Monday, September 24, 2007

Post-surgical Evaluation & Pathology FINALLY!

OK, I saw the surgeon today and the pathology report is FINALLY done, and the news is what it is. Get ready to have your brain scrambled by lots of scientific information.

1. The way doctors look toward treatment of breast cancer has to do with the particular kind that it is.

2. Right now, there are three (minimially) factors that "define" what kind you have.
o One is if your body is able to react to estrogen
o One is if your body is able to react to progesterone
o One is if your body is genetically disposed to "express" a certain genetic receptor named the HER2 receptor

3. So here's my status:
I'm estrogen receptor negative (er-)
I'm progesterone receptor negative (pr-)
I'm HER2 negative

4. That means that the class of drugs that would be used to treat someone that is er+ are not available to treat me, because my body will not react to them. Further the class of drugs that would be used to treat someone that is pr+ are not available to treat me, because my body will not react to them. Finally, the drugs used to treat people who are HER2+ are not available to treat me, because my body will not react to it.

5. Now this seems a little discouraging because I have the common cold of breast cancer -- truely the most common kind. However, all the drugs that have been discovered in recent years, and particularly the "silver bullet" of cancer treatment (Herceptin), are all drugs that will not work for me.

6. So what does a person with my particular profile do to fight cancer? Well, I'll refer you to this site. Put your hands behind your head, lean back in the chair and have a nice read. Now you know the kind of scientific mumbo-jumbo that I need to wade through to figure out what strategy is the one I want to adopt. There is one particularly nice piece of information that came out of the pathology report today. That is: I'm Node Negative. That means of the 5 lymph nodes that were sampled two weeks ago and examined, none of those nodes has any cancer cells running around inside. That means it's not LIKELY in my bloodstream. That is a very good piece of information to know.

7. Clearly, it is important for me to do chemotherapy. Which one? I am not sure......I'm researching things more. The first chemotherapy I got is a VERY aggressive kind called TAC. It's the scary monster of chemo's. I can always get easier (comparitively) with the chemo or scale back on the drugs, but there is a lifetime dose that one can accumulate of the "A" component. Now that we know the definitive pathology report results, we can be more focused on selecting a set of poisons.

8. I go back in a month to decide, probably, how much of me, and when I'll have some of me physically removed. Go to the above site and read and you'll see why this is a complicated thing to decide. There is a part of me that screams "GET THIS CRAP OFFA ME!" However, the advantage of doing the chemo first is that you get to see if any of the poison they throw at the monster, works. So, the moral of the story is, "Be patient." Another reason to do the chemo first is so the surgery can be figured so you can save as much skin as possible and do the least amount of surgical "revision" of the area as possible.

9. If I thought it would save my life, I'd be willing to sacrifice a lot of me to the knife. The bottom line, however, is that just lopping things off doesn't necessarilly improve your chance for survival or reoccurrence.

10. After sitting up in the car for several hours today, I was EXHAUSTED. It's one week today since the chemotherapy was administered, and it just blows me away how just sitting up can be too taxing for me. I mean so EXHAUSTED that I can literally fall down. I'm talking about so tired, I can't eat, can't move, can't catch my breath because I've been doing something like standing still for a few minutes. I wanted to take pictures of my hair today, before it goes away tomorrow. I wanted to see my grandson and just enjoy being in his precious presence. I wanted to just be able to eat a meal and have it digest normally. I wanted to believe I could be independent and take myself to the doctor in north Atlanta. I wanted to believe that once I knew the name of my enemy, I could fight it better. None of these things are meant to be.

Thanks to Jeff who called me today to touch base with me and let me know that my students are managing. I'm sorry you had to "draw" the sick teacher as your coteacher this year. If I could have "dodged this bullet" I sure would have though!

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