Not the news I was expecting to hear
First, I'll catch you up on everything that has been going on since my last post.
On 9/5/18 I met with my plastic surgery team for a post-op appointment. As I had not removed the bandages from surgery, this was the first time I got a glimpse of my new breasts. It wasn't as shocking as I expected. They are basically the same size as my previous breasts, just much firmer, with large scars across the center, and no nipples. The drains stayed in because the output was still too high to have them removed. The team says they will continue to change in shape/size/feeling over the next couple of months, so not to worry if they don't look perfect yet. The only thing I was a bit disappointed about, was the large indent under my left arm where they took out the lymph nodes and surrounding tissue. Hoping that will diminish over time, or maybe I will just get used to it.
On 9/5/18 I also received a call from the breast health center with my official pathology results from surgery. I was informed only 2 lymph nodes were removed during surgery, yay!, and both were negative for cancer. I also learned that the tumor shrunk down to about 2.5cm, and the proportion of cancer within the tumor diminished from 90% (taken during the initial biopsy) to 15% at the time of surgery. My pathological stage after surgery was T2 N1 mi, which means the tumor was greater than 2cm but less than 5cm, and one lymph node was positive for cancer during a biopsy prior to chemotherapy and surgery, and mi stands for microscopic evidence of metastasis to the lymph nodes- which my oncologist later said means the same thing as M0, or no distant metastasis present at time of surgery. Basically a stage 2 after chemotherapy.
On 9/6/18 I met with my general surgeon for a post-op appointment. He provided a copy of my official pathology report and reviewed it with us briefly. He looked at everything and said I graduated from his care at this point. Andy and I thanked him for getting all the cancer out of me. He shook our hands with his large, strong, capable surgeon hands.
9/6-9/9: Rested, spent time with friends and family. Spent time trying to get used to my new normal.
9/10/18: My drain outputs were finally low enough to get the drain tubes removed. Made a same day appointment and got them yanked out, literally. I will just say that it was a very weird sensation and the tubes inside me were much longer than I anticipated. Felt great to have them out and be free to move about without worrying about catching them on something, or waking up because they were aching or itching in the middle of the night! My parents were still in town and it was really nice to spend some quality time with them.
Now for the news I was not expecting. On 9/12/18, my parents, Andy, and I arrived to my oncology follow up appointment with the knowledge that we would be discussing next steps in the treatment process following surgery. We met with my oncologist's fellow first, and talked a bit about my pathology report and my expectations for treatment moving forward. I rattled off what I understood about my final pathology, and the thought that I would likely receive radiation and move on with my life. Then came the word I never wanted to hear uttered from a doctors mouth EVER again...Chemo. I can't even remember exactly what she said because I was so shocked, but it was something like, because there was still evidence of cancer during surgery, our recommendation would be for you to undergo more chemotherapy. Once that sunk in and my oncologist came into the room, we were able to ask questions and learned that due to my age, the aggressiveness of my cancer, and my current odds of cure at this point, it is a newer standard of care to offer chemotherapy post surgery. This is to make sure there are no cancer cells left in my body and to increase my chances of living a long life. A large clinical study was published in 2015 showing statistically significant improvement on overall survival, and it has been a standard of care ever since.
I held back tears during the appointment because I wanted to make sure I understood what was being said and have the opportunity to ask the questions that were swimming through my head. I broke down when I was waiting to make my follow up appointment to have labs drawn and to potentially start chemo, again. I received information on the chemo drug (Xeloda) and the clinical trial that proved that Xeloda after surgery prolongs life in patients with pathology similar to mine. I have not reviewed this information in-depth yet, I want to let the shock subside first. Obviously, it is my choice whether or not to have chemo again, but it seems stupid not to follow the evidence that this could improve my odds significantly and make sure that Andy and I get the chance to grow old together. If there is one thing cancer has taught me, it is that I really want to live!
I am trying to focus on the present and not look too far into the future, because there is a long road in front of me again. One that has not been traveled and is quite daunting since I thought I was nearing the end. I am looking at another 6 to 8 rounds of chemotherapy, followed by radiation, followed by long-term hormone therapy. Despite all of this, I am trying to stay positive, and am leaning on my friends and family to help me through. Doesn't mean I am not pissed and scared shitless, just that I am opting to look at the glass as half full, instead of half empty, as my oncologist would say.
I will keep you all posted as things move along. This was one post I was dreading and it feels good to get it off my chest. Thanks for listening.