Not What We Wanted To Hear

We had an appointment this morning with the Radiation Oncologist.  Ed and I were there to review the pathology report from surgery and to hear from the doctor, “You do not need radiation.”  Instead we heard, “You are in a grey area and I recommend you have radiation.”  Seriously?  Is this really happening?  Funny though because Ed and I both had this weird feeling that something like that would happen.  And it did.

So how do I explain this?  Back to the pathology report:  I did have clean margins and no lymph node activity, which is all great news.  It’s still great news, however, we were reminded today that the breast surgeon still removed a 2.5 cm tumor.  And the tumor was large (4.0 cm) when it was originally discovered.  Had chemo killed the tumor completely (i.e. a complete response to chemo/no tumor remaining at surgery), we would have walked out of there this morning with the report we wanted.  But because there was still some “residual” tumor left at surgery we have a different situation.  The big question is “is there a possibility that there are any microscopic cancer cells left in my right breast where the tumor was located?”  The answer is, “Who the heck knows!”  But if the answer is yes, radiation is a targeted treatment that will kill them and further decrease my chances of local recurrence in the right breast.  While I had a bi-lateral mastectomy and in theory have no breast tissue left, she described it like carving a cantaloupe.  The surgeon carved all the way down to the skin – but could any cancer cells have remained?  Other thoughts:  I am young so they lean towards being more aggressive.  The pros tend to out way the cons in my situation.  It feels a lot like an insurance policy – let’s do it just in case there are any remaining cancer cells.

She referenced a number of related medical articles and made copies for us to review.  She referenced statistics and studies but reminded us it’s tough in this world to truly compare apples to apples.  Boy have we learned that.  She is planning to share my story and pathology report with her peers in the office.  There are roughly 12 Radiation Oncologists in this practice.  They meet every Wednesday to talk about patients like me i.e. in this grey area.  It’s sort of like getting 12 opinions.  She is also going to contact a physician at MD Anderson in TX.  We discussed an article he wrote in 2009.  Oncologists and Radiation Oncologists everywhere rely on the expertise, the research, the protocols of those at MD Anderson.  Sounds great to me – I am all about getting as much feedback and opinions as we can – especially from a well respected institution.

So now we wait for the additional feedback.  I expect to hear back from her mid-to-end of next week.  I don’t know exactly what we will hear, but based on what we know, I would expect I will be undergoing radiation.  I’ve come too far now to not do everything I can to (1) rid myself of cancer, (2) decrease my risk of recurrence, and (3) to increase my lifespan.

If (or when) I end up doing radiation, it is 28 treatments, 5 1/2 weeks, Monday through Friday, at the same time every day.  Not exactly something I want to add t my schedule – but will do what I need to do.  It’s supposedly a very quick appointment – 15 minutes in and out – plus of course driving time.  I would expect we would be ready to start early-to-mid November.  There will be some “prep-work” involved with the Radiation Oncologist and all my “expansions” have to be done with the plastic surgeon prior to radiation starting.  Radiation will also postpone my outpatient surgery where we remove the expanders and replace them with the implants.  I am also told that the plastic surgeon will want to wait 3 – 6 months post radiation to make sure all “effects” have taken place and he knows what he is dealing with.  So we will be into 2012.

Which leads me to side effects of radiation.  They are relatively minimal.  Relatively.  Skin irritation at the local site i.e my right breast.  Fatigue.  Although she tells me her patients that have gone through chemo say this is nothing.  It’s not great for reconstruction.  Will likely cause the right breast to shrink some, which the plastic surgeon will take into account as we expand.  And of course there are a whole host of other side effects but most are unlikely to happen.  Unlikely.

Uugghh.  Deep breath.  Here we go again…

Comments

  1. OMG! This is not what we wanted to hear. And grey area. It sounds like they knew that radiation would come into play if the entire tumor did not disappear. OK. You can do this! I so want this to be over for you. But, I do have to say you are the strongest woman ever!!! We are all here for you. Just tell us what you need.

  2. Mary Johnson says:

    Ok, breathe in, breathe out, repeat! I am so very sorry you have more treatment to go! I am still amazed at your strength and courage even though you were not anticipating radiation! Keep telling yourself it is not a setback, just an insurance policy. I like that analogy. You are awesome, Meredith Gaile, and will come through this with flying colors! Hang in there! We will keep the prayers going and be here for whatever you need!

  3. Melissa Campbell says:

    Oh crap! That is a drag. YOU will do fine because you have tiger blood and you did awesome through chemo… I guess ya gotta do what ya gotta do right? And yes, it is not a set back, just a bit more insurance and that’s only a good thing. We are thinking of you!

    Melissa Lydia and Sean

  4. Basically, this stinks! But I know this too will pass. Keep your eye on March 14th, 2012!!! We will celebrate in a Big Way. Dad and I are so proud of you. MOM

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