Good News and Bad News (but mostly good!)

I had my first appointment with my oncologist on Friday. I liked her very much and she made me feel very comfortable. She went through my pathology report in detail with me so I understood exactly what my prognosis is.

In my particular case, there is good news and bad news, but mostly good. My cancer is considered Stage II purely because of the size of the tumor. Had it been smaller, I would have been classified as Stage I because I do not have any evidence of cancer in my lymph nodes or anywhere else in my body. She said mine is the best reason to be classified as Stage II.

I am also positive for Estrogen and Progesterone receptors. This essentially means that estrogen and progesterone in my body are captured by the cancer cells as they go by and cause the cancer cells to grow. Though it sounds like a bad thing because I am a pre-menopausal female and am still producing estrogen, it is actually a good thing because that means there is a relatively easy way to stop it. Just block the estrogen and progesterone from being able to attach to any cancer cells and half the problem is solved.

My cancer is classified as aggressive. On a scale of 1-9, 9 being most aggressive, I am classified as 9. While this is obviously discouraging to hear, the good news is that aggressive cancers are the ones that are most effectively treated with chemotherapy. By design, chemotherapy kills the quickly dividing cells. If I had a less aggressive type of cancer, it is possible that the chemo would not be as effective. If I have to go through it-it better be worth it in my opinion!

She has set my treatment up as 4 rounds of chemo once every three weeks with a regimen of two different types of drugs. While I would REALLY rather not do chemo, I knew that I was going to have 4-6 rounds with 2-3 drugs, so 4 rounds with 2 drugs is about the best I could hope for.

More bad news---I will definitely be losing my hair and pretty quickly. I will lose my hair 2-3 weeks after my first round of chemo. While I can't spin this into good news, I can say that she has told me that with my particular regime, I should likely not be horribly nauseous. She said that the day of treatment will take about 5 hours and I should feel fine. I should also feel OK the next day and by the end of the third day will begin to feel pretty crappy-achy and tired as if I have the flu. This will last for about a week and then I will be back on my feet, though tired until the next round. She has promised that she will pump me so full of anti-nausea drugs that I should be OK. I am really hopeful that she is right about this one.

She also said that the chemo will send me into menopause. So while feeling achy and tired and generally crappy and losing my hair, I can also look forward to hot flashes, moodiness and night sweats. My doctor was thrilled with this actually and told me that in my case, going into menopause is just as beneficial as going through chemo. I told her she could just yank my uterus and ovaries out if she would like and I will just forego chemo, but oddly she didn't agree with that plan. Although at a later date, it might be an option.

The last part that was relatively unsettling was that in looking at my history, she wants me to take part in some genetic testing. My dad passed away from pancreatic cancer when he was just 48 years old. Though I have always heard that pancreatic cancer is not necessarily hereditary, she told me that it actually can be related to breast cancer and ovarian cancer, especially suspicious given how young he was at the time of diagnosis. I will be talking to a genetic counselor and doing some tests to determine if I carry the breast cancer gene. What I am more worried about is not so much if I have it because clearly I have breast cancer so it doesn't really matter, but whether my sister has it, my daughters have it, my nieces have it. In the case of my children, my husband's sister had breast cancer at 43 as well so my kids may be getting a double whammy for risk. This frightens me more than anything else so far.

So that is my news. Some good, some bad, but all things considered, I still have a very good prognosis. After surgery, chemo, radiation and hormone therapy I should have a 90% chance of survival. That is about the same chances I had before I had cancer so that is pretty good!