Saturday, February 25, 2012

DO I NEED CHEMO?

In my quest for catharsis, I'm finally picking up where I left off (on the heels of my delayed healing issues). Here's what happened next on my breast cancer journey:

I'm sitting in the lobby of the cancer center, waiting to see Dr. D., my oncologist. I will soon learn four crucial pieces of information:

1) My BRCA test results
2) My Stage
3) My Oncotype Dx score
4) Whether or not I need chemo

Husband is with me. In a moment of tenderness, he asks if I am OK. "I can handle anything Dr. D. has to tell me." Husband is as surprised to hear me say this as I am! In the months since my diagnosis, I have researched, read, lived and breathed breast cancer. I’ve been in touch online with countless women with a similar diagnosis. And it's because of these women that I am able to sit in this waiting room and feel a solid wall of strength supporting me. These ladies have my back. I'm really not afraid. Which is a pretty darn good way to walk into an oncology appointment.

Dr. D. is a man of few words. He looks me straight in the eye and answers every one of my questions.

1) I am BRCA1 and BRCA2 negative. That means I do not carry the gene mutation responsible for some breast and ovarian cancers. Whew!

2) I am Stage 1B. Because my tumor was 3.2 centimeters, it pushed me from Stage 1A (where the size limit is 2 cm) to Stage 1B. Still, it's great news; I am over the moon! Waiting for that number affected me on such a deep level that I don't even think I was fully aware of it. I just know that in that moment, I feel relief for the first time since I was told I had clear lymph nodes.

3) My Oncotype score is 16. That means I have a 10% risk of distant recurrence — and puts me at the high end of the low-risk group. There are 3 risk groups: low, middle, and high. If my number fell anywhere in the high-risk group, I would be given chemo; if it fell anywhere in the middle group, chemo would definitely be weighed as an option; but because my number fell in the low-risk group (albeit the high end of the low-risk group), studies have shown that chemo may do more harm than good.
4) I don't need chemo. Given my age (52), low tumor grade (1), low cancer stage (1B), perimenopausal status, and bilateral mastectomy, Dr. D. says that statistically there is no benefit to giving me chemo.  WOW.

I had an intuitive feeling about this; I have felt all along that chemo would do my body irreparable harm. Hearing Dr. D. tell me I don’t need chemo is a huge, huge relief. (Not to mention that it validates my intuition.) Husband is visibly relieved.

5) I don't need radiation. Even though I had a double mastectomy, I might still have needed rads had my tumor been closer to the surface of my skin; but it thankfully was not. (Another major plus.)

This is all good news. So why don't I feel better?

Dr. D. hands me a prescription for Tamoxifen, a hormone blocker I'll be taking for five years before switching to a post-menopausal hormone blocker for another five. Then he adds, "See you in six months."

Say WHAT? Don’t I need to be monitored more often than every six months? How will I know if the Tamoxifen is working? Am I supposed to be checking myself? How do I do that? I don't understand! Wasn't I just diagnosed? I need more hand-holding. I'm not ready to let go just yet.

I leave Dr. D.’s office feeling completely untethered. And not in a good way.

It takes me a good long while to process and allow myself to fully feel the power of Dr. D.'s words. I have been suppressing so many fearful and negative emotions since my journey began that when I hear good news, my reaction is still one of denial. Crazy, isn't it?

12 comments:

  1. Hi Renn,

    Life is full of twists and turns. It is difficult to wrap our brains around it...especially when it comes to this crazy canzer-thingy. Take one day at a time. Wake up every morning and stretch your arms out to the world and say "Here I am! I'm a SURVIVOR!" And continue to be a blessing to someone every chance you get! ~Carol "Living in the Moment"

    ReplyDelete
  2. The emotions you are feeling are but normal. Stay positive and happy. Ive always believed it works wonders. I Wish my mom had these tests done. Then maybe she would have lived longer? Too late for that though....

    ReplyDelete
  3. Taking care of yourself is very important - mentally as well as physically. At the end bof active treatment the doctors say 'See you in six minths' and the patient says 'what? Where is my support?' You still need to focus on yourself emotionally - a therapist, support group, or whatever works.

    Congratulations on not having rads or chemo.

    ReplyDelete
  4. I get it, I really get it: all the news is good and every factor is going your way yet you feel freaked out instead of relieved & joyful. I guess it's because the cancer itself, while early-stage and relatively easy to treat, is still cancer, and the mere presence of it overrides all the aspects of it that go your way. Funny how that works.

    ReplyDelete
  5. @Carol: Yes, living in the moment is so key! Tks.

    @JoanneRK: I'm sorry about your Mom. I know I was fortunate to have had these tests; but we need more of them developed (the Oncotype test, for example, is only for early-stage breast cancer), and made available to everyone.

    @Caroline: Yes, the focus turns from the physical to the mental and emotional. Oh, the fun never ends!

    @Pink: For sure! And if cancer was "curable" we would not have to worry. But we all know cancer is a sneaky SOB.

    ReplyDelete
  6. PHEW....what fantastic news!! Jumping with joy for you dear!! As to that untethered feeling...totally makes sense...just allow yourself to FEEL whatever younare feeling....love and hugs to you...

    ReplyDelete
  7. Oh, I'm so glad you don't need chemo, that's fantastic. AND, I had the exact same feeling of having the rug pulled out from under me when my oncologist told me that after a year and a half of "treating" my bc, they weren't going to do any more scans or tests, just quarterly updates and the Tamoxifen. It took me about 2 months to wrap my head around that. One caveat, I personally had a very odd reaction to the Tamoxifen my first month - I got really emotional and would cry at the drop of a hat. It settled in after about 6 weeks and now it's fine, but I didn't expect it, so figured I'd warn you. I'm so glad you don't need chemo or radiation, that is just wonderful to hear.

    ReplyDelete
  8. Hi Renn, I'm glad you wrote this post. I'm happy your results were so positive. Mine were very similar to yours and since I opted for the bilateral and didn't have radiation or chemo either, I know exactly how you feel. Happy it's not worse, but kind of left out to dry. I don't feel any less worried about recurrence as someone with a more advanced stage. I wish I could, but I guess it's knowing the nature of the beast. I've had little side effects from Tamoxifen, hopefully, you won't have any. Knowing there's someone else going around without chemo or radiation makes me feel better in some way. Thanks for sharing, Renn.

    ReplyDelete
  9. i am so happy about your information
    and totally get your feelings
    xoxo
    :O)
    m

    ReplyDelete
  10. Renn,
    So we take all the good news we can and try to go with it, but it just isn't possible to stop looking over our shoulders is it? I did turn out to be brca2 positive and I did need chemo. Bottom line is, cancer is still cancer no matter what stage or treatment. Totally understand your feelings. And I also feel that wall of support from my sisters, too, at each and every appointment. It definitely helps. Thanks for sharing and for being part of my "wall."

    ReplyDelete
  11. @ HOLLY: Thanks! Hanging tight.

    @ CLAUDIA: I've had a few SEs from the Tamox but things have settled down now. Glad yours have too!

    @ STACEY: Yes, absolutely thrilled it's not worse, so many have it worse, but the feelings are all still the same. Didn't realize you were similarly diagnosed/treated. Thanks for sharing sistah!

    @ NANCY: You're right, there is no disguising The Big C. Thanks for being part of my "wall" too!

    ReplyDelete
  12. Absolutely you would feel that way. They give you the news pat you on the head send you home. I bet he didn't talk about potential side effects. What happens if you get them.
    Me, I would be calling if I needed answers, that's why we have specialists.....

    Take good care

    Love Alli xx

    ReplyDelete

Your comments are encouraging — and encouraged!