with the kids kids know...I have cancer...and I have a port-a-cath that I need to know...probably sterile). I will begin chemotherapy on Monday, April 4th as soon as we get back from Spring Break. For those of you who know anything about chemotherapy, I will be receiving dose dense AC followed by Taxol. I will go into the infusion clinic for chemo every two weeks during the AC phase (which lasts 8 weeks). Then I will go in every week during the Taxol phase (which I think lasts 3 months). After chemo, we will do another breast MRI, re-evaluate, and I will likely go into surgery at that time. Surgery will (at least with high probability) be followed by radiation. That will be followed by 10 years of hormonal therapy. 5 years is the norm currently, but they are moving toward 10 years and he would like to do 10 years due to the weirdness of my particular case. Leave it to me to get weird cancer!

We. Have. A. Plan.

Does it sound fun? No. Will it be a complete and total pain in the ass for my entire family? Yes. But I am trying to stay focused on the long-term. If all goes well, a year from now, this will all be behind us. Chemo will be over. Surgery will be done. Radiation will have been completed. The hormonal therapy is just a pill, so I can live with that forever if need be. In a year, it will all be over. I wore a perm for an entire year in 8th grade. I can handle anything for ONE YEAR, right?

So please keep sending us those positive thoughts. You don't know how much I appreciate it.


Anonymous said...

I am so glad your humor has not left you or your terrific sense of humor. Fuck cancer!!!!! When you need me I am so on a plane to one of my favorite families. I just did a 3 d mammogram. I have dense breasts but mine is fat. I have insisted on ultrasounds from time to time. So glad you love your doctor and you have a plan. Are you thinking reconstruction surgery? If yes explore it before surgery. Don't want to go down the route of Tanya who decided after radiation to do implants and has had no luck. You know me thinking ahead for you. Like I said I know only survivors and you are next. Love you lots.

keisma1109 said...

It will all be a distant memory... It will. In the meantime - one day at a time - one crappy test or shot or chemo drug at a time.

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