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?
My datebook tells me I have a lot to do today before I head to Las Vegas tonight. I wish I could say I am taking a trip to take my mind off my upcoming surgery (while that is a side benefit, it's not the real reason I am going). Instead, I am accompanying two BFFs and one BFF daughter, the latter of which is competing in an athletic event in Vegas. And a road trip sounds soooo good right about now.
First things first, though. I pick up my car, which has been in the shop due to a broken automatic-window-control thingy. Then I stop by the dentist to cement a crown and get my teeth cleaned. For some unknown reason, I decide to tell the hygenist I have breast cancer and of course I start to cry. (And no, I really didn't see that one coming!)
Next up: my pre-op appointment with my internist, Dr. S., in preparation for my January 19th lumpectomy. But he is not in today. Instead, I see a doctor I've never seen before. She greets me in 3-inch heels and carries a folder with the pathology report from my biopsy in her hands. She glances down at it and says (quite casually), "So, you'll be having chemo then?"
Me: "WHAT?"
Daffy Doc continues: "I see you are estrogen negative."
Me: "No, I'm not! I'm estrogen and progesterone positive — I'm HER2 negative!"
DD: "Oh, I must have read that wrong." Pause.
DD (again): "I see your BRCA test is negative."
Me: "WHAT? That can't be back yet. It's too soon. Are you sure?"
DD: "Well, that's what Dr. S. typed it in here. Why would he type it in if it wasn't in?"
Now my blood pressure is on the rise. She asks me a few real questions (not inane assumptive statements) and then a nurse comes in to draw my blood and run an EKG. I'm handed a referral for a chest Xray (which I have to get at another location on the other side of town). On my way out, I ask the nurse at the front desk for a copy of my BRCA results. Guess what? They can't find them. The nurse that drew my blood pipes in: "I haven't seen any BRCA test results come in yet." Really? How surprising.
I wish medical professionals would be a tad more sensitive; these tests, these stats, are a VERY big deal. And when my info is treated nonchalantly like this, it makes me feel whittled down to a bare nub of a patient — just a number on a chart that can easily be misread. Not on my watch. This is MY life we're talking about!
I look at my cell phone and realize I have barely enough time to get the chest Xray and then get home to make dinner before my BFFs arrive. We have a quick bite, hop in the car and steer it towards the freeway. We laugh, we joke, we sing, we break a tail light. BFFs are great!
We roll into Vegas exhausted, and plop down onto our big, comfy pillow-top beds. Oh yeah, this is exactly what I need.
