The past week has been doctor-free, which has been both nerve-wracking and also a relief. It's strange how quickly the switch from constantly seeing doctors to not seeing doctors made me feel like everything was fine - like the cancer episode had been little more than a bad dream, an extended mix-up of medical records, someone else's life into which I'd trespassed. I don't feel sick, therefore I must not be sick. I have been reading and going to class, made a quick trip to a little lake with a couple of my favorite people and while our brief trip was riddled with disaster, the charming toddler in tow made it worthwhile as she bravely wandered into the water, sat down and beckoned minnows to her pink pail with outstretched hands, and kindly set to work filling a hole in the sand as its architect patiently continued digging. I find myself forgetting on occasion that anything is wrong.
As it turns out, I need those appointments with doctors to keep me grounded in reality. This is indeed my life. It's funny the things that make me feel celebrating these days. Tiny shreds of what would otherwise not be great news send me in search of champagne. What's that you say Dr. Christianson? I'm a little less likely to have to go through this again? Hallefuckingluiah! When is the party?
I heard from the genetic counselor today, which whipped me back into this cancerous reality with good news; I do not have a genetic predisposition (at least not one of the three identified mutations that testing can identify) for breast cancer which means a few things:
1. I can pretty much stop worrying about having ovarian cancer later in life and having my ovaries removed (cancers of the breast and ovary are genetically linked).
2. I am leaning more toward lumpectomy than prophylactic double mastectomy.
3. My risk of recurrence is lower than it would be if I had an inherited genetic mutation. This is a confusing explanation because I have a cellular mutation - that's how the cancer happened in the first place - but it is not inherited, so it isn't built into my genetic make up. I keep meaning to make a "logistics of cancer" post but I haven't gotten around to it yet. Maybe this weekend.
4. I don't know how this works out mathematically for me since I do not have the mutations the geneticists were looking for, but I do know that unfortunate women who do have them are three times more likely to have recurrence. This is a sad yardstick by which to measure my good news. I'm not doing it to be cruel, it's just that this number is available and I cannot find a comparable probability for my own rate of recurrence.
What next? The mysterious third anomaly from the mri scans... When I had the mri, the images showed three spots the radiologist wanted to biopsy, which they most often do using an ultrasound machine to guide the needle to the area in question. For whatever reason at my last biopsies, they were unable to find said mysterious third location with the ultrasound machine. The doctor took samples of the two spots she could find and offered me two options regarding the third: 1. Before surgery, have an mri, the images from which will be used to guide a wire that gets inserted into the breast and ends at the location of the mystery tissue. The surgeon will follow the wire, remove some tissue, then have it tested to see if it was cancerous. The surgeon would, as I understand it, make her best judgement about how much tissue to remove. 2. Have an mri-guided needle biopsy wherein I lay in the mri machine, have images made, and a doctor in the room uses the images to map out where the biopsy needle should go. This is not guaranteed to actually get a sample of the tissue in question.
I picked option 2. I'd rather not have more tissue removed than is necessary (if I'm considering breast conservation, I don't have much to sacrifice), and either way I'm going to have an mri and have something stuck into my breast, and I'd rather that process serve a very focused surgery than one that involved guesswork or exploration.
Now, I go back to waiting. Waiting to hear from U of M about going in for a second opinion and more guidance on our fertility options. Waiting to hear from the surgeon about writing me a referral for the biopsy of the mysterious third anomaly that showed up in the MRI. Waiting to meet again with the oncologist to discuss treatment options. A week ago I felt overwhelmed thinking about surgery, treatment, etc. and now I am tiring of the waiting. I am ready to hit the operating table.
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