And the punches just keep rolling on in.........

After I spoke with an Oncologist last week, I was starting to feel better about this whole "cancer" thing. I even saw my plastic surgeon this week who agreed on most points, and offered his services if assistance was needed moving the tissue expander out of the way.

Well after those appointments I felt like all was okay - apparently I was wrong! One doctor told me that I shouldn't have to radiation, only chemotherapy. The other doctor said there wasn't any medical reason that he knew of as to why I would have to remove my expanders in order to go through radiation. In fact I looked up several articles, and they all said it was okay to have them. But this was until the Surgical Oncologist......

We all knew eventually I'd be heading back into surgery, though it looks this time that it won't be till May 9th. I have to wait all this time just to go in, remove an expander, place a port-a-cath, and cut away a small area of muscle wall - small because he'd rather not cut a large section out of my muscle. Instead he'd rather radiate it. As much as I don't want to remove my expander, he claims that radiation can cause little hard areas to form around the expander - hard areas that would make it difficult in determining whether they were cancerous lumps or just hard areas. I don't mind having to remove the expander really. What I do mind is that a few weeks after I heal, I would undergo radiation daily for 7 weeks. After that would follow some term of chemotherapy. He couldn't guesstimate how long that would go on. He then said that it would be about a year before I would be able to undergo reconstruction again.

I'm NOT happy about any of it because I'm losing at least a year of my life, not to mention all the progress that has been made thus far - because not only will he be removing the expander, he will also be removing any extra skin and tissue from the area, so that there is no flap of loose skin in the area.
I'm at a loss because where do I go from here with my left breast reconstruction? I just feel that by time this is said and done with I will be nearing 40, and I say that based on the track record I have had.

I am just crushed over this whole thing and every time I think about it I have some horrible panic attack where I can't breathe and I just start crying all over again.
In one hand I honestly do believe that what they are doing or pushing for is a little bit excessive. They use scare tactics, so that you chose exactly what it is that they want you to have. I know they sold my husband on it, but all it did was make me feel even more conflicted. I don't know who to trust or if I can even trust a physician I've never seen. I really do have a lot of respect and belief in my plastic surgeon. I don't believe that he would EVER steer me wrong. A part of me really wants to talk with him and get his honest opinion of all of this, and see if we were both given the same story. For now I have the surgery on the books to include removal of the tissue expander, but may end up changing it as I believe that I am being pushed into an option that really isn't necessary. I will keep you posted as I get more info.

Tell me, do you ever feel like your doctor is pushing something upon you that's not really necessary?

When Bad Goes To Worse !

Yesterday started off a day like any other. Got up, got Nat on the bus, scrubbed my newly zit covered face (knew the stress would "catch" up to me sooner or later, but I didn't think that I would end up hittin' puberty a second time around!) Once Natalie was on her way to school, I skipped my morning meds so I wouldn't fall asleep - I then showered, dressed, and drove across town to East Jefferson Hospital where this Oncologist had an office. I filled out mounds of paperwork, and allowed them to copy my records back to 2005.

At first I wasn't sure if I was going to like this doctor or not because he didn't seem to listen - but one thing I did like was that not only did he answer my questions, he answered them in a way I would understand. I was glad to FINALLY have some answers and more understanding of everything! But once I knew what the deal was, I felt like a dumbass!

You see, I told you all the pathology of the tumor my surgeon found and how it compared to my original tumor - but I neglected to read further down the page to the diagnosis that was made. I had skimmed over it several times before looking for a "staging" but could not find one. I assumed that was what all the scans were for, to help determine staging and if it had spread. While each scan recommends additional scans, this oncologist told me yesterday to just slow down and breathe. It's not like it's going anywhere fast. He seems to think that this is part of my original cancer - and though he can't really explain how it happened, he's almost positive that my body is just one of the few that did not respond correctly to the meds, which is believable to me because as a teenager I had a bout with Pelvic Inflammatory Disease. It went on for over a month to no avail. I got a shot in the butt, multiple RX's for antibiotics, weekly paps. The doctors swore it was gone - I cried in pain. Finally they sent me to the hospital to have a MRI, only to find out that I still had it. I never responded to the meds. A weekend full of IV treatment and I was finally all better. So I believe his theory could be possible. What I can't believe is that I read right past the problem when looking for staging!

The diagnosis reads: Biopsy from the right breast reveals infiltrating, moderately well differentiated, duct carcinoma of the breast. The tumor is seen to invade skeletal muscle and extends to the margins of resection.

My original diagnosis was infiltrating ductal carcinoma and was a stage IIa. What I missed here was "the tumor is seen to invade skeletal muscle." Since all my scans came back ok, and show no signs of metastatic disease (even what appeared on my bone scan as possible metastatic or degenerative disease, had the metastatic portion over-ruled by the pet ct scan) I can say that the cancer is localized to the remaining breast muscle wall.

Originally, I had a modified radical mastectomy done in 2005, but since the cancer has invaded what is left of that muscle wall, I will have to speak with a surgical oncologist about removing the remaining skeletal muscle. I won't know till I meet with him next week, or maybe not even until surgery exactly how much (how deep or wide) will have to be removed. However, I do know that my plastic surgeon has mentioned before that he is able to move muscle from one area (butt or back) to my breast to make it work, so let's just hope that not only it can be done, but that my body will accept the switch on the first try

Also, I was told that my treatment will depend on the findings after the skeletal muscle is removed - so chemotherapy or radiation is still a possibility, though this guy seems anti-radiation. And of course I will most likely be taken off the Femara and given something else, hopefully something a wee bit more effective!

I may not have gotten specific answers as to how, but I am quite satisfied with the answers I did receive.
Now it's time to go do the taxes, hope it's not as painful as I've imagined. One bad day in a weekend is enough, though with Ruben leaving Sunday I suppose that will be two....and maybe taxes will just make three. If I could I think I would just go back to bed now!

Cancer Shock

Did you hear the news about Patrick Swayze having pancreatic cancer, and possibly only having weeks to live? I hope to god it's not true! Could you imagine if he died? The mourning I think would supersede that of Health Ledger, in my opinion. Swayze is a classic, and has many followers just from Dirty Dancing alone. And this news came just after the death of Jeff Healey, the blind guitarist who was in Roadhouse with Swayze - who died from cancer. What is this world coming to? It is said that only 5% of those who are diagnosed with pancreatic cancer survive. Those are terrible odds! It makes my news of cancer sit a little easier - knowing my chances of survival are good. But I wonder, is anyone else as tired as I am constantly hearing about cancer? I think it's about time a cure was found! What the fuck is taking so long?

Even after sleeping on it, it still isn't any easier to swallow.....

I went to bed early, at 8 last night. I just didn't have the energy to stay awake any longer after the day I had had. Instead of feeling well rested this morning, I still feel like I've been punched in the gut repeatedly. It's not about whether or not this prognosis is good or bad because I intend on surviving. I'm just in a state of shock that the cancer returned so quickly, and I wonder how many cases are out there like mine.

I'm not sure if anyone picked up on the coincidence, but yesterday was exactly 3 years and 1 day after my original diagnosis - March 3rd, 2005 was the day I found out I had cancer initially.
My surgeon joked, saying that if I hadn't asked for bigger boobs, this may never have been found - and that this may be the only case in which requesting bigger boobs may have saved someone's life. I sure hope so!

I've been breaking down all the details, thinking about how this may have re-occurred. 8 months ago when the expander was originally placed, nothing appeared abnormal. Up until June 2006, all my blood work screenings from my previous Oncologist came up negative. I haven't had my blood tested since then. I've been looking for a new Oncologist, and have even seen 2, but I didn't like either - the first doctor wasn't concerned with testing my blood, and the second I did the blood work but the lab screwed it all up, and since they don't work with anybody else I refused to go back. But even the 2nd doctor wasn't concerned about re-occurrence. So either this cancer has been developing for the last year and a half, or just sometime in the last 8 months. In either case it should not have come back. My original pathology stated my cancer thrived off of my hormones, but being that I am menopausal, I have no hormones - and what little estrogen my body does make on it's own was blocked (or should have been) by Femara, the drug I have taken since chemo ended.

So this is what I do know, based on the pathology from the 2nd tumor found:
25x15x12mm (my first tumor was 20 x 20x 15mm); biopsy revealed Infiltrating (moderately well differentiated) Duct Carcinoma (my first was diagnosed as Infiltrating Ductal Carcinoma); so far there has been no staging yet (my first was Stage 2; T2 N0 M0); Estrogen Receptor Positive 90% (my first was the same); Progesterone Receptor Negative 0 (my first was Progesterone Receptor Positive 5-10%); DNA Ploidy = Tetraploid (my first was DNA Ploidy = Diploid); S Phase = 9.6% (my first was S Phase 2.2%) HER2 & CEP17 FISH = 1.1 Negative (my first was Her-2/Neu = Negative score of 1+).
So there's been little to no change there. Now it all comes down to all these tests I'm going to have done. Hopefully the cancer hasn't spread, and we can nip this in the bud with a little chemo and/or radiation. We'll see, but in any case, this won't be the death of me! I refuse to succumb to this disease - it may make me bitter, but it won't take me, cause I don't plan on dying for another 30, 40 plus years!

The Nightmare Continues.....

I went today to meet with my plastic surgeon, 1 week post-op to have my drains and staples removed. While there we were hit with some unfortunate, bad news. While performing surgery on me last week he found what looked like scar tissue in the muscle of my right breast. He removed it to be on the safe side and sent it to pathology to find out if there was anything there to be concerned with. Pathology came back that the tumor was positive for cancer. The margins were not clear, meaning I may still have some cancer cells left. Other than that I don't really know anything else. Right now the doctor that performed my mastectomy back in July is setting up multiple tests - CAT scan, MRI, Chest scan, Bone scan, and tons of blood work. He is also referring me to an Oncologist that he swears by. He is calling this a local re occurrence, as we do not know yet if it is metastatic, or spread to any other organs/parts. He talked about possible radiation, but I told him I would prefer to do chemo again so I know it is gone. He also said something about changing or adding to my meds. Of course all of this relies on how all my tests come back, which they are setting up now. So really right now I don't know anything more than that I had a tumor test positive for cancer. So I guess I shouldn't have changed the title of my blog.