Wednesday, 4 July 2012
Here we go
Back from the hospital, and I now know some, but not all, of the bare facts about my cancer, and it's quite a lot to take on board. I haven't even begun to try and get my head around any of it yet, so I really don't know how I'll feel about it when I've taken everything on board properly, but right now I'm a little shocked, but mostly upbeat and cheerful. Even my Consultant said I was the most positive patient she had ever met, which made my day a bit! It's probably not true, but I can put a very good front on.
So here it is.
1. Right boob, loads more cancer still left there, and it's much bigger and more widespread than they had any inkling of before surgery. Only option is a full mastectomy.
2. Of the 25 lymph nodes they removed, 9 are cancerous. I thought this was amazingly brilliant news, less than half, but apparently it's not. I had this idea that the lymph nodes were like stepping stones across the river, and the cancer had to virtually reach the other side. Well they are, and it can, but whilst it's on any of those stepping-stones, it can also chuck a load of nasty cancer cells into the river, which can then be carried around the body. OK, so I wouldn't pass any medical exams with my rudimentary biological knowledge, but the troll on the bridge with the nasty bag of cancer-poison to spill is an analogy I can understand. To cut a long story short, 9 cancerous lymph nodes is not as bad as all 25, but it certainly isn't cause to put the champagne on ice either.
3. They now have to do two CT scans, one to see if there is any cancer elsewhere in my internal organs, and one to check all my bones for signs of it. The CT scans both mean I'll have to have a canula fitted, which is a source of huge anxiety to me.
4. Needle-phobic or not, I will never be able to have any injections or blood tests in my right arm in the future, because I no longer have lymph nodes to protect me from infection there. This means that future vein access is going to be even harder to gain, because they only have one arm to try now.
5. Once they've done the CT scans, they should know if the cancer has spread, and if so, how serious it is. If it has, cures are unlikely, but they will then try to "manage" it. I was told that some people can live for a very long time with it being "managed".
6. However, any tumour would have to be at least 0.5cm to be visible. Cancer may have spread but still be at cell level, so it wouldn't be picked up.
7. It turns out that the cancer in my left boob was worse than they thought too, and had started spreading, although they are pretty sure they have got it all. However, if the bone and body scans are clear, they will now want to remove and test the lymph nodes on the left side too to get a clearer picture of the likelilhood of actual spread. Hopefully, they would only take the first three, but it could be that all of them get removed. This would not be good at all - I'm going to have long-term difficulties with my right arm, I really don't need the same with my left.
8. I now definitely need chemotherapy. Probably 6 - 8 sessions, 3 weeks apart, to start in the next couple of weeks and go on until around Christmas or maybe a bit after.
9. Once Chemo is finished, I then will definitely need several weeks of radiotherapy.
10. Once they are both out the way, then back on the operating table to have the mastectomy.
11. Then 5 years on a Tamoxifen-type drug. This is good news too, really, because they know that both the primary tumours they've found are oestrogen-receptive, so it follows that any secondary tumours spreading from these will be too. The Tamoxifen family of drugs blocks oestrogen production, which means that the tumours can't grow easily, and in some cases can shrink.
Then the good news - they are planning treatment for the next SIX years - that's pretty flaming encouraging! WM and I went for a rather nice lunch afterwards. Chemo won't start for 2 - 3 weeks, so I've got time to get completely better, and maybe even get a little bit of fun in first.