Archives for category: Facts

Sit on it, cancer!

July 10, 2012 //

Okay, most of you know that I do a lot of work with parents on how to deal with those lovely toddler/preschool tantrums. And I’m not talking about the typical ones, I’m talking about the kids who have the really intense, long, and frequent tantrums. I get a 4 year-old who comes in, gets told “no”, and just loses it. It’s very scary to see and hear a child out of control like this and it is understandable that parents can feel really powerless. After the dust settles, a joke I often tell at these times to put things back in perspective is, “Yes, it’s very scary when a child is out of control like that. But remember, he’s a little kid. If worse comes to worst, you can always sit on him.”

So, why I am I telling this story? Well, I’ve had trouble explaining to people (and myself) how my long-term prognosis can be so positive, when I’m going to need at least one more surgery. My long term prognosis is positive because my cancer is not aggressive and whatever is still in there, is just in my breast. It hasn’t gone to my lymph system or into my blood. But MRI and mammography did not pick up on the 2.5 cm of stage 0 cancer they found in the breast tissue they removed from my body. (I am guessing that my breast tissue will be easier to read when I become menopausal because “busy breast” is supposed to be very common in pre-menopausal women and to “mellow out” with age. But that could take a significant number of years.) Although stage 0 cancer is not invasive can’t kill me, there is no guarantee that it won’t develop into an invasive cancer. And given that they found two small invasive tumors in the area, they know that my breast already knows how to make invasive cancer.

My cancer is tantruming and putting up a fuss. But it is still little enough to contain so they are “sitting on it”, so to speak. I am hoping this surgery takes care of things but if not, I will get a mastectomy and then later reconstruction surgery. The mastectomy is major surgery so it would mean taking 4-6 weeks off from work. This is not my preference, actually my preference is not to have cancer at all, but I think it would be the right choice for me if it comes to that.

Categories Facts, Feelings

Protected: Taking it easy-sort of

July 8, 2012 //

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Categories Facts, Feelings

Pathology report-mostly good news

July 6, 2012 //

I met with Dr. Kristine Rinn, a medical oncologist. “Aren’t they all oncologists?” you ask. (At least that was my question.) A medical oncologist deals with the systemic, medication treatments for cancer. Surgery and radiation are local treatments because they only focus on one body part or region rather than the whole body. Medications, since they travel through your blood stream are systemic in that they impact one’s entire body. The most commonly known type of systemic cancer treatment is chemotherapy. However, there are a number of systemic treatments for breast cancer, including hormone blocking medication, which is called endocrine therapy.

So Dr. Rinn went over the pathology report with me because she was the first doctor I saw since it became available earlier today. I will be meeting with my surgeon soon, as well.

The good news follows:

1) The cancer I have is not an aggressive type. It is also very small. Younger women tend to have larger and more aggressive tumors. However, that is not the case for me. I have a small, old lady type tumor. In the breast cancer world, this is a good thing. Dr. Rinn told me that she thought I was going to be “just fine” in terms of long term health.

2) There was no cancer found in my lymph nodes.

3) There was no evidence of lymph vascular invasion. This basically means that they looked for the bus station that leads to the lymph system and there was no cancer waiting for a ride to other parts of my body.

4) All of the margins for the tumor detected on mammogram and biopsy were good.

5) Dr. Rinn seems awesome!

The unclear and/or negative news:

1) There was a second, smaller tumor found right next to the main one. The second tumor is 3mm. This is not so unusual. However, two tumors is worse than just one.

2) They couldn’t tell if those cells that looked like they might be stage 0 cancer, were stage 0 cancer or not. Whatever they are, there are two spots where they are too close to the margin of the tissue that was removed during surgery. There is also concern that this area, which comprised 2.5 cm, over half of the removed tissue, was not detected through the mammogram or MRI imaging.

3) Although my chances of needing chemotherapy are low, more testing of my tumor is needed to assess this and it’s done in one lab in the country. The testing is called oncotype testing. It is done for women with no evidence of breast cancer in the lymph node who also have a hormone responsive tumor. Swedish is sending off a sample of my tumor to be evaluated by the lab. They will look at 21 genes, which are correlated with long-term cancer recurrence. They are able to use the information to assess 1) the chances that my cancer will recur and 2) whether my cancer would likely benefit from chemotherapy treatment. The results will be available in 2-4 weeks and at that time, Dr. Rinn, John, and I will go over her treatment recommendations.

The long and short of it is that I am going to need to have another surgery. I am at peace with this. The approach now is to preserve as much breast tissue as possible and one possible negative for this is that another surgery might be needed. I will have more information about this after I meet with Dr. Beatty.

Categories Facts

The Battlefield is Smaller

July 3, 2012 //

The pathology report is still not fully complete. However, some very important and positive information was available.

-There is no evidence of cancer in the lymph nodes closest to the tumor. So this means that the cancer I had or have is contained in my breast. This also dropped the likelihood of my having chemotherapy down some more.

-The margin (width) of healthy tissue surrounding the tumor was good.

The unknown:

There are 2-3 additional areas of atypical lobular dysplasia (ALD). My understanding is that ALD are markers for cancer. There is a chance that these areas are cancerous, the non-invasive kind (stage 0), called Ductal Carcinoma In Situ (DCIS).

The long and short of this is that I may have to have another surgery. If the areas are DCIS (a kind of stage 0 cancer) and if one or more of these areas is too close to the edge of the tissue that they removed in surgery, I will need another surgery to take out more tissue. This does not likely mean the need for a mastectomy, just another lumpectomy.

Apparently, my tissue is hard to interpret (I have dense tissue) so the pathologist is consulting with two more senior pathologists to get their opinion before the final written report is available.

Dr. Beatty said it could be another week until it is completed but he will call as soon as he knows anything.

In sum, the cancer battlefield has gotten smaller, but they are still trying to figure out the number of ground troops that The People’s Republic of Cancer has hiding in there.

In the meantime, I am celebrating the lymph node news and distracting myself with other things.

Categories Facts

No news is no news

July 2, 2012 //

The pathology report was not ready today so no news. I have a follow-up appointment with my surgeon tomorrow so it should be ready by then. The appointment is not until the afternoon. Before then I will be trying to distract myself from thinking about it.

Stay tuned.

Categories Facts

Happy Birthday, John!

July 1, 2012 //

John’s birthday is actually tomorrow, but I have work followed by a big doctor’s appointment, which could potentially usurp his birthday. Even if the pathology report has good news, I may be too pooped to party.

Anyway, back to John. As most of you know, my husband is an awesome guy. I was almost 21 years old when we met. I had not dated much in high school at all and had a few boyfriends in college, none of them being the greatest match for me or vice versa. As only a young adult’s logic can take them, I was coming to the conclusion that perhaps my lack of luck with men was a calling to become a nun, sort of by default. I was seriously considering meeting with Sister Catherine, at our church when I met John in a writing class at U.W. We both needed to take a writing class as a graduation requirement. This particular class, which had about 20 students, was linked to a huge lecture class taught by the famous history professor, Jon Bridgman. That class had about 500 students and covered classical history.

I first noticed John’s intelligence and kindness. He was a thoughtful speaker. It was clear that he liked to read (myself also a book lover) and that he took his education seriously. (I’d had a previous boyfriend or two who was more interested in begging me for my lecture notes instead of attending class.) There were a few minor obstacles, like the fact that he had a long distance girlfriend and that although he thought I was beautiful and a nice person, he didn’t like me. In his words, I was “loud and obnoxious.” I also thought his sense of humor was pretty lame and corny. (Yes, I know this is a shock since John is known for his wit.) But John was at times so amused with the absurd thoughts in his mind that he would just laugh for 20 minutes straight only to be able to choke out a word or two between guffaws, for example, “cock roaches!” See, not so hilarious without knowing his mind.

In the 25 years that John and I have been together, I sometimes think of how different my life would have been if I had just moved on after John told me that I was too loud and obnoxious for him or when he told me that he had a girlfriend. Something told me that things would work out and that we would be a good pair. Plus, my mom even liked him based on description and said that I should be patient because he sounded like a really good guy.

John and I were in different states during the 1st of his birthdays he’s had since we’ve been together. It was the summer of 1987 and he was working at fish canneries in Alaska. For his birthday, I made him two care packages. The first was “things that don’t smell like fish” and I filled it with homemade potpourris and sachets of herbs. The second box was “things that don’t taste like fish” and it was filled with homemade baklava and other goodies. I’ve never thought of this before but in the last several years, we’ve traditionally celebrated John’s birthday with a “seafood blow-out”, which is my cooking all kinds of seafood for dinner.

We might need to hold off on the “seafood blow-out” tomorrow. Did I mention that I’ve been pretty tired lately? Instead, I offer this “gratitude blow-out” to John. Happy Birthday, John. I’m glad I was patient with you and I’m glad that you took a chance on me! You are a wonderful person, husband, and dad.

Categories Facts, Feelings, Not Cancer-the other part of my life

Now my husband is bored

June 29, 2012 //

I think John had something else in mind in terms of taking care of me. When I was first diagnosed last month he went directly to his HR department to find out how much paid leave he could use to take care of me. He soberly reported, “It’s not as good as I hoped. It’s only 5 weeks.” My reply, “John, I’m not going to hospice care. Five weeks is plenty.” (Plus, there’s the whole self-employed part of me that thinks, “Paid leave? Woo hoo! What are you complaining about?”)

So I think he had something more along the lines of the English Patient type care taking. The fact that I am doing much better than anyone expected is confusing. This morning, he started talking about movies again. The man is seriously passionate about seeing movies when they are in the theater. And his motivation to include me in this passion has ramped up recently. He would probably laugh at me, but I suspect this is his way of checking that I will still be around for him. That’s understandable and sweet but it is also irritating. I know that I have a hard time not feeling responsible for people. I’m actually feeling a little guilty that I don’t want to go to the movies this weekend and that John is feeling bored taking care of me. I know it’s irrational but since I have not yet learned to let go of this, I end up feeling annoyed with my husband who is just doing his best in dealing with a scary situation over which he has almost no control. Though I have to say, the fact that he has a good job and carries my health insurance is no small feat. Having excellent health insurance is an enormous privilege. I hope our country keeps moving toward shifting it from a privilege to a right.

Okay, now I’ve gone from annoyance to gratitude. Thanks again, Blog!

Categories Facts, Feelings

Apparently I am not convalescing hard enough

June 28, 2012 //

So, I am doing pretty well today, one day after surgery. My pain rating (on a scale of 0-10) is about about 1-2. John says he is running out of things to do around the house and noted that I don’t seem to need much besides a steady supply of decaf coffee. He asked my plans for the day. Plans? Sitting on my butt is my plan. Perhaps I confused him when I unloaded the dishwasher this morning with my left hand. (The surgery was on the right side.) Yes, I know you are all yelling at me in your heads as you read this. I am following the directions given to me by my nurse! I am taking it easy.

Anyway, John asked me “Do you want to go to a movie today. If not, I can go without you.”

“And leave me home alone?”

“Well, you haven’t really needed me much.”

“What if I get an infection? I’m not cool with you leaving today and I don’t want to go to a movie. I think it would be uncomfortable to sit in a theater.”

John did not need much convincing to stay home. I just think he needs to be needed. People just being around is a lot of help. A hard part of this process is that I don’t know how much help I will need and what kind I will need. I know that’s hard for John, too.

I promise to stay away from the dishwasher for the rest of the day.

Categories Facts, Feelings

Bored Already

June 27, 2012 //

Okay, I got bored resting within two hours of getting home. The biggest thrill was my first trip to the bathroom, which yielded blue pee. This would have been more exciting if I had not been warned of this ahead of time. (The reason? There was blue dye in the radioactive isotope for the sentinel node biopsy). Also, it might have been a little more exciting if it were a different color. Given the popularity of blue as a color for toilet cleaners, blue toilet water is actually kind of mundane. Plus, my pee color changed back to normal really quickly. Bored again.

This does not mean that I am not resting. I am still resting, just restlessly doing so. It’s not as if my couch cushions are unfamiliar with my butt, either. I can very easily waste time on the couch surfing, reading my Kindle, etc when I have a pile of laundry waiting for me to fold. Wasting time on the couch is so much more fun when it is every so slightly naughty than when it is mandatory.

I will be good. I will rest. I will be bored. Bored is way better than many alternatives. It’s like I told the anesthesiologist when he kept apologizing about having a hard time getting my veins to present themselves so that he could run an I.V. (It wasn’t his fault. My veins are tricky. Plus, he didn’t have to make more than one attempt with the needle, which has happened multiple times with other folks.) I just told him, “You all are trying to save my life. In the larger scheme of things, this is no big deal at all.”

I will be bored. Boredom I can live with.

Categories Facts, Feelings

Surgery is done–At home resting comfortably

June 27, 2012 //

The hospital stay was shorter than I thought it might be. Surgery went well and I feel pretty okay all things considered. Also, there was a bit of a miscommunication on our end with relatives. If you heard a rumor that I had lymph nodes removed, that is not true. For those of you keeping score at home, this is what I had done today:

1) Placement of a wire guide in my breast to help the surgeon in locate the tumor and surrounding margin of healthy tissue, all to be removed. (For those of you with more questions about margins, you will have to wait until the pathologist’s report.)

2) Sentinel node biopsy: Basically, they biopsied some of my lymph nodes, special ones called “sentinel nodes” to see if any cancer has spread to my lymph nodes. Prior to surgery, there was about a 10% probability of lymph node involvement. About 2% of the time, the surgeon is able to see that there is evidence of spread and if so, lymph nodes are removed at the same time as the lumpectomy. Dr. Beatty said that he did not see anything. So that lowers the chance of lymph node involvement to about 8%. The pathologist will be able to determine this and the pathology report will be available on Friday or Monday.

3) Lumpectomy: Dr. Beatty removed about a golf-ball sized piece of tissue. The majority of the tissue was healthy because he was trying to remove the tumor encased in a “margin” of healthy tissue. He tried to get margins of about 1.5 centimeters and he said that about 1/3 of the time, he is able to get at least a 1 cm margin, which is good. But there is some very experienced guessing that goes into the process with such a small tumor.

Everyone at Swedish was awesome, efficient and warm at the same time. My friend, George may be particularly happy to hear that my anesthesiologist had good bedside manner and even better, I did not have any nausea or other ill effects from the anesthetic.

Categories Facts