The Diagnosis and Treatment Plan

The doctor called with biopsy results on Monday morning, December 23rd.  I was prepared that the tumor was malignant and really wasn't holding out any hope that it wasn't.  I just needed it confirmed so that we could move on to the next step.  I had moved beyond the stage of being completely grief-stricken by that point.  A nurse who served as a breast care advocate at the hospital where I'd had my biopsy had called and talked with me after the biopsy.  She was no-nonsense and cut to the chase with me immediately.  She said two words very early in our conversation that immediately made me feel as though a weight was lifted from my chest:  "complete cure."  She said that, given my age, the doctors would be very aggressive in treating my cancer and would want a complete cure.  In other words, I still have a lot of life left to live!  I loved hearing this, because I had said from the moment I felt that lump that I wanted to throw everything at this cancer.  I vowed I would fight it with everything I have.  However, up to that point, no one had been talking about an action plan with me.  It was all focused on the biopsy and the results. 

Anyway, when the doctor called with the results, she reported that it was indeed breast cancer.  Infiltrating Ductal Carcinoma to be exact.  It was grade 3.  I was scheduled to see a breast surgeon on December 26. 

We worked hard to put all of that on the back burner for a couple of days while we enjoyed Christmas with our kids.  They had a great one, getting what they had requested from Santa.  Jack got a globe, a telescope, a Razor scooter, and  Rip Rider.  Lucy got her Barbie Baby-sitter, a pink princess bike, an ironing board (funny girl!), and plenty of accessories to help care for her babies she loves so much.  We made sure we participated in each and every family tradition, and I tried to focus on enjoying every moment of it.  Nothing like a cancer diagnosis to make you appreciate what's important in life!

Over the next week, we met the team of doctors who would be helping lead me in this fight against cancer.  First, the breast surgeon, then the oncologist, and finally the plastic surgeon who would do my reconstructive surgery.  We learned a lot, quickly.  First, we were told that the cancer was Stage 2.  We were also introduced to the term "triple negative," a term a quickly grew to dislike.  We found out that my cancer is negative for all three hormone receptors (estrogen, progesterone, and HER2/neu).  When cancer is positive for any of these receptors, certain drugs can be given to target these.  However, these drugs are not going to be an option for me.  For this reason and because of the size of the tumor, the doctors agreed that neoadjuvent therapy was the best option for me.  In other words, I will receive chemotherapy prior to having surgery.  Surgery will definitely include a mastectomy, and the doctors have been supportive of my desire to have a bilateral mastectomy.  It was also recommended that I go for genetic testing, in order to determine whether I have a mutation of either the BRCA 1 or BRCA 2 gene.  Testing positive for either gene would put me at a higher risk of developing breast cancer again, which would definitely indicate the need for a bilateral mastectomy.  Each of these genes also increases the risk for ovarian cancer.  I've been for this testing, the results of which take two weeks.  I haven't received those results yet.

In this time period, I also went for multiple other tests (bone scan, CT's, MRI, echocardiogram) to check for any metastasis and to make sure my heart is healthy for chemo.  I began to feel as though I was constantly in a medical office or hospital.  My doctor's appointments seemed to rule my life, and every time I turned around I was being poked, prodded, or scanned.

Once the plan was in place, we were ready to move forward.  We shared the news with our kids, trying to give them straightforward information but without too many scary details.  Of course, they had different levels of understanding for what we were telling them.  Jack had heard of cancer before and immediately asked about dying.  Lucy clung to my analogy of how the chemo meds were going to fight the cancer inside my body.  We even acted out how it might look inside my body when the medicine is doing its job.  This really stuck with her, and every time cancer is mentioned, she begins doing karate chops!  She also thought it was funny that I said I was going to "kick cancer's butt," since "butt" is not a word she's usually allowed to say.  Jack, my rule-follower, was not at all pleased that we were using that word!  However, he has been very sweet and has vowed to shave his head with me when it's time.  (Quentin has also made this promise!)

I'm a planner and a do-er, so it felt good when we finally had a plan in place.  I focused on January 15 as the date I would start chemo and begin to kick cancer's butt!  In doing this, I slightly underestimated the outpatient surgery scheduled for January 13.  The surgery was for the placement of a port, which would remain implanted just below my collarbone for the duration of treatment.  The surgery went well, but caused me much more pain than I had imagined it would.  It's going to take awhile to get used to having that object in my body, but I'll do it if that's part of beating this thing!

Ready for my port placement surgery!