First meeting was with my surgeon, Dr. Teller. She checked me over and declared me well on the road to recovery. The two incisions are healing nicely and the swelling has reduced significantly. She then went over the pathology report and translated the medical jargon for us. The smaller tumor was a 1 cm invasive lobular tumor, estrogen and progesterone receptive and with cells that "had behaved themselves", classifying it as a grade 1 (the best case). Margins were clean so she had removed it in entirety.
The larger tumor was more of a bad boy. It was a 2cm invasive ductal, also estrogen and progesterone receptive but with cells which had "acted up" a bit, classifying it as a grade 2, like a bunch of neighborhood kids let loose with cans of shaving cream. [Grade 3 cells are the true nasties, running amok with the cell architecture and disrupting their neighbors like a continuous wild frat party]. Dr. Teller got clean margins on that troublemaker so it is totally gonzo!
She also took three sentinel lymph nodes using the radioactive seeds to track them. They all tested completely negative indicating that the "party" had been contained. All great news to be sure!
The next meeting was with the Oncologist, Dr. Inhorn. He and Ashley, his Nurse Practicioner spent a good deal of time with us, outlining some next steps in great detail. He was a bit surprised that I had both a ductal and a lobular tumor since typically women usually have one or the other. But, as he indicated, "cancer" and "typical" don't really belong in the same sentence. He talked to us about a relatively new test called OncotypeDX. Chemotherapy wasn't originally a part of my treatment plan but this test, studied and written up in the New England Journal of Medicine in 2018 provides a more definitive predictor of chemo's effectiveness in preventing future recurrences of tumors like mine. My larger tumor will be genetically analyzed and assigned a number based on its genetic makeup ("markers"). A number lower than 26 would mean I skip chemo and go right to radiation. A higher number means chemo would likely snuff the crap out of any residual cancer and send it packing. B and I both agreed that it was a test worth taking. Results will take two weeks, arriving right before I am scheduled to begin Radiation. Over 26 and I "drink the kool-aid" first for three months; under 26 and I go right to radiation. I've never found myself hoping for a low score on a test in my life but you can bet your butt I'm looking for one now! The magic reveal date will be February 21st. Cross your fingers, gang...and say a few prayers if so inclined. I will still need to take Estrogen Suppressant medication by pill for five years after the radiation, likely an aromatase inhibitor such as anastrozole.
Our final meeting was with Dr. Bristol, the radiologist. In contrast to Dr. Inhorn's mild and conservative manner, very paternal, scientific and cerebral, Dr. Bristol breezed in wearing a sports warm-up suit and athletic shoes...very hip. He spoke about ten times faster than either Dr. Teller or Dr. Inhorn, going over the facts of my case completely in about 90 seconds. He had met with both previous doctors so knew exactly what was going on and radiated (sorry!) complete assurance. He outlined the Radiation process which will be the same whether it begins in two weeks or after three months of chemo: sixteen sessions over a three week period with some very mild side effects.
All three doctors, while totally different in demeanor, left us a complete sense of confidence that we were in the right place. They are the perfect team, in our opinion, each with a special expertise and total respect for the other members' skills and judgement. Together they are truly Unstoppable!!! I am totally convinced that I am most definitely on my way to a complete cure. And this wild ride will all have been worth every moment!
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