So after my visit yesterday I've decided to do all of my treatment at Rush University Medical Center for a number of reasons. Although I love my surgeon in Barrington, Rush definitely has more to offer in terms of all my doctors ( surgeon, oncologist, and radiation oncologist) all work together and we meet as a big team. Having all of my doctors in constant communication and working together lifts a huge weight of worry. Also my new surgeon worked with my Barrington surgeon for many years which also made me feel at ease because they both are wonderful!
During my fertility treatments I met a woman who also went to this same team for the same surgery and absolutely loved them, which is a priceless reassurance that I could not be happier to have. Also after meeting with them.. quite a few things changed. Instead of getting my surgery first I'm actually going to be starting chemo next week. Why?
Because depending on when my cancer actually came to be compared to when I felt it is an unknown window of time. With breast cancer the biggest threat on your life is if it spreads outside of the breasts, because the breasts can be removed to eliminate the cancer. Bones, Lungs, and your Heart cannot. Even though I'm Stage 1 and found my cancer early it is also a Grade 3. The stage represents the development of the disease.. where it has gone how big it is etc. The grade represents the speed and aggressiveness at which the cells are reproducing and growing.. Grade 3 is the most aggressive. Which is why 3 tumors that were non existent grew to visibility and pain in only 4 weeks.
Some women who have a slower grade tumor may have these additional "multifocal" areas of their cancer but because almost no one does an MRI after a lumpectomy they go unseen. Chemo and Radiation for the most part eliminate those alternative areas.. but with Lumpectomy there is always a chance of them coming back. Often when you hear of women who have gone through Chemo and Radiation.. and 10 years later have a relapse it is most likely because those additional areas were unknown and still half alive after treatment.
I consider myself incredibly lucky to have had that MRI and found these new tumors because the thought of chemo and surgery all over again later in life is something I'd rather be without. Which is why although only one of my breasts has cancer I'm electing to do both. This is called a prophylactic mastectomy, which means I'm doing both to eliminate the chance of it coming back in either side. It also makes reconstruction look better because they can both look as good as technology can make them these days ;)
This also means no more mammograms or MRI's for me after surgery! :D which I'm thrilled about.. because it means no more biopsies (which are worse then surgery) or worrying that it has come back. Christina Applegate elected to do this same surgery because she had one of the genetic mutations they now can test for. Although I am negative for the BRCA 1&2 and P53 because of how my cancer is behaving and my age I'm not taking any chances. Relapse % is usually estimated based on 10 years.. and in 10 years I'll only be 33. Which is why treating young women with this disease is incredibly different then older women who already have a family.. or are in their 80's.
So why Chemo first in my case? Because my cancer could have been here for a year unknown to me my doctors want to protect me from my biggest threat.. Chemo acts by killing any rapidly developing cells.. cancer (especially grade 3) is very rapidly developing. Therefore any cells that MAY (we have no evidence that this has happened) have escaped out of my breast into my body somewhere else will be killed and eliminated. This is like an insurance policy if you will :) Unfortunately other rapidly developing cells are in your:
-hair
-nails
-skin
-mouth
-g.i. tract
Which is why chemo makes you look and feel sick, although they have great advances in medicine so it looks nothing like "my sisters keeper" Very few people are barfing or even nauseous and mostly you just feel tired for a few days after!
Then after 8 treatments 4AC/4T in february right in time for Valentines Day <3 I'll be ready to get my surgery and take out the "danger boobs" and a friend of mine facing this same disease cleverly termed them. This is also good because I'll recover from surgery faster, and my hair will be coming back with my new boobs! :D
Radiation will come as soon as I heal up from surgery which poses some issues of its own.. basically its like a super strength tanning bed but you don't get tan.. and it can actually kill your skin resulting in further surgery. This will be every day for 6 weeks, and even thought they are removing all the tissue radiation will target my chest wall and be an even further insurance policy to kill off anything that could possibly be left behind. Fortunately Radiation does not make your hair fall out and the only real side effects are fatigue and severe sunburn, and unfortunately the effects it can have on your skin-but because I'm really young I'm hoping this will be minimal.
I'll be going either tomorrow or monday for Bone and CT scans.. and had an Eco-cardiogram last Tuesday. These are just to get images of everything to have a baseline before chemo. Since Chemo (especially AC) can effect your heart greatly they will monitor me for signs of damage throughout treatment. Also because I'm young the chances of this are very small but it's standard protocol. Also I'll have either a Port or a Power Picc implanted in me to help with infustions ( so im not being stuck with needles 24/7 ) It stays in for the course of treatment then is removed. It can also be used for scans when they need to inject contrast, or even draw blood!
ON THE FUNNY SIDE!
At hosptials like Rush, Northwester, and UofC they have either residents, fellows, or medical students who follow the doctors and are learning. I had the sweetest medical student with my doctors at Rush yesterday and she said something that I found hilarious. "She defies all of the Board questions" aka everything they're learning about breast cancer.. I defy. Just to give you an idea here are some of the aspects of my disease that don't make sense, and I'll probably never have answers:
- age
- no family history
- extreme pain
- unable to physically feel lump
- no genetic mutations
- 3 new tumors after extremely successful lumpectomy
- not a smoker
- not a heavy drinker or alcoholic
- not obese
- raised on organic/ free ranged diet
- barely eat meat or dairy
And that's just the beginning of how there's no explanation for this disease happening to me, which is why I caution every woman who reads this breast cancer is changing in our world, it does happen you YOUNG women and 1 in 8 women will get breast cancer. Think about this next time you're on a bus or a train do the math.. and know that this disease does not discriminate against age. YOU ARE your best advocate. Many of women get turned away by their doctors later to discover their disease further down the line. October is not just about awareness it's about education that can lead to saving lives. Daughters, Mothers, Grandmothers, Friends, Nieces, and even Men are getting breast cancer every day.
My best personal advice: If you feel something, say something. and NEVER take no for an answer.. cancer DOES HURT mine does, and I've met many others who have said the same.
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