The week before the North Caroline trip I met with Dr. Sinopoly, the radiation ocologist and Dr. Harris, medical oncology. I learned about the radiation portion of the 'breast conserving protocol - 33 treatments, 5 days a week for about 6 1/2 weeks. Swell.
I learned that the purpose of this therapy is to destroy any lingering cancer cells (if there are any) that may still be located in the breast tissue. The radiation actually works to destroy the cells' DNA so it can't replicate. The bad news is that it also destroys the good cells, too. That's why one side effect can be fatigue and my the cells undergo, quite literally, a fight for their lives. Exercise and good nutrition are ways to combat this, so I'll be all over that!
The medical oncology approach was quite a different story. Here again, the bilateral nature of this throws a kink in the plan. Unless I want to treat this aggressively, taken separately, the tumors were of a size and stage and of markers that would indicate no chemotherapy is required. Chemotherapy, I learned, is a systemic attempt to destroy any rogue cancer cells that may have broken off and traveled somewhere else in the body. The problem with it is that it can sometimes cause other cancers or issues and it often has unpleasant side effects - hair breakage, nausea, and a general beat up feeling, among other things.
The fact that I had bilateral tumors present at the same time was a cause for some elevated concern. Dr. Harris and I discussed three things.
First, hormonal therapy will be recommended. For the next five years I'll take prophylactic measures (pills) that will reduce the amount of estrogen my body produces. My tumors were estrogen receptor positive which means they respond to estrogen. The theory goes, reduce the estrogen and switch off the ability of the cells to receive this hormone and grow another tumor. (Am I the only one who doesn't get this? If God intended me to have estrogen, why is it that this naturally occuring substance ---something my own body makes--- causes this life threatening mutation?)
Second, we talked about being tested for the BRCA1 and BRCA 2 genes. These are specific, hereditary gene mutations that indicate an increased risk for breast and other cancers. Of course, this is an intersting dilemma because what do you do with the information? If it is negative I ask more why questions. If it is positive, what do I do? A preemptive strike and remove all the parts of me that make me a woman? Ignore it and hope for the best? And of course, the biggest issue of all is the fact that it has affects my family members, too. Does my mom want to know? My sister? Does my brother want my niece to know?
Finally, we discussed another testing option that was approved by the FDA about a year ago. The Oncotype DX test looks at 21 different markers in the tumors and returns a probability of recurrance, somewhere in the body, over the next 10 years. With this information we can decided if chemotherapy would be advantageous (supposedly) or not (supposedly). I opted for the test.Since it is new, there is a good chance that my insurance won't pay for it, but that is of little concern for me now. If I'm not here a few years down the road, no one will collect on anything.
I want more information.
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