We met with the medical oncologist today. It was okay. It was SUPER frustrating. It was sad. There is much to report, but also much that remains unknown. I am trying to process everything and writing it all down seems as cathartic a response as any. So, without further ado - my Wednesday in evaluative thirds:
Good:
My current cancer is strongly responsive to estrogen (97%) and moderately to progesterone (64%).
Good:
I'm post-menopausal, thanks to the hysterectomy and oophorectomy of 2010. Therefore, I'm eligible for a course of Arimidex. Depending on if you prefer scientific or generalized internet writing, Arimidex can either be considered an aromatase inhibitor or hormonal chemotherapy. It's an oral medication to prevent the cancer from spreading and I'll take it for 5 years as an initial treatment and then a possible 5 years more after that.
Bad:
The Arimidex won't make me lose my hair, but the main side effect is joint and bone pain. It can cause bone loss, which I learned is called osteopenia. Disappointingly, it's not the result of the spell that Gilderoy Lockhart casts to mend Harry Potter's broken forearm after a particularly nasty quidditch spill. That's something else entirely and it requires a medication called Skele-gro which no one even offered to me.
I'm scheduled for a DEXA Scan, which stands for dual-energy X-ray absorptiometry. It will give us a base line for how strong my bones are or aren't so that we can monitor their porosity. Bones are supposed to look like honeycomb under the microscope. If mine look more like nerve synapses then we become concerned (or kind of impressed)? If I start breaking bones from sneezing or sitting down too aggressively, then I guess we have a problem.
Ugly:
My oncologist told me that I should institute a low carb diet for the next five years, as Arimidex has a tendency to make women gain weight.
"How much?" I asked.
"Do you really want to know?" he answered with a grimace.
"Yes."
"10% is the average. It could be less ... but it could be 20%."
Come on! I don't want to tell you my weight, but I will say that 10% is not a negligible 5 pounds. It's significant. I told the doctor that I wasn't interested in gaining 10% of my body weight. He didn't seem to think that my objection would make a difference to the medication.
Good:
The invasive ductal carcinoma is grade 1. That is the slowest growing type of cancer.
Bad/Good:
There was also some DCIS (ductal carcinoma in situ) in the sample. DCIS is considered a grade 0 and is sometimes called pre-cancer. If left untreated, it will become invasive cancer. Some of that was found and was removed during the surgery. Is there more still hanging out in there? Unknown.
Ugly:
The pathology report says that the "gross description" of the sample is "4 Fibrofatty core biopsies." That's just mean. I like French fries. I can't help it. Don't pick on me.
Ugly:
I don't want to be rude, but the lab report says that my case was "seen in consultation with Dr. Lundberg." I didn't meet Lundberg, but her/his name sounds suspiciously like Lumberg, who is the villain from the movie Office Space. I'm concerned.
Bad:
The oncologist I saw today is not the doctor that I had in 2010. I loved that doctor, but he moved out of MN, I think back to his native country of Germany. For the last several years I have been seeing this other oncologist who is fine, but not the same as the guy who held my hand through the misery of Cancer 1. I see him once a year for follow-up and have always considered him to be acceptable. Today, he was notably sub-par.
He asked me if I just had a mastectomy. "No. I had that 12 years ago."
He asked me about the lymphadenopathy and lymph surgery that I had in 2014. "That's when Dr. Petryk thought I had lymphoma, but it was later determined to be lupus."
He asked me if I am post menopausal. This was the killer.
"I had a mastectomy in 2010." (I pointed to the medical-gibberish on the computer that I have learned to decode.)
"A mastectomy doesn't mean that you are post-menopausal."
"An oophorectomy does. I had an oophorectomy in March of 2010. It's right here on the screen."
"Ooh. You're right. That's exactly what it's called when they take out your ovaries."
Me (in my head): "I KNOW! I'M NOT AN IDIOT. SHOW ME THAT YOU ARE NOT AN IDIOT OR WE ARE GOING TO SEE IF I STILL KNOW HOW TO DO TAE KWON DO."
I do, by the way. I have nun chucks and am not afraid to use them on anyone ... or on cancer.
Good:
Because I have had cancer twice and am young (medically speaking), it is concerning. My oncologist wants to do genetic testing on my healthy cells to see if there are any answers hidden in my DNA. The tests will tell us if there is possibly a genetic mutation with which I was born or some other reason that this is happening. His exact words were: "You're too young to have already had a cancer and a recurrence. Something is not right."
I agree.
Good:
The oncologist also ordered oncotype DX testing. This is a detailed look at the cells of the cancer tumor to determine several things, most importantly among them is the benefit that chemotherapy would offer to my specific cancer. I had this done in 2010 and the result fell into the intermediate category. In 2010, it was determined that chemo wouldn't be beneficial. This time, we will see. I won't learn that until early June when I go for a follow-up appointment.
What else? Oh, right. Laila and Owen got hit by a semi truck this morning on their way to school. It was a low speed impact. They are both okay. The car is likely totaled.
I guess that's it. I'm going to finish the trashy reality tv show I'm half-watching and go to bed. Tomorrow is a regular work day and then Friday is 2 hours with radiology. So, more to come I guess.
Thanks for your support.
Liz
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