Cancer

In less than 6 weeks I will celebrate my 3rd anniversary of chemo completion.  I always knew I’d make it this far but I never imagined what the journey would be like or who would be there along the way. Let me explain:

In Nov. 2005 I was diagnosed with a stage 1 ER/PR(-), HER2neu neg. adenocarcinoma of the right breast. In English, that means that I had the most common type of breast cancer that was confined to the breast-no spread to the lymph nodes or anywhere else.  (that explains the “adenocarcinoma” & the “stage 1”.)  HER2 neu is a particular type of gene that is expressed in some cancers-it has become a factor to consider when planning treatment. 

 The ER/PR designation is also a planning factor: ER stands for Estrogen Receptor while PR stands for Progesterone Receptor, and it simply explains how the cancer cells receive the nourishment they require to grow. Breast cancer cells can be positive for both, negative for both or negative for one & positive for the other. For me, the cells were negative, meaning that the cancer cells did not require the female hormones estrogen and progesterone as a source of food. 

The designation of ER/PR(-) meant that I would require chemotherapy in addition to any other treatments.  Chemo in this case was designed to ensure that any stray cancer cells present after the surgical treatment would be killed off & unable to reproduce.  Had the cells been ER/PR+, the drug Tamoxifen or one of its relatives would have been used after surgery.

I opted for a modified radical mastectomy with immediate reconstruction. Upon initial diagnosis, I was leaning towards a lumpectomy but I did not want to be tied to a radiation schedule of 5-7 weeks (every day, 5 days out of 7) on top of the anticipated 6 month chemo.  The only way around that was a type of radiation called brachytherapy-where the radiation is implanted close to the cancer providing a short but  intense burst of local therapy.  After a referral to a radiation oncologist who specialized in this type of treatment, my cancer was  deemed too close to the chest wall for this treatment.

I have a medical background, much of it in oncology or cancer treatment. Probably just enough to scare the crap out of myself & be dangerous! That background explains my deep fear of general anesthesia. I knew that there was no way to do a mastectomy with local anesthesia so my feeling was “Do it all now because there is no way I’ll willingly have general anesthesia twice!” That’s why I opted for immediate reconstruction…

In the next post I’ll explain more about the pre-surgery time and why I chose the surgery I did. It’s such a personal thing, no one way is right for everyone. All we can do is get as much information as we can and use it to make the best decision.

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