My Husband Had a Mammogram!
We spent two hours at the Women's Imaging Center yesterday, and Bo doesn't have breast cancer! I knew he didn't. The universe just doesn't work that way. He was diagnosed with something called "Gynecomastia" which is a benign enlargement of the male breast. Now that they have ruled out cancer, his doctor will have to run tests to determine the underlying cause. I wonder if there is a test for sympathy... He had my sympathy because in addition to the ultrasound, they decided to do a mammogram. He said that it smashed what little bit of chest he had. Yes, I know exactly what he means!!
While I was at the Women's Imaging Center, I did meet with Dr. D, the radiologist, regarding my MRI results, and she showed me the actual images from the two MRIs. Sure enough, even to my untrained eye, there was no noticeable difference. That was the first time I have seen images of the tumor, and it was pretty ominous looking. It was one larger mass, with two smaller masses branching out from it. Dr. D considers it to be one tumor, and at its largest point, it is nearly 4 centimeters in diameter.
Dr. D told me that Dr. P, my oncologist, was supposed to call me last week and asked if I had heard from her. No. She then shared with me that Dr. P wants to go ahead and proceed with surgery. Dr. D was aware that Dr. H, my surgeon, wants to continue chemo and then do surgery. I expressed my concern and frustration that my two primary physicians were in conflict, and what kind of position that put me in - total limbo. Cancer is hard enough to manage, never mind managing the physicians! In their defense, however, treament is not an exact science, and there is no right anwer. She was sympathetic to my situation and when I asked her if I should get a second opinion, she said that was certainly an option and mentioned a couple of surgeons I could call.
I left feeling very discouraged and decided the best way to express that emotion was to let the tears flow. So I did, and then I got over it and took action. I can work a plan, but ambiguity is very difficult for me. It was time for a plan. I called my brother, John, who I knew was vacationing in Provincetown with a friend of his, Joe, who is an oncologist. Joe was very encouraging and said that even though the response wasn't what we wanted, the tumor didn't grow, so it doesn't appear to be chemo resistant. He also reiterated that the tumor may in fact be dying but that the MRI wouldn't show be able to show that. Additionally, some tumors, because of their composition, dissolve faster than others. Joe specializes in cancers of the blood, but he called an colleague who does nothing but breast cancer oncology. She recommended continuing chemo...
From the very beginning, Joe, has recommended that I get a second opinion at the Massey Cancer Center at the Medical College of Virginia (MCV) in Richmond, and John has really been pushing me to do the same. I felt the time had come to do that. It is not that I have any doubts about my doctors or about the care I am receiving. They are top in their fields in this region, and I know they are all committed to curing me. It is just that if they can't agree, a new and different set of eyes may help me evaluate the options. Afterall, I only have one life (depending on your religious beliefs), and no one cares about it quite as much as I do. (Bo says he does, and I know he does. I also know he would trade places with me if he could, but I wouldn't let him, even if I could.) So, I went ahead and made an appointment with a renowned oncology surgeon at MCV, Dr. B. I meet with him next Tuesday. He recommended I continue my chemo in the meantime.
Dr. Hoeffer called last evening, and he made his case for continuing chemo. If I heard him correctly, he said that there is a 10% response rate among women to Adriamycin and Cytoxin, but when you introduce the Taxotere, the combination of drugs results in a 44% response rate. The question he couldn't answer, because no one knows the answer: "Is the tumor's response, or lack thereof, indicative of the response to the cancer that may have spread beyond the breast?" No matter. The tumor responded because it isn't bigger, so that means, if it is anywhere else, that responded too!
I finally spoke with Dr. P today. She said she had tried to reach me on Friday but didn't want to leave a message. As I had already heard, she feels very strongly that we remove the tumor now and get me on hormonal treatment as quickly as possible. She doesn't even think that we should continue chemo following the surgery, just radiation. She discussed this course of action with her colleagues at Duke, and they were in agreement; although, I think she said that they didn't see any harm in continuing the chemo either. She did come up with a compromise that really put my mind at ease for the first time since Friday afternoon when I received the MRI results.
I am going to go in tomorrow for my fifth cycle of chemo which will be the Taxotere. She will measure the tumor at that time so we can evaluate if there has been any response at my next appointment. This means that I am receiving some sort of treatment while I am waiting for my appointment with Dr. B. I feel so much better because the tumor will again be under attack. Reinforcements are on the way to aid the pirahna with chainsaws!
With all that being said, I researched and confirmed with the doctors, that there is no statistical difference in survival rates between chemo prior to surgery (neo-adjuvent) versus chemo after surgery (adjuvent). Don't you think that would make me feel a little better that either way, I have an equal chance? Actually, it kind of does, but I still want to evaluate the options and understand the rationale behind each. It's that whole control thing I have going on - cancer hasn't cured me of that... yet!
While I was at the Women's Imaging Center, I did meet with Dr. D, the radiologist, regarding my MRI results, and she showed me the actual images from the two MRIs. Sure enough, even to my untrained eye, there was no noticeable difference. That was the first time I have seen images of the tumor, and it was pretty ominous looking. It was one larger mass, with two smaller masses branching out from it. Dr. D considers it to be one tumor, and at its largest point, it is nearly 4 centimeters in diameter.
Dr. D told me that Dr. P, my oncologist, was supposed to call me last week and asked if I had heard from her. No. She then shared with me that Dr. P wants to go ahead and proceed with surgery. Dr. D was aware that Dr. H, my surgeon, wants to continue chemo and then do surgery. I expressed my concern and frustration that my two primary physicians were in conflict, and what kind of position that put me in - total limbo. Cancer is hard enough to manage, never mind managing the physicians! In their defense, however, treament is not an exact science, and there is no right anwer. She was sympathetic to my situation and when I asked her if I should get a second opinion, she said that was certainly an option and mentioned a couple of surgeons I could call.
I left feeling very discouraged and decided the best way to express that emotion was to let the tears flow. So I did, and then I got over it and took action. I can work a plan, but ambiguity is very difficult for me. It was time for a plan. I called my brother, John, who I knew was vacationing in Provincetown with a friend of his, Joe, who is an oncologist. Joe was very encouraging and said that even though the response wasn't what we wanted, the tumor didn't grow, so it doesn't appear to be chemo resistant. He also reiterated that the tumor may in fact be dying but that the MRI wouldn't show be able to show that. Additionally, some tumors, because of their composition, dissolve faster than others. Joe specializes in cancers of the blood, but he called an colleague who does nothing but breast cancer oncology. She recommended continuing chemo...
From the very beginning, Joe, has recommended that I get a second opinion at the Massey Cancer Center at the Medical College of Virginia (MCV) in Richmond, and John has really been pushing me to do the same. I felt the time had come to do that. It is not that I have any doubts about my doctors or about the care I am receiving. They are top in their fields in this region, and I know they are all committed to curing me. It is just that if they can't agree, a new and different set of eyes may help me evaluate the options. Afterall, I only have one life (depending on your religious beliefs), and no one cares about it quite as much as I do. (Bo says he does, and I know he does. I also know he would trade places with me if he could, but I wouldn't let him, even if I could.) So, I went ahead and made an appointment with a renowned oncology surgeon at MCV, Dr. B. I meet with him next Tuesday. He recommended I continue my chemo in the meantime.
Dr. Hoeffer called last evening, and he made his case for continuing chemo. If I heard him correctly, he said that there is a 10% response rate among women to Adriamycin and Cytoxin, but when you introduce the Taxotere, the combination of drugs results in a 44% response rate. The question he couldn't answer, because no one knows the answer: "Is the tumor's response, or lack thereof, indicative of the response to the cancer that may have spread beyond the breast?" No matter. The tumor responded because it isn't bigger, so that means, if it is anywhere else, that responded too!
I finally spoke with Dr. P today. She said she had tried to reach me on Friday but didn't want to leave a message. As I had already heard, she feels very strongly that we remove the tumor now and get me on hormonal treatment as quickly as possible. She doesn't even think that we should continue chemo following the surgery, just radiation. She discussed this course of action with her colleagues at Duke, and they were in agreement; although, I think she said that they didn't see any harm in continuing the chemo either. She did come up with a compromise that really put my mind at ease for the first time since Friday afternoon when I received the MRI results.
I am going to go in tomorrow for my fifth cycle of chemo which will be the Taxotere. She will measure the tumor at that time so we can evaluate if there has been any response at my next appointment. This means that I am receiving some sort of treatment while I am waiting for my appointment with Dr. B. I feel so much better because the tumor will again be under attack. Reinforcements are on the way to aid the pirahna with chainsaws!
With all that being said, I researched and confirmed with the doctors, that there is no statistical difference in survival rates between chemo prior to surgery (neo-adjuvent) versus chemo after surgery (adjuvent). Don't you think that would make me feel a little better that either way, I have an equal chance? Actually, it kind of does, but I still want to evaluate the options and understand the rationale behind each. It's that whole control thing I have going on - cancer hasn't cured me of that... yet!
posted by Mary @ 3:09 PM
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