The Oncologist

The very next day Mike went with me to meet the oncologist, Dr. M. A very different personality that Dr. R. Office larger and more bureaucratic, his demeanor more clinical, not as personal. He often, in talking, would refer to M his assistant, as in, M will do this, or, You can tell M if that happens and she can call in a prescription for you. I guess M does a lot.

He also strongly suggested a lumpectomy, not mastectomy. Same survival rates, less surgery, keep the breast. But said it was up to me.

He said my tumor in the breast is so small (0.9 cm which is less than half an inch) that there is only a small small small chance it had spread outside the breast. But just in case, they would do a Sentinel Node Biopsy while I was under. I said I had heard that. He also was going to order an Oncotype DX of the tumor, to see if it is a high chance it would return. If so, they might do chemo before radiation, even if it hasn't spread. Fine with me, take out what you need, do all the tests you want. Just tell me how to knock these cancer cells out of me, and so far away they won't be able to find their way back.

He drew all this on a white board in the examination room. I found the visit to be an out of this world moment. Here I sit on the exam table, he never touched my breast, only looked at the biopsy report. Mike and he are in plastic side chairs, and we all are looking up at a small white board while he talks about Prognostic markers and Oncotype DX. I felt like I was back in college, learning about Quantum Physics. Certainly not in Orlando talking about some cells in my very own breast that had called a mutiny against their fellow breast cells, dividing too fast and furiously. They were right there in my breast as we spoke. As he spoke. Maybe it was good to keep it all clinical and in the realm of the abstract. There will be enough time in the coming months for these rebellious cells to create real life moments for me.

Called the surgeon to schedule the lumpectomy. Mike is out of town in two weeks for business so we will put it off until the third week. At first I was miffed. Why can't I have it sooner, right away, get this train out of the station and on it's way to Healing? Now I see, this gives me time to get ready. Time has much more importance to me these days.

I am definitely a bit numb. This all seems to be happening to someone else, a third party. Not me.

My thoughts on breast cancer?  I picture pink. Races to raise money for cancer. Pink ribbon symbol. And the implants. I don't know that much about breast cancer. Now I will. Never thought I would get it. Never.

The Surgeon

The whole cancer treatment world expects that you are totally at their beck and call. That you will see the doctor when they have an opening. Whenever that opening is. I can see their point.

Unfortunately Mike had meeting in Georgia scheduled the one day the surgeon had an opening in the coming two weeks, so I went without him. My dear friend L went with me. She is calm under chaos, intelligent and asks great questions. My advocate, because I knew I would remember little of the appointment.

I chose a surgeon who was highly recommended by my one friend who was an oncologist specializing in breast cancer and is now in academia. Just give me one recommendation for each, I asked her - surgeon, oncologist, radiologist. What more information could I possible gather than that from someone in the field who I trust?

The appointment was fantastic. Dr. R is a gift to anyone who needs her. First, her humble yet upbeat office is full of staff who are competent and compassionate. And she, well, she knows what she is doing, she listens, she solves problems, she is awesome. Should every doctor be this way.

Statistically, mastectomy gives same long term survival rates as lumpectomy with radiation, in my situation. She was clear on this. She would recommend lumpectomy, with no hesitation. We talked about the lumpectomy, sentinel node biopsy would be done at same time. If they found cancer in the sentinel node while I was still under, they would take out all the nodes on the left side.

Sounds good to me. L was great, kept going over the appointment discussion in the car with me driving home. Yes it was my decision to have a lumpectomy or mastectomy. If cutting off my breasts gave me a better chance long term of living, I would do it. But it doesn't, so why cut them off?

Mike came home that night, and I greeted him with  ... I'm keeping the girls!