Drumroll please....

Alleluia! 

Alleluia! 

Aaaaaaalle-luuu-ia!

(This decidedly non-religious girl is having a religious moment.)

I had a great appointment with my surgeon this morning. I have said all along that I’ve felt positive about this whole thing. More positive than my family. More positive than my friends. More positive even than my wife, who has spent every moment of the last five months worrying about losing me. Somehow, I’ve never once seriously thought, I am going to die from this cancer. I’ve always felt that it would be difficult – I mean Stage 3 breast cancer is certainly not fun – but that it is something I could get through.  From the beginning, I had no justification for feeling this way. I had no sound reasoning for feeling so positive. I just knew in my heart of hearts that this might break me, but it wouldn’t kill me. 

Today, my stupid optimism has been somewhat vindicated. 

The first thing my surgeon said when she came into the exam room today was, “You’re MRI looks fabulous!”

My initial breast MRI five months ago showed one relatively small-ish tumor, but an additional 10.1 cm of cancer spread throughout all four quadrants of the breast.  Basically, my entire left breast was oozing with cancer cells. That is why we opted to do chemo first and postpone surgery. 

Yesterday’s MRI showed none of the disease that had been in all four quadrants, and only a 1.9 cm tumor. My cancer shrank from 10.1 cm to 1.9 cm. I went from complete and total cancer infestation to one relatively small tumor less than 2 cm wide. 

That is fucking phenomenal!

All these five months of miserable chemo seem to have payed off. The chemo did its job. And even better, it DID NOT KILL ME.

So now we move into stage 2 of my cancer treatment. We discussed all of the surgical options at length today with my surgeon (who is the same age as me and who I think could totally be my new BFF if we didn’t have the whole doctor/patient dynamic going on). Because my cancer has shrunk so significantly, I am now a candidate for a lumpectomy. We discussed the pros and cons of lumpectomy surgery versus mastectomy surgery at length. Though both surgeries have the exact same cancer survival rates, the lumpectomy could slightly increase the risk of recurrence of cancer in my left breast. There would be a slightly higher chance I would have to go through this all again, but no higher risk of metastatic breast cancer, which is the real danger.

I’ve opted to go ahead with the mastectomy rather than the lumpectomy. While the return of cancer in my breast will not kill me, it’s one hell of a buzz kill. And one hell of a hassle for everyone involved. So I am opting to minimize that outcome as much as possible. 

For symmetry’s sake and because I am rather large chested and could end up quite unbalanced and wonky-looking (that's a scientific term, by the way), I am opting for a bilateral mastectomy. Take them both, baby!

Because the original cancer was in all three levels of my lymph nodes, we are going to remove the first two levels of lymph nodes in my left armpit, as well. They can’t remove all three levels because that will give me pretty close to a 100% chance of developing lymphedema. Removing two levels, however, only gives me a 30-35% chance of developing lymphedema. I can live with that. I will also see an occupational therapist to talk about lymphedema prevention and exercises I will need to do as I heal. So I feel like all bases will be covered in that regard.

Finally, we discussed reconstruction at length. I made a decision several weeks ago and I am sticking to it. I was lying in bed wide awake at 4am one morning and had an epiphany. I decided in that moment that I did not want to have reconstructive surgery. I even woke Ruanita up to tell her…at 4:00 in the morning. She was highly amused, as you can imagine. 

Here’s the thing…I really just don’t care about my boobs at this point in my life. I can’t imagine having implants. They have no sensation. They don’t feel real. They require additional surgeries. They cause additional pain and longer recovery times. I just feel so done with all of this and don’t want to drag it out with additional procedures. My doctor was amazing and encouraged me to think about how I want to see myself in 5 or 10 years. And when I did that, I just felt no attachment to – or interest in – boobs. I can wear prosthetics. I can just live flat. I have options. And no additional pain or surgery. No additional opportunities for complications.

I am 100% content with my decision.

So, all that said, I have surgery scheduled for September 22^nd. The chemo is still working in my body at this point, so we are going to give it a couple of weeks to keep working and couple of weeks for me to recover a tad before surgery. My surgeon recommended that I take four weeks off from work for recovery following surgery, so I intend to take every minute of that. I WILL have radiation after surgery, but the length and schedule for my radiation will be determined after surgery. I also need to talk to my oncologist about the possibility having my ovaries removed to suppress the hormones that seem to feed my kind of cancer. That would be a separate surgery done at a different date. I also need to talk to my oncologist about having my port removed, which can happen at the same time as my mastectomy. 

All in all, today was a day of very good news. I am thrilled about the chemo results and I am happy to have a plan in place for the next phase of treatment. I see a light at the end of the tunnel!

And I still feeling stupidly, ridiculously positive.