Wednesday, December 12, 2007

Pump Up the Jam & A Second Opinion

Hello everyone,
On Monday, I had my first expansion appointment. It was interesting - Dr. Havard first injected some lidocaine and then injected 50 cc's of saline into the temporary tissue expanders. For those of you who don't know, these "tissue expanders" were placed under my pec muscles, but high on my chest, maybe only a couple of inches below my collar bone. They were not placed in the normal area for breasts because that area is still healing after the mastectomy and they didn't want the scar tissue to adhere to these tissue expanders. Then, when it's time to insert the permanent implants, they will "release the muscle" and the new implants will be in the normal place. I also found out that it takes about 450 cc's to get up to a "B" cup - that's nine injections! And, because Havard has a couple of vacations planned in December and January, that means that my expansion appointments will go into at least March. By then, the nurse said that it'll probably look like I have a chin rest!

I had my appointment with Dr. Luoh at OHSU yesterday. And, ironically, while he still really stressed that I should have chemo, what he had to say made me even more sure of my decision NOT to do chemo. First, he feels that this cancer is actually a new cancer and this is a good thing - apparently, the prognosis for "new" cancer is better than a recurrence of an old one. He said that if it was a recurrence, there's a greater chance for a "distant relapse" or metastasis to another part of my body. The chance is less for a new cancer. I also asked him what he thought my chance for a distant relapse was. He estimated 50% (whereas Kenyon thought it was 80%). Herceptin cuts that down to about 25%, ovary removal plus aromatase inhibitors puts it down to about 15% and chemo only gives me about another 5-7%. One of my colleagues, Melissa Cheyney, pointed out that a normal woman on the street has a 12.5% chance of developing breast cancer in her lifetime. Which basically means that by doing Herceptin and the ovary removal/aromatase inhibitors, I'm near the "normal" category, without chemo! So, in terms of quality of life, both short- and long-term, I will refuse chemo. The risks outweigh the benefits. Dr. Luoh kept stressing that he felt it was an early stage breast cancer and he usually wants to treat such cancers very aggressively, and especially since I'm young and relatively healthy, he thought I could handle the side effects. But having gone through those side effects before (while the nausea won't be as bad, I would suffer from new side effects like neuropathy - I'd lose some feeling in my fingers, hands, and feet), I have no desire to repeat them. And, as I said before, I think I am still dealing with fatigue from the first time around - why would I want to add to it?

Well, I'm going to sign off. I had a busy day yesterday - not only was I in Portland all day, but yesterday evening, my department chair hosted a celebratory dinner for one of my colleagues, which was fun, but I didn't get home 'til almost 10pm, which is about an hour later than I usually get to bed! I'm tired - yawning as I type! Take care and thank you again to everyone who brought meals!

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