Weebles Wobble . . .

but they don't fall down.

!@#%*#$#!!!!!! I mean, what else can I say except TO HELL WITH CANCER!!! I just found out yesterday that the surgeons did not get all the cancer when they did the mastectomy. F#@k! I mean that, too.

About 2 1/2 weeks ago (Jan 14), I noticed that there was a red splotchy area under the right implant. (In retrospect, there may have been a red splotchy area over the implant, too, but because of the incision and how it was healing, with some discoloration and extra pigmentation, it was hard to tell.) I mentioned it to my plastic surgeon when I saw him later that morning and he said that he wasn't sure what it was but perhaps it might be my skin reacting to the corticosteroid ointment that I'd just started using to try to minimize scarring. He said to stop using it and see how my skin responded. On Jan 16, I had my MUGA scan (see the post "I'm a Medical Puzzle") and when Dr. Kenyon called me the following day to tell me the results (my ejection fraction was 41 or below normal), I mentioned the red splotchy area. I asked him how long it might take the skin to clear up if it's had a reaction to the ointment and his reply was to wait about two weeks. So, on Jan 28, when I had another appointment with the plastic surgeon, I showed him and again, he said he wasn't sure what it was. But since I had a consult with the radiation oncologist the next day, he said that he'd call her to give her the heads up. It seemed to be spreading. I saw the radiation onc the next day and she wasn't sure what it was. She brought in my oncologist, Dr. Kenyon, who wasn't sure what it was either, but for peace of mind, he said we'd do a skin biopsy. His assistant took a sample of the skin and yesterday, we got the results. It was cancer!

My fear was that it was inflammatory breast cancer. But it apparently has the same pathology as the cancer from the mastectomy, so the explanation is that there were some cancer cells left in the tissue since they can never take all of it away with surgery. Now it's in the skin and spreading through the lymph channels in the skin as if it were inflammatory breast cancer. So, now I know that cancer is still there. Kenyon consulted with his colleague, Dr. Livingston in Tucson, and the recommended treatment is chemo, radiation, maybe consider Herceptin while watching my heart fairly closely, and possibly Tykerb. He said that they would use some milder chemo drugs. I don't know yet about the timing of radiation: do we do it now and stop the expansion? Do radiation while I'm expanding? Wait until expansion is completed and then do radiation? I don't know, but I will talk to Kenyon later today to figure it all out. My bet that radiation is the first course of treatment, since we know it's there and it's still local and not spread anywhere else in my body. Radiation kills it locally. Chemo would attack it if it were elsewhere. And, it is noticeably getting a bit bigger - not by much, but I notice it. I think I might opt for radiation sooner rather than later. CRAP!

I'd been looking forward to jumping into my research and perhaps beginning a couple of new things, but this has put a crimp in all those plans. It's time to pull in again and just finish the projects I already have and not start anything new. I already notified NSF, who had just asked me to serve on a panel to review some proposals, and said that I would probably have to decline the panel review. I have another commitment at NSF that was to start in March and extend through June, and I think I might have to decline that, too, as I will either still be in the middle of treatment or just finishing and maybe tired or my immune system might be compromised and I won't want to travel. I thought about taking on the responsibility of mentoring a Ph.D. student, but I have decided against that and will wait for the following year, after these treatments are behind me.

S*&T!!! Like I told Scott and my family and friends, or like they told me, now we know the cancer is still there. It's time to pull out the full arsenal. I didn't want to do the treatments (chemo and radiation) "just in case" because the risks of long-term side effects seemed greater than the benefits (why treatment something that is probably not there?). So, now I know and that means there is a fight in store for the next 6 or more months. Goddammit!

My belief is that it hasn't spread elsewhere, still, so that is why radiation seems the first course for me. I will do chemo, too, and one of my friends, Tammy, has offered to hold the puke bucket for me after chemo. She said she may end up puking with me, too, but hey, she said, maybe this means she'll lose some weight!

Like I said in the title to this post, "weebles wobble but they don't fall down". I'm wobbling, but damn if I'm going to let this thing put me down!! I'm going to get some tequila and later today, I plan to have a toast with Scott and my friends and the toast is, "TO HELL WITH CANCER"! If and when you read this, think about me, and if you are one to drink, please do the same toast. Maybe if we all shout together, we can scare it off or at least let it know that it's in for the fight of its life! Goddamn crap, anyway.

A New Blog

Hi everyone!
So, blogging is new to me, but since I will need a quick and easy way to keep everyone "abreast" (thank you David McMurray!) of what's going on with me as I undergo my second round of treatments for breast cancer, I decided to create one at the suggestion of one of my friends, Andrew Valls.

Okay, for those of you who don't know, I was diagnosed on October 3, 2007, with a second and different cancer in the right breast. Five years ago, from August 2002 to March 2003, I underwent treatments for a 2.0 cm infiltrating lobular carcinoma. The treatments included a lumpectomy with sentinel node dissection, four treatments of adriamycin and cytoxan, and 6 1/2 weeks of radiation. Since the tumor was estrogen-positive, I started taking tamoxifen in April 2003 and just finished taking it on October 10.

This time around, I have a very small (2-3mm) infiltrating ductal carcinoma. I have decided to go with bilateral mastectomy (which decreases my overal risk of recurrence from 20% to 1-2%) followed by reconstruction. So far, I know that it is estrogen positive as well and since I'm premenopausal and tamoxifen (which tends to work with premenopausal women) did not work, I may have to either surgically or chemically induce menopause by taking out my ovaries or stopping them from working with monthly injections. But that's a decision to make later.

For reconstruction, I will go with implants, although I won't need to decide on saline or silione just yet. Even if I wanted to do a TRAM flap (i.e., use my own tummy tissue and muscle), I only have enough tummy tissue for one breast! So, I'd need an implant anyway. Implants have a shorter surgery time and a shorter recovery time. And, apparently, they will be able to use the nipple from the non-cancerous breast to help reconstruct the nipple on the right side. Ah, the things you don't know.

Two women at the support group last night were kind and generous enough to show me what mastectomy and reconstruction look like -thank you ladies! It's helping to demystify the whole process and what to expect.

We're waiting to see whether or not I need to do chemo. So far, the chest x-ray is normal and I am now waiting for the results of the PET scan.

Overall, I'm doing okay and am planning to have a "Boob Ball" on November 3, in order to say good-bye to the troublesome cancer appendages and also to celebrate life and laughter. My only requirement for guests is that they need to bring a boob joke, which I will put into a notebook that I can enjoy after surgery. Of course, there are times when I feel sad or lonely or tired or stressed out, but my friends and family and colleagues have been great - I just need to make a phone call and I feel a lot better! Scott (my boyfriend) and my family, especially, have been great. When Scott is able, he's here with me and has attended a couple of consultations with doctors. He's also helping me as I work through feelings and consider treatment options. Humor helps tremendously!

So, anyway, save the date! For those of you in town, the "Boob Ball" is November 3, probably around 6 or 7pm. And, remember your boob jokes!! : )
Dee (or Deanna or Dede)