Finally the day was here and I went on June 12th to see my oncologist to discuss what my final pathology really meant and what I needed to do following a successful lumpectomy.
One thing I despise about doctors appointments is the long wait! Never seems to fail that no matter what you do, you are going to wait at least an hour before ever getting started. Of course, I have already covered how well I deal with waits so you can imagine what the wait was like for me. I think I need to replace the patch of carpet in the waiting room which I wore out with my nervous jiggling leg and foot. Oh well!
I was called back and they did lab work on me and then I was sent back to wait some more. After another 45 minutes, I was finally called back to a room to see the doctor. When he came in, he introduced himself, and said he wanted to do four things: get my history, do a physical exam, discuss what breast cancer is and then determine where I fit into that picture and what my treatment would be. I instantly liked him. He was knowledgeable, kind, clear and willing to listen and answer questions.
The history went quickly and we talked back and forth about my and my families medical histories. Then he examined me and paid close attention to the incisions from my lumpectomy as well as the site where my port should be placed. Then we all sat down and discussed my case.
He started out by reviewing what breast cancer is and how it was staged and graded. I was a bit bored as I had read way too many books and websites in my down time and was very familiar with everything he was telling me. Then it became clear why he spent so much time covering the basics. He began graphing the survival rates of breast cancer and then he placed me according to the stage and grade of my cancer on that graph of outcomes. Suddenly statistics were very real and I saw what they meant to me. I have to tell you, there is nothing like seeing your chances of survival mapped out on a piece of paper and seeing yourself plotted on a chart against percentage points. For every percentage point I decreased, I felt my stomach knot. You’d think being young and fairly healthy would give you better chances of survival, but not with breast cancer. Youth just means you have more chance of reoccurrence. Then we talked about how my percentage points of survival improved by the surgery I had already had. That loosened the knot in my stomach, but not nearly enough. He plotted what the required radiation treatments would do for me and again, the knot loosened as I gained percentage points back. Then he plotted where I would be with an adjust treatment like chemotherapy. I gained back several percentage points back and the decision for me was a no-brainer.
Then the other shoe dropped as he explained that I had one more decision to make. Because of the size, stage and grade of my cancer, I sat borderline on treatment choices, one inch either direction would have squarely put me in either category, but I would have to decide which way to go. I could go the standard route of CMF therapy which would require 8 treatments and would take about 6 months to complete or I could do 4 treatments of AC which would be done in 12-16 weeks. The major difference was in that one was much more aggressive than the other and the side effects would. One would be milder, but the fatigue would last longer. The other deciding factor was that the harsher treatment was proven highly effective in fighting more aggressive cancers which stood to reason that they would be highly effective in getting rid of mine. As it stood the difference in survival rate from one treatment to the other was only 3-4 % points.
I had expected to go in, be told what to do and get started. I had no idea I would be staring down another tough decision. It was clear Bill did not want me to be unnecessarily harsh on myself and wanted me to weigh the decision carefully. All I knew was I wanted those four more percentage points, I didn’t care what it took to get it. We left there that day and went home to decide what we thought would be the best treatment option for me. I went home, went to bed and woke up later to face the world and my decision. Bill explained to me he did not care what I chose he just did not want me to choose the harshest route without giving the other route consideration. I finally found the words to explain to him there were two factors that kept creeping through my mind. First, going all out DID increase my odds, even if by just a little. Second, would I be able to live with myself knowing there was more I could have done to treat it. Would I lay awake at night and wonder if it would come back because I was not aggressive enough. I told him that I wanted to know that if it ever came back I had done everything there was possible to prevent it. He said he understood that and together we decided to go with the AC chemotherapy treatments.
I called the office the next morning and let them know. They set my first appointment up for the 20th and asked if I could have my port put in by then. I had already called my surgeon’s office and they had me schedule for the port implant the very next day. The doctor ordered an echocardiogram on my heart to ensure I was up to snuff before starting the aggressive treatments and that was to take place late Friday.
So here we were, on the road and ready to go. I finally felt better because we were moving again, but honestly, it was little consolation.
