Well, after a long, long waiting time, the oncotyping test results are in... and the news is good! As you may recall, I have very strongly (100%) positive receptors for both estrogen and progesterone. This means that my cancer thrived on these hormones. However, my HER1/HER2 receptors were negative which means that the cancer remains mid-grade aggressive.
The lumpectomy along with the use of radiation and a hormone inhibitor (tamoxifen) for 5 years, likely will cut my chances of a repeat incident of this cancer over the next 10 years to about 6%. The addition of chemotherapy only will improve the chance by 1% to 5%. Thus, the risk/benefit ratio of doing chemo truly doesn't seem like it makes sense, given the many serious side effects of chemo. Without radiation and tamoxifen, it is highly likely it will return.
Having said that, Tamoxifen, though a wonder drug, does have some side effects such as migraines, increased hot flashes, reduced memory, poor sleep, etc. I already live with this stuff so I am hoping that the side effects won't be much worse than what I already have.... and I firmly believe that this still is way better than the alternative of NOT taking Tamoxifen! To combat these issues, I have decided to be assertive and seek the support of a number of complimentary medical practitioners and I am continuing to workout 5 - 6 days a week 30 minutes at a time (too tired for more) to build up my own body's armies of helpers. In the meantime, please excuse me over the next few years if I am cranky, weepy, tired, always cooling off the thermostat or forgetful!
I already have booked a radiation planning session for next week where they will mark the area to be "nuked" and then I will commence a daily visit to Princess Margaret for treatment starting a week or two after that. Radiation should last about 5 weeks and it is essential that I not miss a single day. My plan is to work mornings, come down early afternoons, then off to rest after that. Fortunately, I have hired some new team members at the clinic who are wonderful and so I now have additional help. If there is anything that this "c" challenge has brought to me is that I got the help I had been seeking and so my plan is to start reducing my workload. Yep, you heard right... I am planning to work normal hours for a change...
The only very small glitch is that I did not yet receive the DNA results of another test that was conducted at PMH that looks at other cancer markers. It takes 2 months to receive these results due to the complexity of the test and it is one of the very few places in the world that offer this. In the very slight event that I have a marker code that would predict new cancer growth on the other breast, then I'd be a candidate to have a double mastectomy (still no chemo as the cancer doesn't respond to chemo). So far, my cancer is NOT behaving like an inherited type of cancer and so my bet is that this will not be necessary.
Since the results for this testing will only be available late May and because radiation will work best BEFORE mid June, I elected to go ahead and do the radiation. Typically, those individuals at higher risk of needing a mastectomy would not pursue radiation as this may affect their surgery/reconstruction. But, looking objectively at science, I want to knock this sucker out of my body and I do know that radiation is an essential part of the toolkit. My thought is this: start it, as we know it is a critical element to a cure and in the event that I need anything else, it will be at the beginning of the radiation cycle which means I can deal with it before the area becomes too scarred etc....
So, that's it in a nutshell. I feel greatly relieved as I can PLAN ahead and that means not just more work. I started looking at cruises in August on the way home from the hospital! I am hoping that we can take the kids to Alaska to celebrate their graduations from high school and university and my graduation from treatment!
By the way, if you are interested in learning more about oncotyping or tamoxifen, the links are included below!
My love to you all and thanks so much for your continued support!
Melissa/Missy
http://www.breastcancer.org/symptoms/testing/types/oncotype_dx.jsp
http://www.breastcancer.org/treatment/hormonal/serms/tamoxifen/
Saturday, 30 April 2011
Wednesday, 30 March 2011
And Now.... A Sigh of Relief
To cut to the chase, the Reader's Digest version of my post-operative appointment was very routine. I am healing well and, now for some great news:
1. The tumour aka Griswold (1.4 cm) and its margins (6.9cm x 7.5cm x 2.9cm) were successfully removed. There are no cancer cells at the tips of the margins that were taken. That means, "they got it all!" Thank G-d!
2. All 4 lymph nodes that were tested are clear! Yey!
3. On the aggressiveness of the cancer, from a scale of 1 (meaning not aggressive) to 3 (meaning highly aggressive), my cancer is a 2. Not bad at all! Combined with the other factors, I am still at a Stage 1 Cancer (pT1cNO (i-) (sn); 1.4cm, Nottingham Grade II/III for you science/medical nerds.
4. As far as the cancer's receptive cells are concerned, I am both estrogen positive and progesterone positive. Kind of unusual in my family.... as no one else has been positive to hormone receptors. Not a bad thing, just a weird thing. But, then again, I've been told that I am a little weird. In the cancer world, this is very common actually.... and nothing to worry about.
5. The HER2 receptors have not yet been identified. So, we are waiting for these results. Plus, I qualified for the government to pay for oncotype testing of the genetic qualities of the tumour in the States. That means that Griswold will be vacationing in California for a few weeks with $4000.00 as spending money courtesy of socialized medicine! Information gathered from this testing will help determine what type of chemotherapy would be needed, if any... we'll wait and see. I'll report back as soon as I know.
TREATMENT
1. I will definitely have at least 5 weeks of radiation but AFTER chemo, if chemo is deemed useful. Thus, if no chemo, I'd start in May sometime. If chemo is needed, I probably wouldn't start until late summer....
2. I will likely remain on estrogen or other hormone blockers (e.g. Tamoxifen or something in that family) for a number of years.... Not a bad thing at all.... Lots of positive research and great outcomes from this!
3. Chemo, if the oncotype testing proves this will be useful. Time, amount, etc. are yet to be determined...
IMMEDIATE NEXT STEPS
1. I consult with the Radiology Oncologist at Princess Margaret tomorrow morning. This is just so that I can become part of their patient roster for later treatment. Don't tell the boss.... but I think I may play hooky later on and, possibly, go to the One of A Kind Craft Show after my appointment tomorrow :)
2. Genetics meeting on Monday, April 4. They seem very keen to figure out how I link to the cancer picture in my family. Good luck to them.......
3. Medical Oncology meeting at Mt. Sinai with Dr. Christine Elser the end of April to review all info (including HER2 and other genetic markers) to determine full treatment plan.
SO......
It's business as usual... No disruptions to Passover! I will be up to full strength and armed with Pema my secret weapon to help out! Can't wait!!!! I'll be working full-time for the next month and then, we'll see what happens in May! My goal is to definitely attend David's bar-mitzvah in New Rochelle! We have to break this cycle of missing certain Rosenstein functions due to pregnancy/final exams and/or an appendectomy!
In closing, I feel great. Had a wonderful lunch with Jordan. Kids feel like a weight has been lifted off them. The sun is shining, I took Lacy out for a long walk and I am so, very happy and relieved. Sure, there's stuff ahead to deal with, but in the grand scheme of things, very small. Just inconvenient really.
Again, thanks for your notes, expressions of love, gifts, food, prayers and everything else. I am truly blessed!
With love to you all!
Melissa/Missy
1. The tumour aka Griswold (1.4 cm) and its margins (6.9cm x 7.5cm x 2.9cm) were successfully removed. There are no cancer cells at the tips of the margins that were taken. That means, "they got it all!" Thank G-d!
2. All 4 lymph nodes that were tested are clear! Yey!
3. On the aggressiveness of the cancer, from a scale of 1 (meaning not aggressive) to 3 (meaning highly aggressive), my cancer is a 2. Not bad at all! Combined with the other factors, I am still at a Stage 1 Cancer (pT1cNO (i-) (sn); 1.4cm, Nottingham Grade II/III for you science/medical nerds.
4. As far as the cancer's receptive cells are concerned, I am both estrogen positive and progesterone positive. Kind of unusual in my family.... as no one else has been positive to hormone receptors. Not a bad thing, just a weird thing. But, then again, I've been told that I am a little weird. In the cancer world, this is very common actually.... and nothing to worry about.
5. The HER2 receptors have not yet been identified. So, we are waiting for these results. Plus, I qualified for the government to pay for oncotype testing of the genetic qualities of the tumour in the States. That means that Griswold will be vacationing in California for a few weeks with $4000.00 as spending money courtesy of socialized medicine! Information gathered from this testing will help determine what type of chemotherapy would be needed, if any... we'll wait and see. I'll report back as soon as I know.
TREATMENT
1. I will definitely have at least 5 weeks of radiation but AFTER chemo, if chemo is deemed useful. Thus, if no chemo, I'd start in May sometime. If chemo is needed, I probably wouldn't start until late summer....
2. I will likely remain on estrogen or other hormone blockers (e.g. Tamoxifen or something in that family) for a number of years.... Not a bad thing at all.... Lots of positive research and great outcomes from this!
3. Chemo, if the oncotype testing proves this will be useful. Time, amount, etc. are yet to be determined...
IMMEDIATE NEXT STEPS
1. I consult with the Radiology Oncologist at Princess Margaret tomorrow morning. This is just so that I can become part of their patient roster for later treatment. Don't tell the boss.... but I think I may play hooky later on and, possibly, go to the One of A Kind Craft Show after my appointment tomorrow :)
2. Genetics meeting on Monday, April 4. They seem very keen to figure out how I link to the cancer picture in my family. Good luck to them.......
3. Medical Oncology meeting at Mt. Sinai with Dr. Christine Elser the end of April to review all info (including HER2 and other genetic markers) to determine full treatment plan.
SO......
It's business as usual... No disruptions to Passover! I will be up to full strength and armed with Pema my secret weapon to help out! Can't wait!!!! I'll be working full-time for the next month and then, we'll see what happens in May! My goal is to definitely attend David's bar-mitzvah in New Rochelle! We have to break this cycle of missing certain Rosenstein functions due to pregnancy/final exams and/or an appendectomy!
In closing, I feel great. Had a wonderful lunch with Jordan. Kids feel like a weight has been lifted off them. The sun is shining, I took Lacy out for a long walk and I am so, very happy and relieved. Sure, there's stuff ahead to deal with, but in the grand scheme of things, very small. Just inconvenient really.
Again, thanks for your notes, expressions of love, gifts, food, prayers and everything else. I am truly blessed!
With love to you all!
Melissa/Missy
Tuesday, 29 March 2011
On to Post-Op Appointment
Tomorrow marks the day when I'll be checked and, hopefully, hear the full pathology report.
Actually, I am looking forward to this as then I should get some sense of my schedule over the next few weeks...
I am back at work although privileged to work at home... I actually get lots done provided that Lacy doesn't snore too loudly and that out parrot refrains from singing "Oh Canada" off key!
I will post the results tomorrow so that you will be kept informed. In the meantime, I will ask a favor of you to email rather than call me as it is hard for my family (kids especially) to hear about this constantly....
Thank you again and again for all that you do for me! Your kind thoughts, food, gifts, books, jokes nourish my spirit and I feel so blessed!
xoxo Melissa/Missy
Actually, I am looking forward to this as then I should get some sense of my schedule over the next few weeks...
I am back at work although privileged to work at home... I actually get lots done provided that Lacy doesn't snore too loudly and that out parrot refrains from singing "Oh Canada" off key!
I will post the results tomorrow so that you will be kept informed. In the meantime, I will ask a favor of you to email rather than call me as it is hard for my family (kids especially) to hear about this constantly....
Thank you again and again for all that you do for me! Your kind thoughts, food, gifts, books, jokes nourish my spirit and I feel so blessed!
xoxo Melissa/Missy
Tuesday, 22 March 2011
Going Back To Work
After a little setback from an infected incision, the wound is finally better! I stayed at home yesterday but managed to get a lot done on the computer!
Little Doggy Nightengale couldn't be happier that I'm actually going in to the office today as she needs to catch up on her beauty sleep! As I type this, she is by my side on the kitchen floor... One eye on me and one eye on the pesky squirrels outside who keep taunting her!
Nibbles (our parrot) is happily munching away on his breakfast and being quiet for a change.... He has been bugging me a lot. When I go upstairs, he yells, "Mom.... MOM!" and I think it's one of the kids... If I come downstairs, he innocently says, "oh, hello" or "hi little fella, how are ya?"
Jordan has been great at cooking and keeping me company. He's been hard at work networking the house and getting lots of TV shows and movies. Amanda has been shopping, running errands and also cooking.... All this and finishing Grade 12! Little Superwoman! Jonah is hard at work with exams and final papers and presentations due... He moves out of Guelph the end of April for good and graduates in August! Time flies! Can't wait to have him home!
So, a few more sips of coffee and I'll be off to work! Now it's business as usual! This is good!
Thanks to you all for your car and van loads of food, gifts, flowers and warm wishes! I appreciate it so much!
xoxo Melissa/Missy
Little Doggy Nightengale couldn't be happier that I'm actually going in to the office today as she needs to catch up on her beauty sleep! As I type this, she is by my side on the kitchen floor... One eye on me and one eye on the pesky squirrels outside who keep taunting her!
Nibbles (our parrot) is happily munching away on his breakfast and being quiet for a change.... He has been bugging me a lot. When I go upstairs, he yells, "Mom.... MOM!" and I think it's one of the kids... If I come downstairs, he innocently says, "oh, hello" or "hi little fella, how are ya?"
Jordan has been great at cooking and keeping me company. He's been hard at work networking the house and getting lots of TV shows and movies. Amanda has been shopping, running errands and also cooking.... All this and finishing Grade 12! Little Superwoman! Jonah is hard at work with exams and final papers and presentations due... He moves out of Guelph the end of April for good and graduates in August! Time flies! Can't wait to have him home!
So, a few more sips of coffee and I'll be off to work! Now it's business as usual! This is good!
Thanks to you all for your car and van loads of food, gifts, flowers and warm wishes! I appreciate it so much!
xoxo Melissa/Missy
Friday, 18 March 2011
Patient Status - Friday March 18, 2011
Our patient is still quite sore but it seems to be a question of positioning. As long as she doesn't apply pressure against her underarm, she is ok. Missy is eating breakfast on the couch in the den as she surfs the net with her iPhone. Lacy the dog is bringing her kibble into the den (one piece at a time) and is joining Missy for breakfast. It's amazing how dogs sense that something isn't right.
Once the pathology results arrive at the end of the month, we will have a clearer idea regarding next steps.
I am going to shut up for a while and let Missy maintain her blog as she is feeling better.
Thank you all for your support and for sending email instead of phoning.
Love,
J
Thursday, 17 March 2011
Patient Status - Thursday March 17, 2011
9:40 AM - Our patient had a good night's sleep and a good washing this morning - she smells much better. Missy is sore but Advil is more than sufficient for pain. She has started borrowing my shirts for comfort. I have downloaded seasons one through seven of House for her and so far she has slept through three episodes. Bubbie just dropped off a "small" dinner. The first 50 people who reply can come join us for dinner..... oye....
Wednesday, 16 March 2011
Melissa's Turn
I am not sure what went on with Jordan manning the blog yesterday as I was out of it! And he was bored and getting a little punchy! So,... Do I need to apologize at all?
The surgery was very routine... It took about 90min. Initially, it was quite painful when I woke up but the drugs provided instant relief... Gotta love them... But I haven't needed more than Advil today....
I slept while eating my soup last nite at home and then slept for another 10 hrs. Woke up, had some more soup and Popsicles and went back to sleep with Lacy Nightengale by my side (see photo). In fact, I think I'll have another nap after this blog entry....
I had a crazy dream last nite that Jordan had an addition put on our house to surprise me... It was for some extra office space... I told him, "Great, but it needs better doors and then this will give us more room for guests at Pesach!" So, you can tell I'm well on my road to returning back to my old self....
Jordan has been terrific. Right by my side (nudging Lacy to get there) the whole way, making sure I eat, fielding calls and ensuring I don't fall when stumbling around the house...
Amanda came to visit me in the hospital which was a big step for her knowing how much she hates them! She supplied me with 4 kinds of soup at home as well as frozen yogurt from Menchies yum! Jonah has been in constant contact with us and has an exam today! He has continued to keep me laughing and my spirits high! Even from afar I feel his presence...
And then there is my treasured community of family and friends...
With such an outpouring of support from you, I am truly blessed, grateful and humbled by it.... So, please know how much each of you mean to me and,,,,,
Thank you!
xoxo Melissa/Missy
The surgery was very routine... It took about 90min. Initially, it was quite painful when I woke up but the drugs provided instant relief... Gotta love them... But I haven't needed more than Advil today....
I slept while eating my soup last nite at home and then slept for another 10 hrs. Woke up, had some more soup and Popsicles and went back to sleep with Lacy Nightengale by my side (see photo). In fact, I think I'll have another nap after this blog entry....
I had a crazy dream last nite that Jordan had an addition put on our house to surprise me... It was for some extra office space... I told him, "Great, but it needs better doors and then this will give us more room for guests at Pesach!" So, you can tell I'm well on my road to returning back to my old self....
Jordan has been terrific. Right by my side (nudging Lacy to get there) the whole way, making sure I eat, fielding calls and ensuring I don't fall when stumbling around the house...
Amanda came to visit me in the hospital which was a big step for her knowing how much she hates them! She supplied me with 4 kinds of soup at home as well as frozen yogurt from Menchies yum! Jonah has been in constant contact with us and has an exam today! He has continued to keep me laughing and my spirits high! Even from afar I feel his presence...
And then there is my treasured community of family and friends...
With such an outpouring of support from you, I am truly blessed, grateful and humbled by it.... So, please know how much each of you mean to me and,,,,,
Thank you!
xoxo Melissa/Missy
Subscribe to:
Posts (Atom)