Surgery is Scheduled!

So my tumor is now operable! I met with the breast surgeon a couple days ago, and it seems like now instead of just being this spongy mass that takes up two thirds of my boob, it is now a removable, albeit still a large, mass! So I will have a left mastectomy to remove everything, and reconstruction much later down the road after chemo and radiation.

Strangely, my cancer case is very unusual. I am so young, it is such an aggressive cancer, and it is so advanced. Dr. Khanny Baby (how my family refers to all doctors, with a diminutive "y" and then "Baby" at the end) says, "I defy protocol," and he presented me at a Dallas area Tumor Board to get more opinions. Not quite sure what was said as I won't see him until next week, but my surgeon was there and I met with her later on in the day after the presentation of my case.

As you might remember, I had/have cancer up into my neck in my lymph nodes. Dr. Iyengar, my surgeon, explained that in the old cancer diagnostic, cancer in the lymph nodes at the number 5 position was considered Stage IV. That has been revamped recently, and cancer at the lymph nodes at position 7 is Stage IV. See this beautiful chart below:)

As I mentioned in my previous post, the number 7 is no longer palpable, but that doesn't mean that cancer cells still aren't in there. I can still feel the enlarged lymph node at position number 5.

Then this is what she said that got me: "Our goal with Stage IV cancer is to prolong life, not to cure you."

WTF? I was kind of pissed, but then I did some research and I found she is right(from cancer.org):

Stage IV cancers have spread beyond the breast and lymph nodes (lymph nodes under the arm) to other parts of the body. While surgery and/or radiation may be useful in some situations, they are very unlikely to cure these cancers, so systemic therapy is the main treatment. Radiation therapy and/or surgery may also be used in certain situations, such as to treat a small number of metastases in a certain area, to prevent bone fractures or blockage in the liver, or to provide relief of pain or other symptoms. If your doctor recommends such local treatments, it is important that you understand their goal -- whether it is to try to cure the cancer or to prevent or treat symptoms.

Later she mentioned that we were going to treat me as a Stage III cancer patient, which made me feel a little bit better. I think that because the metastasis is still lymphatic in nature, so they can do radiation on my neck and breast (although sometimes it causes 2nd and 3rd degree burns! Ouch!) after more systemic treatment of chemo (taxol) and hope that takes care of it.

However, this comment made me realize, and this is probably a good thing, was that I am going to be dealing with this my entire life. What a pain in the ass!

Okay, so for those who care, this is my treatment schedule!

March: Chemo
April: Surgery
May-August: Chemo
September: Radiation
Then TWO YEARS of Herceptin (blah!)

I have had two chemo sessions, and interestingly enough, my tumor hasn't shrunk much since my first one. However, my lymph node under my arm has gone from 2 cm to .5 cm. Yippie!

Now my question was, why did it work so well at first, and not now? And I got some interesting answers:

Tumors aren't composed of one kind of cell. It could be that all cancer cells of a certain characteristic shrunk, and the other cells are taking longer to respond, or will only respond to another kind of drug.

Or the chemo could be killing the cancer cells, but the tumor doesn't shrink, it is just stuck there as a massive lump of dead cells.

The chemo can affect the tumor in different ways, killing the tumor like peeling layers off an onion, or it can also bore holes into it like Swiss cheese. The tumor looks like it isn't shrinking, but its mass is decreasing and it is become very "holey."

They won't know ANY of this until they remove it during surgery and the pathologist can take a look at it.

Sorry if this blog wasn't as entertaining, but there was a lot to digest this week. My WBC count sucks and won't get above 1.2, so I am stuck inside, watching TV this week.

However, I was blessed with a two-hour special of 24, three nights of American idol, and a great episode of Lost where Sawyer was on 80% of the time. Someone up there loves me :)

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