Part Three - Coming Up October 27, 2010

Greetings Everyone!

Right now in Crescent City it's a beautiful, sunny, somewhat windy, fall day with rain projected at 70 - 90% today and maybe a total of one inch by the time the storm moves on.  Last week we had huge wind, lightning and rain storms that brought big tree limbs down, cut our power twice in 24 hours and filled our gutters (again) with all the tree debris that's been accumulating since the last storm.  One of Jim's big home owner jobs is to take my electric blower (yes, mine - and, it was a birthday gift, too!), get on the roof and blow all of the mess off of the roof and out of the gutters.  He's already been up there once this season, and it immediately stormed and clogged the gutters again.  I argue strongly against this dangerous little home chore when the roof is wet - which is pretty much all the time at the moment.  I don't always win.  Cross your fingers for dry days this weekend - that's usually when the urge to roof climb strikes.

So...the last chemo is doing its best to make me miserable, but beginning to fade.  I was able to work last week (Tuesday through Saturday - yahoo steroids!) with energy falling as the week went on.  By Sunday, I was a couch potato and slept most of the day.  Monday I actually managed to pass out - an unexpected event, since I am usually really able to monitor being dizzy and manage it to not actually faint.  Got surprised, but not injured.  A better day Tuesday and today, so far.  The good news is that I should be able to climb back up and out of this in a few more days - and the GREAT news is that I don't have a cycle to start again next Monday!!

However, the next part of this journey has begun...information, set-up, planning and scheduling of radiation.  I've really been re-immersed in the numbers that got us started on this journey again, which (lucky you) I've decided to share.  Here goes:

1. In April, I was diagnosed with invasive lobular carcinoma of the right breast;
2. In June - after two lumpectomies - I had a mastectomy and extensive axilary node dissection.  All cancer that was seen was removed.  The margins (edges) of the main tumor were "clean."  However, 23 of 24 nodes were positive for cancer.
3. The extent of cancer that was found caused me to be "staged" at Stage 3.  There are four stages given, based on the size of the initial tumor and whether or not lymph nodes were found to contain cancer.  Because of the larger size of the tumor and the large number of positive lymph nodes, I moved right up to Stage 3.  (Stage 1 is very early and, of course, Stage 4 is a late catch.)  Stage 3 is considered "advanced" disease - but because I had no evidence of distant metastasis (as in bones, liver, etc.), I am not at Stage 4 or "late" disease.
4. Statistically (based on data from 2001 and 2002), women in my situation have about a 49% five-year survival rate overall.  This means that, with treatment, its about a flip of a coin for me.  Not the best number, but still hopefull since I have no obvious mets.  And, survival rates are improving every year...
5. Both Jennifer Brown, the medical/chemo oncologist, and Janice Ryu, the new radiation oncologist, confirm that survival is increased when chemotherapy, radiation and hormone therapy are given after mastectomy.  Dr. Brown told me she has gone for a "cure" with the chemo and has been very aggressive.  I believe her.
6. Dr. Ryu has prescribed 5,000 rads total dose of radiation over 25 daily treatments.  This is a lower number of treatments than I've heard proposed before, so I'm still gathering information about how "aggressive" she's being.  I plan to ambush my oncologist on Friday with this somewhat sensitive question.  At this moment, I start radiation on November 16.
7. Hormone therapy is given to women whose tumors test E2 and P2 positive, which mine did.  Dr. Brown says that the tumor type that I have is actually very responsive to hormone therapy and that this is one of the most important components of the total treatment plan.  For me it will be an aromatase inhibitor, which is a newer class of drugs designed to remove all the remaning estrogen from my body.  Like menopause didn't do enough, already!  I'll take hormone therapy for at least five years - so I'm told today.  Who knows what will change and/or be new in that amount of time.
8. By December 22, I should be done with radiation, chemo and nicely adjusted to hormone therapy.  The side effects of all of this year will march on for a little longer after that.  But, as my friends said today, then normal life - real life - begins again at our house.

Why all the contemplation of numbers and statistics?  Probably partly because it takes a while for things to sink in and there's nothing like repetition to get the information actually lodged in my brain. Having finished chemo and in talking with the radiation doc, the numbers are once again fresh and in my thoughts.  This whole thing has really made Jim and me think about how we live our lives, how we want to continue living our lives and how lucky we've really been over the past 20+ years.  I believe that the numbers are actually going to be better than projected for me and that another 10 years or more is in my future - and we have plans for every one of those days!

But, I wrote in this vein today partly because this is how I'm dealing with stuff...and how I plan to keep dealing no matter what happens.  Radiation - big scary machines that do invisible things to kill cells - is another step on this journey and has me thinking again about this little trip Jim  and I (and you) are on.  I want to have all the information I can find that 's accurate and informative.  I wish I'd paid better attention in statistics those many years ago so I could really understand the statistics in some of the research I'm reading.  I wish I understood cellular biology and angiotensin growth factors and many other clinical/biological things that are being researched that may come to apply at some point.  None-the-less, my plan is to do the best I can with the cards dealt and to know about as many of the cards that are not yet face up...and sprinkle a little denial into the mix once in a while.  I will be a partner in my health care and I will be making the decisions about what happens to me.  This won't be happening "to" me - it's happening in me and with me and I'll be right there asking questions and trying to figure out the next best steps for me.  Right now, those steps involve a big scary machine and hormone therapy to get to a cure.

And, just so you know...Jim's giving me about another week to "get over" chemo and then he has a work-out, shape up plan that sounds grueling.  Studies do show that women with breast cancer who exercise and stay at the correct BMI (ahemmm), live longer than those who don't.  Any of you remember me when I worked out hard 6 - 7 days a week?  Well, Jim does and he's making plans for my re-addiction to the whole exercise thing.  Maybe whining will divert him for a little longer.

Thanks to Susan, Kelly and Karen for the great lunch today.  Happy Birthday, Susan!

BTW: It's raining! :)