Thursday, June 19, 2014

We Have a Plan of Action

Sorry that the poll did not work well yesterday, but I'm glad I didn't order an entire roll of these stickers.

When Larry and I left Dr. N's office today we did not have a plan.  Instead we had more indecision from the Tumor Board.  They were still on the fence and because they met at Olive Garden this week the janitor didn't bother to attend (he's gluten free) and therefore there was no deciding vote.  Just kidding about the attendance of the janitor.  The Tumor Board really was still on the fence,said it was 'patient choice' and they meet via web conference call.

Based on that indecision Dr. N had called two additional docs and was considering taking my case to the city-wide tumor board.  We left with the plan that he would hear back from these last two docs and call me and let me know their opinion.

The indecision by the numbers:
Out of 100 women with same size tumor, no node activity, estrogen receptor positive, histologic grade 2, only further radiation treatment:

  • 80% are alive and without cancer in 10 years
  • 17% relapse
  • 3% die of other causes

If you look only at the 17% who relapse if they went through additional treatments:

  • Hormone therapy alone (forced menopause to get rid of the estrogen source feeding any microscopic cancer cells floating around) helped 7 more women
  • Chemo alone helped 10 more women
  • Combined helped 13 more women
That 7 to 13% benefit is a 50% improvement on eliminating the relapse.  Yes, it's a percent of a percent, but that very circumstance made me laugh.  Tim B, if you were reading I know you would be laughing too.  

But really that 50% improvement of chances was already swaying me to a decision.  I mean what self respecting over-achiever would ever want to score in the 80's when they could go the extra mile and get an "A".

We left, still in undecided mode, but stopped downstairs to talk amongst ourselves when Dr. N called back and we went back upstairs to hear what he had learned in the subsequent 10 minutes.  A doc had reviewed my case and because of two factors she recommended chemo.

  1. The tumor was multi-focal (the seeds of the strawberry).
  2. There was lympho-vascular involvement in the tumor.

Neither of those two factors were considered in the numbers above, which are riskier.  So we have a decision.  I feel fine about it.  I just want to get started so I can get finished.

Next Steps:

  • Next week I will need to go to 'Chemo Training'.  I have no idea what that might entail.  
  • I also need to get a copy of my heart echo tests, he wanted to order new ones, and I quickly stopped him and said wait I just had that done less than two months ago.  
  • I will also need to get the port-a-cath installed.  I suppose that's better than a port-a-potty.  

The chemo plan will be 4 total treatments at the lowest dose.  Have a treatment, wait three weeks, have another treatment, wait three weeks, etc. until four treatments are completed.

J was instantly wondering if I would lose my hair, doc says yes.  Oh man, you're going to look weird.  :)

THEN, start radiation.  Only one torture at a time. No further details about that yet.

Answered Prayers:

  • I am so thankful that there is so much data available for a person like me to use for analysis
  • That so many have been praying for me
  • That treatment options are available
  • I feel great physically and emotionally
  • That the genetic tests showed that nothing cancer related (that they tested for) passed down to C, S, J, c and e
  • We have a plan of action

Prayer Requests:

  • God would be glorified
  • I would be cancer free
  • Appointments next week would be easily coordinated
  • That I wouldn't feel too sickly when treatments start
I'm gettin my boots on.  

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