July 25: Cancer Report

After 6 hours at the Seattle Cancer Care Alliance today, here's what I know:

1. My MRI was boring. This is excellent. By "boring" I mean that nothing unexpected was found. The tumor size is 2.0 cm at its widest. It's only 2 mm from my skin, but not "involved" in the skin, which is good.

2. My biopsy (the one that really hurt) was worth it. They ran a bunch more tests than I thought they would. My "prognostics" are:

.....very strong findings for estrogen and progesterone receptors. These are the garden variety, super-well-understood markers for tumor cells that respond to super-well-figured-out chemo, like Tamoxifen.

.....no HER2/neu found. This is a truly nasty bugger to have; I'm delighted to not have it. They will do more tests to be more sure later.

.....15% Ki-67. The presence of Ki-67 means the tumor is growing. When they read this again after surgery, the comparison of the two numbers will help determine what chemo I get.

3. My surgeon is from South Africa and I totally dig him. He gave me every shred of info I wanted. Lumpectomy should be scheduled within a month. The details on this, and on the way he'll pick a lymph node to pull out, are fascinating. Best case: done in one day, one lymph node comes out with the tumor, 2-3 days recovery. Worst case: bunches of lymph nodes have to come out, overnight stay, I'll wear a drain in the incision, and much systemic badness follows.

4. My medical oncologist is a woman older than me and I totally dig her too. After surgery, she'll run the diagnostics to figure out what, if any, chemo I need. There's no real way to predict what kind or how long, and she said not to assume that I'd lose my hair or start menopause. Best case: no chemo. Worst case: up to a year on cell-killing, baldifying, nasty stuff with a port in my chest, and THEN I'd start radiation while I have hot flashes.

5. Radiation! Not sure how I had myself convinced that this wasn't part of the story. When they do a lumpectomy instead of a mastectomy, after chemo, they do radiation to clean up any cookie crumbs still lying around. Radiation is a for sure, then, and it's a 15 minute deal every day for some 6-8 weeks. After chemo, if any.

So, big day at the SCCA. Kinda serious, kinda fun, and now back to waiting for the next thing to happen. Surgery. Sometime in August.