Wednesday, July 4, 2012

D-day

I have traveled this road before. Five years ago I had breast cancer while in medical school. A week before my graduation from family medicine residency, my breast biopsy revealed invasive breast cancer once again. 
 
 
When I saw the new snowy nodule on my routine mammogram, and then on my ultrasound later that evening, I knew what was coming. The biopsy was swift and the results would arrive the next day. I arranged to receive them over the phone to avoid the nauseating silence and clock-watching in the clinic waiting room.  Instead, my family, David and Lynne joined Christoph and his family at Toad in the Hole Pub to watch the Eurocup Germany v. Greece game.  A decent collective distractor.  I was more saavy this time.  My doctor called just as Greece scored a goal. The Germany fans clammered with disapproval as I shimmed out of the pub to recieve the news I already knew.  We filed home quietly and sat in my parents living room. Cancer happens, and it feels unlucky. People cry and swoop in. When cancer happens again, there is less to say. You think, this is not something that should feel familiar.
Last time I wrote privately. In my mind, on the backs of bills, on my laptop in my sundrenched living room in New Mexico with Katie and Boots.  This time I will write here.



The Nitty Gritty
What we know: 
1. The cancer appears small and low grade (slower growing).
2. My surgery date is July 19th in Santa Rosa.
3. The tumor is highly estrogen receptor positive so I will need aggressive anti-estrogen treatment for five years (ovarian suppression and an aromatase inhibitor).

What we don't know:
1. if this is a recurrence or a new cancer.
2. if it has spread to my lymph nodes.  I am hopeful it has not because the tumor is small.
3. if I will have chemotherapy.
4. if this cancer is Her2 positive or negative (first test says yes, a second says no, the third test and several others are in the pipeline).  This result matters because if positive I would have herceptin + chemotherapy.

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