The Journey Begins...

Today GG met with the oncologist for the first time. As we sat in the waiting room at Cancer Care Northwest, I couldn't help but look around the room and notice people who were in much worse situtations. The adorable hats hiding the bald heads, the wheelchairs, the sickness that filled the room. And then the nurses dressed in bright-colored scrubs talking to patients in cheery voices. I looked around the room and noticed a children's play area, and said a prayer Miss T would never have to play with those toys.

Dr. Moline was a kind, hard, soft-spoken, breast-cancer guru. She had to yell for most of the three hour appointment to accomodate GG's hearing, but she did a good job. And yes, you read that right, she spent about 2 1/2 hours with us, answering questions and explaining. 

Here's the Dirty Details:

GG's official diagnosis is Invasive Duct Carcinoma.  In our terms, this means she has breast cancer that can spread. It's the most common form of breast cancer. It is NOT hereditary, which is excellent.  It is not caused by hormones, but even the bioidentical hormones are still "hormones" and her body has treated them that way.  It's likely that without the hormones for the last 10 years, GG wouldn't have had the cancer show up for some time. 

How Big is the Cancer?  

We don't know, and we won't know until an MRI is done. We can guess at this point that it is around 1 cm, and we pray that we are right.  We looked at the Mammograms for the past 5 years, and the boob looks exactly the same in every one of them, except for this years has 3 little tiny spots on it. Just like when you look at an x-ray, the dense parts are white. In GG's case, there is a huge white spot covering about half of her boob, and that is all dense area that they cannot tell much about. An MRI will give a better view of that dense area and we will know at that point how big the mass is. It's not technically a lump, as the cells have not formed into a lump. So it's a mass of cells and we need to know how big that mass is. 

Other Factors

GG was tested for two receptors, Estrogen Receptor and HER2.  The Estrogen Receptor came back positive, which is a GOOD thing.  It means the cancer hasn't taken away the "breastness" and it is less likely to spread. It also means the drugs used as inhibitors are much more likely to work. PRAISE GOD! 

The HER2 test is still not back.  It's likely due to the holidays as they test this in batches rather than individually due to it being a very difficult test. If this comes back negative, that's a GOOD THING. Pray for Negative HER2 results, please.

Let's talk about Treatment.

We treat 3 different things.

1. The BOOB

Once the MRI is done, it will be used as a roadmap for the breast surgeon to know what she's working with. She will start by getting out all the cancer with good margins. This will likely be done with a LUMPECTOMY.  We can all put 2 and 2 together and figure out that if the MRI shows the mass is too large, the Dr. will talk Mastectomy. We are hopeful it is a small mass, and pray that it's under 1 cm. 

Once the Lumpectomy is done, GG will do Radiation. Radiation is M-F for 6 1/2 weeks. She will do this every day for about 35 treatments. It is possible the radiation could be shorter depending on tumor size and depth, but the most likely is the 6 1/2 weeks. 

2. The Lymph Nodes

If you've ever seen one of those pictures of the boobs in the dr's office, you'll notice that they have all kinds of little things that look like nerves. Those are the passages from the boob going first to the lymph nodes in the armpit, but having access to the entire body after that. Generally there are about 2-3 lymph nodes in each side that could be affected. She will have a Sentinal Node Biopsy and the first node will be removed during the lumpectomy. If it is negative for cancer, we are DONE with the nodes. If it is postive for cancer, she might remove all the nodes. 

3. The Rest of the Body

When considering the treatment for the body, we think: what is the risk of spread? and what is the treatment?

GG will meet with a medical oncologist after her lumpectomy and biopsy of the nodes to determine this.  To determine if GG will need chemo, the medical oncologist will consider these things:

1. Tumor Size + Node Status + Age & Health + Estrogen Receptor/Her2 Receptor + Tiebraker

1. Tumor Size - we don't know. But we will once the MRI is done.

2. Node Status - Again, we don't know. Please pray nodes are NEGATIVE for cancer. 

3. Age & Health - GG is only 60 and very healthy, especially with her fresh weight loss and healthy eating. She's a rockstar as far as physical shape goes, so as the oncologist put it today - "I noticed your family history of living a very long time (NO SHIT GG's Grandma lived to be 102!!), and you have no other health issues, so we would want to treat the rest of your body."

4. Estrogen Receptro/Her2 Receptor - we DO know the Estrogen Receptor is GOOD and we are praying the Her2 is good.

5. Tiebraker - the medical oncologist's have  few tiebrakers to decide if chemo should be used or not. 

Based on what the Dr. said today, I believe that if the cancer hasn't gone to the lymph nodes, she will be out of the woods with chemo. The Dr. thought it was safe to say the chances of it having spread to the nodes was about 10%.

What's the Bottom Line?

GG will have her MRI next Tuesday, and that will give the surgeon a roadmap. It will also tell us how big the mass is, which miss Patient GG is anxiously awaiting. 

She will have her lumpectomy the 25th, and get that shit out of her.

Approximately 4-6 weeks later, depending on her healing, GG will start Radiation. 

She will meet with the medical oncologist about 1-2 weeks after surgery to determine the rest of the plan.

The Juicy Details

GG is actually handling it like a rockstar. If you know her (and you should or why the hell are you reading this), you know she cries at the drop of a hat, or a puppy, or anything for that matter. This woman is a walking waterworks. I suggested she not cry until January 1, 2013 but unfortunately that's not an option. BUT she only cried a tiny bit today and she didn't lose her shit. She was so strong sitting there listening to the Dr. and asking intelligent questions.  She rocked that appointment. 

Action Man is Rock Solid as always. He's a realist and he thinks in numbers, so all he would want to read out of this blog is the "What's the Bottom Line?" paragraph. But let's all give a shout out to what an amazing couple these two are. 

And here's some food for thought: