I listen intently as my surgeon, Dr. Silva, explains different treatment options and goes over the pathology and mammogram reports. Soon – very soon – it’s too much to handle; I blank out. I’m still in that “this can’t be happening to me” stage and I definitely can’t say “I have breast cancer”. All I want at this point is to have it out – cut it out – cut it off – I don’t care … just get rid of IT … not one, take both … these things just tried to kill me!
Dr. Silva is a very patient, caring woman. She explains to me that my right breast is clean, there is no cancer. She tells me that what I have is a random gene mutation, chromosome 17, the HER2 positive protein. I don’t have the gene that Angelina Jolie has (BRCA1 mutation). She explains that IF a tumor were to appear in the other side, it would be a whole new cancer and we’d have to start over with testing and classification and … I can understand why some women choose to have both breasts removed, it takes away the ‘what if’ factor and the uncertainty. But – even though I’ve had 6 babies, 5 of them totally natural – I’m a baby about pain. I hate being cut on (or poked or prodded or examined for that matter – guess I better get over that!). Understand, I can tolerate anything for a short time, but pain that extends … the less the better.
My options are a lumpectomy (partial mastectomy), with a 15-30% chance of reoccurrence but same long term survival rate, or a simple (total) mastectomy, with a 5% chance of reoccurrence in the muscle or skin. Both require chemotherapy, either before to shrink the tumor, or after to clean up any sneaky cells floating around. The lumpectomy requires daily radiation for 30 days or so, with mastectomy perhaps no radiation is required. It’s an easy choice. I do not want to take a chance on having to do another lumpectomy to get clean edges and ending up with having to do a mastectomy anyway. Make the cut once and move on.
I am ready to get this thing in motion; Dr. Silva explains that we have time. Time??? She wants me to think about it and meet with the other doctors on my team: radiology oncologist, medical oncologist, and plastic surgeons. Just so I have as much information as I need to make the right decision. Sounds good to me – info is good right? So I follow Stella, my oncologist nurse, to the appointment desk. The earliest appointments are for the following week (WEEK?), 3 one hour blocks. Since I prefer not to have radiation if at all possible, we skip that appointment (for now).
The week drags by, and finally it’s time to meet with my doctors. I’m fortunate to have Shawn with me to take notes – he was also there with me the previous week. I’m expecting to see Dr. Powers, my plastic surgeon, but in walks a crew of 3, none of them Dr. Powers. The lead is a resident working with Dr. Powers, and I’m assuming the other two are students (it is a teaching hospital). The male resident is young (very) and good looking (my daughters say hot) and all I can think is that I wanted a female doctor! But he’s good, he explains everything … and then he takes pictures. I understand that they need before/after shots, but it still didn’t make it any easier! Dr. Powers finally comes in. She’s very direct and it’s apparent that she really knows her stuff. I feel good about the reconstruction decisions.
The next doctor I meet is Dr. Washington, the medical oncologist. She tells me she’s going to teach me about my cancer and how we’re going to get rid of it. And she does. She also tells me that chemotherapy is going to kick my butt. She says you think the surgery is bad, but it’s nothing compared to the chemo. Okay … scary, but I would much rather have honesty than sugar coating. I’ve discovered that one of the most important things in this process is to have doctors that trust you and that you trust. I’m exceptionally pleased with Dr. Washington, which is a good thing, since I’ll be seeing her ALOT. My new BFF.
Dr. Silva arrives. She tells me that Dr. Powers and Dr. Washington have conferred with her, they have come to agreement and she just wants to go over everything to make sure it’s what I have decided. We talk about the mastectomy, the beginning of reconstruction immediately (if possible), and after recovery from surgery, six sessions of chemo every 21 days along with 52 weeks (concurrent with the 6 sessions) of Herceptin to kill the HER2 positive protein. She schedules surgery for August 29.
It’s going to be a really, really long year.