This was my facebook post before the team appointment two days ago. I walked in there raring to go, dressed up Kate-nice to go to an Ethiopian restaurant for dinner in Boston once we were done, so we could celebrate having all the puzzle pieces in place and being able to plan the next couple of months of radiation, recovery, and return home.
All signs before this appointment had pointed toward me being able to avoid any really intensive treatments, and I felt a little guilty because whereas some women in the breast cancer facebook group I’m in are suffering through years and years of treatments and horribly painful physical effects, here I was, dodging the bullet with this cute little cancer they were able to just cut out & zap, and that I was going to avoid all the really bad stuff.
The way I imagined this going was me, in there for about an hour while we sat around a conference table with all the docs on the team, talking about my situation, getting the details and making a plan so I can go home and get my life together for the radiation treatment in Boston this spring. I was thinking I could be back home & done as early as June if I wanted. We’d have a great meeting, shake each other’s hands, and remark on how lucky I was to have caught it so early, then Mom & I would go meet Jill Blues in Boston for dinner.
Long story, short: we never went to Ethiopian.
The radiation oncologist was the first one in the room. He checked out the surgery scars and said they were healing well, then was talking about the radiation treatment. I said something about how I was planning to go home first and it would likely be mid-April and he gave me a look and said “Oh, well if you don’t do the chemo, you’ll at least have to heal from the second surgery….”
“Um, what?”
He realized that the surgeon hadn’t made it in there yet and basically drew me a picture of what pathology had found, which included margins that, under the microscope, they discovered weren’t clear on two sides. The tumor was now 1.5cm (it was 1.2 a month ago) and it was showing signs of reaching down lymph & blood vessels and invading more of the surrounding ducts.
So kindof like this:
He mentioned that because they found cells spreading from the tumor at the edges of the sample they removed, that in my file, the surgeon indicated she wanted to go in and take more tissue to be sure they got everything.
The poor radiation oncologist, who is pretty much in charge of the last treatment stage of all of this, which is the ray-gun zapping of my boob once it’s good & ready, had assumed that I’d spoken with the other members of the team already, and was a bit freaked to learn that he was the first person telling me this info. And I get it. I wouldn’t want to be that person either.
He left and the next people came through to measure my arm for lymph edema, or to talk to me about some other forms or something, and then the social worker came in. She told me that there were myriad options for non-medical support at MGH Cancer Center and that she would be able to help me. I asked her about getting housing at the Hope Lodge for the daily radiation treatments and she gave me someone’s card. I asked her who would be the person to talk with about anxiety and panic attacks and insomnia, etc and she said it was her, and that it was normal. So at least I know it’s normal to be losing my mind. She said that when they’re doing radiation and chemo that she can come to me and have a therapy session while the treatments are going on, and see about a weekly massage or acupuncture they can add to the treatments for no extra cost.
My antennae went up at the word “chemo” but I figured she didn’t know what my medical profile looked like so she was covering all bases, because of course I didn’t need chemo.
The surgical oncologist came in and checked out the incisions that are healing pretty beautifully.
Let me pause for a moment here to say I just love this woman and trust her with every ounce of my being. She’s first and foremost an obvious genius-level scientist, surgeon, and top-of-the-line specialist, but she’s also a kind, gentle soul with an amazing bedside manner. She dresses smartly all the time and treats me with nothing but compassion and respect, which is something I’d learned not to expect in New Orleans healthcare. Also someone in the Cancer Center told me some people call her “the Seamstress” because she’s been sewing her whole life so her technique is beautiful and exacting, and because she uses delicate surgery techniques that leave the smallest scars possible. Love it.
So she came in and looked at everything and then told me the same thing that the first doctor had, and said I’d be going back into surgery for them to take more tissue around the site, and would Tuesday work. So I’m having more surgery on Tuesday.
“STOP LOOKING AT MY BEWB”
We finished up and the medical oncologist came in. It was my first time meeting him and that that point I’d been sitting in a gown on that table getting increasingly horrible news for about 4 hours, so I couldn’t even tell you his name right now. But he sat down and started to go over everything. He told me all the stats and stages and numbers that I’ve been dying to know since this whole thing started, and I was in such a daze I remember about 20% of it. I took some notes, though.
I asked what stage the cancer was and he explained that although the stage is something that a lot of people count on to see how how they’re doing, it’s more a measure of tumor size at this point and there are many other factors to consider. I’m going to list those all here as best I can and link each one to a page explaining it, in case you want any more info. Here’s how he ran down my case:
HER2: 2+, waiting for a FISH test.
N0/M0 mean they don’t haven’t found cells in the lymph nodes or anywhere else in the body.
ER + & PR + means that estrogen & progesterone feed the cancer. . Mine is highly estrogen receptive, so yay.
Re: the HER2 thing, he said the previous information I’d been given about the tumor being HER2- wasn’t 100% correct and that they had found it to be a 2+ on a 0-3 scale, meaning they had to send it out for another test.
This is my summary of his summary of the big picture:
My cancer is an angry little f*cker. I caught it early and I’m lucky as all get-out that I did, because it’s growing like a weed from all my womanly estrogen. They found more cancer in there than they thought when they cut it out & sent it to the lab, and although most Stage 1 peeps don’t have to have chemo (and although they’d told me before that I’d likely avoid it), I can’t. The thing was too active and was reaching out too far.
He said it was N0 M0 because they didn’t see cells in the nodes, but nobody on the team was comfortable resting on that because of how it was already reaching out, trying like hell to get to spread. Basically if it hadn’t sent some cells off around the body already, it was just friggin’ about to.
You read that right. F*cking chemo.
So yeah. I went from a simple lumpectomy and 4-6 weeks of radiation to two surgeries, 4+ months of chemo, a month off, then 6+ weeks of intensive daily radiation, then 5 years of hormone therapy.
Needless to say my bubble was burst. We wrapped up, which I don’t really remember. I got a script for my anxiety, thank God, had some blood drawn, and walked out to the sun setting and gentle snow falling over the Boston cityscape view from the 9th floor Cancer Center walkway.
We called Jill and all agreed that a night out in Boston wasn’t in the cards. Jill found a little Indian place near where we were staying and we had dinner there and processed a little bit. Jill Blues is an wonderful counsellor and a good friend, and with her and my mom, I was in good company to function on as low a level as I needed that night. The snow was falling lovely and heavy, the size of corn flakes. It was a surreal yet beautiful moment, where I was realizing it would be harder but I could do it. I have the best friends and family, really. If they’re on my side, of course I can.
That morning I thought I was getting by relatively easy, but alas there would be no Thug-Life Gazelle escape for me.
Oh what the hell, everyone needs a little Thug Life Gazelle.
That’s all I got for now. Fingers crossed for Tuesday, I guess.
Life in Kate-Land 
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