Today was completely fascinating.
I’m going to show you my cancer. So you understand the perspective, I am laying on a bed with a hole in it. I am on my stomach. My breasts are hanging in the hole. The right breast, is on the right side of this picture.
The tumor is on the right side, near the blue / lock-like marker – and looks sort of hazy. Above it, is a brilliant white, malignant lymph node.
Here is the MRI of my breasts from January.
And from yesterday.
HUGE shrinkage in the primary tumor. Very excited. High fives all around.
The lymph nodes, however, did not change much at all. And this has changed our plan of attack. Instead of having the sentinel node identified, removed and sent to the lab, we are going to skip that surgery all together and have the cluster of nodes in the fat tissue of the arm pit removed with the mastectomy. The original intention was, ultimately, to remove less nodes. Since none have shown a response to chemo, at least from the MRI’s vantage point, the theory now is a larger sum should be removed and recovering from a second surgery is not necessary.
They are hopeful that if they take out 10 nodes, for instance, 2 of them have cancer. Not all 8-10. This might mean some other surgery is in my future, more chemo, or some other strategy not discussed.
What does it mean? Frankly, we don’t know yet. Here’s what it could mean.
It could mean that the lymph nodes are now dead cancer cells, and are showing up because they took up the contrast (The dye used to identify the tumor cells) anyway, which is what lymph nodes would naturally do. The dead cells or scar tissue of the lymph node is making it visibly the same size as before treatment. Best case scenario.
It could mean that the pathology of the lymph nodes is different than the primary tumor (ie: NOT Triple positive) and didn’t respond to the chemo regime I was assigned. This might mean I have more chemo in my future, once we know what the pathology is. Not my favorite, but it is what it is.
It definitely means that I am now at risk for lymphedema in my right arm – which is a swelling due to fluid retention. I have a 30% chance of this happening, because of the amount of lymph nodes they are removing. This would be a chronic issue. We will just have to wait to see what happens. At the first sign of swelling I have an action plan to follow, to try to eliminate the problem before it progresses too far along. This was not good news to me, and, if I’m being truly honest, what I fear / have feared the most. I don’t want to contend with a swollen arm for the rest of my life. Or wear a sleeve. Or deal with it at all. But, like all things, it will not help me to worry about it – it won’t change the outcome, and so I will hope for the best: Dead cancer cells who can’t wait to get the hell out of my body.
I asked if I need to seek counseling for removing my breasts. The answer was “If you are asking, you should seek it.” There are people on staff at the Wellness House that can help me with this, and that was where my doctor recommend I go first. Get as much info as I can from anyone who knows anything, and the more informed I am, the more confident I will be, and the more emotionally stable I will become. I must admit, it makes me misty eyed thinking that I will not have my own breasts anymore. I fed 3 kids with them. They are part of me. I would not willingly choose plastic surgery, ever. They are, however, trying to kill me. There isn’t a better option in my mind than the path I’m on now. A nice, new, perky set might also make me misty eyed. In a promising way.
We talked a bit about radiation, but then decided it was something that could wait until after I get through surgery. We also talked a bit about the ovaries coming out, and there has been a study in the last 18 months published showing significant reduction in recurrence for patients who are ER+ (estrogen receptor positive). But, again, will table this until I get through the more eminent phase of this journey.
Lots has happened. And plans have changed. Bill and I both feel good about it, and we like the surgeon, a lot. We now have a meal-train started to help us with dinners through the next month. I wasn’t sure I wanted this, to start, but I’ve got to be honest, the meals look pretty good. Plus, less to think about it. My Dad and Butz & Kasey (+ the gingy dog) are taking my kids for the time I’ll be in surgery/recovering. They are going up to our northwoods family cottage in Watersmeet. It’s a holiday weekend, and the kids are getting out of school super early this year. It actually worked out great. I’m excited for them, and jealous – so thankful for the help and, again, one less thing to think about.
I’m feeling the aftermath of round 6. Still recovering from the icks. Getting my appetite back. Still managing the ‘rea. But I’m a bit jacked up on adrenaline with all that’s coming my way, and I feel like it’s helping me cope better with the side effects. As are gin + tonics. 🙂
There may be a bit of silence now, as we head into the big day. If not me, Bill will post after the surgery and let this audience know how I’m doing. I have an infusion on the 25th, so at least you’ll hear from me then…
Cheers, all. This too shall pass.