June 20 --- Chemo oh no

June 20   Chemo Oh No

Chris and I met with Dr. Vargas.  Essentially he told us that because of the Positive Her2 results, I will have the surgery, Chemo, and radiation.  The Chemo will be 1 every 3 weeks for 6 treatments; the radiation 5 days a week (M-F)  for 3 weeks.

I am to meet with my oncologist as soon as possible so that the treatments can be set up shortly after the surgery on the 26th.

The only positive thing I can take from today is that I probably will lose my hair.  This is a good thing as I've always wanted to share Catherine and her experience with alopecia.  Now we both will be bald for a time.  We've joked about how fun it will be and we can draw on each other's heads, maybe we'll get as fancy as this woman.

June 17 -- An Unexpected Phone Call

An Unexpected Phone Call

Monday night (6/16)  I am surprised to hear a message from Dr. Vargas to call him back.  It's probably some detail about the surgery so I'll call him in the morning.

Tuesday (6/17) I returned Dr. Vargas' call; of course he's not available.  An hour later he calls me.  "Mrs. Colleran," he says with his kind Spanish accent, "we have received the results for the Her2 test."  He reminds me that he mentioned it when we met and believed that it would be negative.  To his surprise it has come back positive.   "What does that mean?" I ask.  He tells me that it means that there is a protein in the cancer that makes it more aggressive; yet he believes because the cancer is so small that the cure rate still holds at 90-95%.

He asks me if I have any questions --- my head starts to swim and I can't think of anything.  Then I turn and tell Chris.

Once again the thoughts of what ifs and concerns for the girls begin over the next few days.  I start to feel like I have so much to do in order to find any peace.  Chris and I need to complete our estate planning,  I must call Steve's family and get the girls to Oklahoma for a visit, I must, I must ... the list goes on and on.

I call Dr. Vargas' office because I have so many questions.  The book they gave me has helped to clear my mind to focus on what is at hand.  Good --- I get to see him in two days (Friday, 6/20).

In the meantime I've done lots of research and found facts that are important to know:
Prevention

Tamoxifen is approved for breast cancer prevention in women aged 35 and older who are at high risk. Discuss this with your doctor.

Women at very high risk of breast cancer may consider preventive (prophylactic) mastectomy. This is surgery to remove the breasts before breast cancer is ever diagnosed. Possible candidates include:

• Women who have already had one breast removed due to cancer
• Women with a strong family history of breast cancer
• Women with genes or genetic mutations that raise their risk of breast cancer (such as BRCA1 or BRCA2)

In 2014, it is estimated that among U.S. women there will be [37]:

• 232,670 new cases of invasive breast cancer (This includes new cases of primary breast cancer among survivors, but not recurrence of original breast cancer among survivors.)
   
• 62,570 new cases of in situ breast cancer (This includes ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS). Of those, about 83 percent will be DCIS. DCIS is a non-invasive breast cancer and LCIS is a condition that increases the risk of invasive breast cancer. Learn more about DCIS and LCIS.)
   
• 40,000 breast cancer deaths  

Take a look at this website for lots more credible information:  http://ww5.komen.org/BreastCancer/Statistics.html#USwomen

 

More thoughts......

As the week after seeing Dr. Vargas continues on, the thought of actually having breast cancer comes and goes.  So very busy with the girls, Chris, Dad, Peggy, teaching an online course, and everyday detail of life.

I am grateful that mine is a little cancer..... and no chemo, won't go through long grueling days of sickness.
I have nothing to worry about, and lots to be grateful for.

June 13, 2014 Oh no -- Friday the 13th!

June 13, 2014  Oh no! Friday the the 13th, 1st meeting with the cancer surgeon...

It Friday, Chris and I are once again in yet another reception area, waiting to see the a doctor to discuss my cancer.  Wow -- it is really surreal.

We are called in by a nurse.  She points Chris to the exam room, and keeps me to take my vitals.  How can someone with such healthy reading have cancer?  It just doesn't make sense.  Soon we are in the exam room and she is asking me a boatload of question and typing my answers into the computer.  Why the heck did I fill out all of the preliminary paperwork if she is doing over again now.  Finally, I stop and say "here, all the answers you seek are on these papers in the exact same order that you are asking me."  She looks at me, looks at the papers, mutters "thank you, the doctor will be right in."

A few minutes later, Dr. Vargas walks in.  He is tall, handsome, and well dressed (should be, bet he makes load of money).  He has a calming voice with a decidedly Spanish accent.  I learn he is from Peru originally. His body language and gently manners are kind, mindful, and soothing.  He looks me gently in the eye and begins to tell me for findings of the biopsy tests.

Essentially it comes down to this, these are the technical results:

• a moderately differentiated invasive ductal carcinoma
• tumor size - about .6 centimeters or 5 millimeters
• lymph nodes - negative (no cancer cells detected)
• metastases - negative (cancer is contained and has not spread)
• grade presentation - moderate (grade II)  this means that the cancer cells are between grade I, looking like normal cells; and grade III looking very abnormal
• Ki-67 - Favorable <10%   This is a test of rate of growth of the cancer cells. If it is 20% or higher it is a rapid rate.  Mine is very slow, which is favorable and means high rate of cure.
• ER >90% - has to do with my prognosis and recurrence rate of the cancer.  This score means that I have a high rate of no recurrence 90 to 95%
• Her-2-new --- this will be either negative or positive.  Dr. Vargas tells me that it has something to do with a protein.  We won't have the result on this for a few more days, he believes it will be negative
• FISH -- another result that is pending.

So in our terms, I have a cancer tumor in a duct of my left breast, it is a little larger than 1/4 inch. I have a highly favorable rate for cure and very low rate that it will reoccur.

He told me that the surgery is on an outpatient basis, he will do a lumpectomy, and remove attached lymphnodes.  Following which I will only need radiation to the specific area -- five days a week for 6 weeks.  And my hair will not fall out --- not that I care about that at all.  All AMAZING!

He introduced us to his team, who are all professional and gentle.  I left the office with a surgery appointment: Thursday June 26 3:30 pm,  be there two hours early for prep.

One of the nurses, Miranda, whose official title is Breast Cancer Navigator, is an RN.  She spoke with us to educate us about the process and answer any questions.  She gave me a book to use as I go through the whole process.  I have found it very very useful.  It is Breast Cancer Treatment Handbook, by Judy C. Kneece, RN, OCN, published by EduCare, Inc.  You can easily find it online if you'd like a copy for someone who is going through this.

So I leave Dr. Vargas feeling pretty confident with a certainty that all is being done in time to minimize the breast cancer.  In a few weeks it will all be behind us.  Life is good!

In between thoughts, worries, hopes

In between thoughts, worries, hopes

Chris and I spent most of the week in a daze.  Together we were researching all we could about breast cancer, treatments, surgery and the cancer surgeon himself, Hernan Vargas, M.D.  Individually we keep our thoughts, feelings and fears mostly to ourselves.  Although, there are moments throughout week that we admit to each other that we have them.  Chris is encouraging and I try to be optimistic and hopeful.

I am not so concerned about me or the illness. After much reading, I am confident in the treatment of today's medicine, and I am very confident in my surgeon.  He is a very accomplished man and has stellar recommendations from patients and other physicians.  I have peace that I am doing as much as I can on that front.  Still...what if?

In the depths of my heart I sometimes feel woeful for my daughters.  They have been through so much in their lives, the loss of their mother and how that will effect their lives is unimaginable.  Though I come from a large extended family, only a few cousins are really close to me.  My father is aging and I worry how my demise would hurt him.   And what about Chris?  He already lost loved ones through cancer, including Ruth (whom he lived with for 25 years before meeting me.  She died of brain cancer.  Four years later we had already dated a year, and got married.  He is a survivor and would get on with his life, I am certain.

What really fills my heart and head and keeps me up at night is "what will become of my daughters?"  Have I given them enough of a legacy of love, faith and family? Also, financially -- what can I leave them besides all of my belongings to help them through life. I feel the impulse to start doing things with Steve's (my ex-husband and their father) family to ensure that the girls have a sense of support and belonging.  I want to bring my dear cousins near me and to help the girls  know them because of their loving hearts, generous nature and faithfulness to God.  Should I not make it, hopefully the girls will feel secure in their family ties.  I worry about what will be left for them. Will Chris look after them?  Will he make sure that they are in his will?  What about Steve?  Will he be able to stabilize his life to meet the girls needs as they emerge into adulthood?  What about our faith?  Do they know enough in their hearts about the ever presence of God and his loving graces?

Chris let on that he too had been thinking about the future if I didn't make it.  Putting ease to some of my worries, he was making a variety of plans  -- all that include our daughters.  Thank you, Chris, for caring so much.

Sonogram and Biopsy

June 7, 2014 -- Sonogram and Biopsy
Chris and I arrive at the radiologist early.  I barely get sit down when they call my name.  Back to the dressing room, hospital gown, open in front.  Moments later, I'm lying on a gurney in the sonogram room.  The technicians begins her task and slathers gobs of gel on the transducer probe, then slowly smears that all over my left breast, taking pictures and fiddling with the keep board and all the while look on the computer screen. All done, but she doesn't wipe me off.  She takes the images to the radiologist.

Within minutes a woman steps in, introduces herself as the radiologist, Erica Berg, M.D..  She is a lovely Chinese woman, who looks Korean to me -- go figure.  Her beauty reminds me of my daughters and I immediately like her gentle yet straight forward manner.

She explains that I do have a mass and that it does look like cancer, but the only way to make sure is with a biopsy.  I'm given the option of having one performed there in the office immediately or go to a hospital for an outpatient procedure.  Chris and I decide that we might as well get it done.

The doctor steps out.  A few moments later, she's back with syringes.  She uses a local anesthetic to numb the breast are, the takes a few biopsies from different angles.

I go back to the dressing room, change into my clothes and meet her and Chris in another exam room, but only for consultation. Dr. Berg tells us that she is reasonably certain that it is cancer.  The biopsy will be sent to a lab and we'll hear in three business days the result.  She adivses us that our next step is to see a breast cancer surgeon and to make an appointment as soon as possible.  The results of the biopsy will be sent to my family doctor and to the surgeon.  "I've already spoken with your family doctor, Emily Faltimier M.D. and asked who she would recommend. I was glad to hear her say Dr. Vargas at the INOVA Breast Cancer Institute.  He is one of my favorites and I strongly recommend him too."  She reminds me that the mass seems to be only 5 to 6 millimeters in size and caught very early.  She had just gone through the process with her mother-in-law in January and assures me its nothing to worry about.

A centimeter is made up of 10 millimeters.  This chart shows different sizes of breast tumors, mine is half the size of the smallest circle, only detectable by mammography.

I leave the office so glad that I kept up with my mammograms.  Without them there is no way I would have ever known that I had this small mass.  I am grateful for the strides that have been made in medicine and technology,  I am a fan of preventative medicine and try to keep up with it in my own life.  I have gratitude in my heart for all the people I know who have keep up the fight to find a cure for breast cancer.  I have learned that we are very very close to a cure, and that things have changed in diagnosis and treatment so much in the last ten years.

Dear Ones --- please keep up with preventative medical practices in your life and, especially, make sure you get your routine mammograms!
Monday, two days later,I called for an appointment to meet with the Cancer Surgeon Dr. Vargas.  An appointment is set for Friday, June 13  12:34 pm.

The Phone Call

June 5, 2014 -- The Call
The phone rings and caller ID shows Fairfax Radiology.  The voice on the phone says "Ms. Colleran, the radiologist would like to see you again.  She'd like to take a sonogram of your left breast.  When is the earliest you can come in?"  An appointment for Saturday, June 7 is set.

In my mind a fog begins to set in.  I'm wondering if I should be sad, shocked, scared or whatever.  I decide to do or think nothing about it until after the appointment.

June 3, 2014 What is that spot?

Hi there family and friends:

I am writing this blog to share my experiences with breast cancer.
But first, I must thank everyone who has worked to financially support breast cancer research.  It is because of this work that people like me no longer have to fear this, and can be proactive to ensure that breast cancer is not a death sentence.   From the bottom of my heart

 Thank You! What you have done, saves lives.

I will post to this blog anytime something new happens, or I have thoughts and feelings that I want to share with you.  My hope is that it becomes a reminder for prayer, and a source of encouragement for many.  Hopefully I will also be able to give answers to some as I learn facts and truths along the way.

June 3, 2014 -- What is that spot?

I am in for my routine mammogram.  As usual not expecting anything out of the ordinary.  In fact, I've been consciously thinking in recent days how lovely life is and how blessed I am to come from a family of "long-livers" (my term for people who live beyond 90!).  Praising God that this season of my life is so full with joys, victories, challenges, and reasons to live by faith.   Two elderly parents that my husband, Chris, and I love and look after in their different assisted living situations; and our two teenage daughters 16 & 18 years respectively; a growing marriage, and loving husband.  My fulfilling career that I hope to continue with for many more year before easing into retirement.

I'm called back by the technician who take me to a dressing room to but on a hospital gown -- open in the front.  A few minutes later, I 'm at the mammogram machine and she carefully places each breast for imaging. This time it really hurt and the two plastic plate squeeeeeeeeeeze down.  "Ouch" I tell her, she sweetly apologizes.  In my mind, I'm thinking its a good pain as I know they'll get great images.

I strain my neck to turn and look at the images on her computer screen. "Oh no", I see a spot.  I ask her "what is that?"  She mumbles something like "not sure, the radiologist will call you if there's an issue."

I come home, and immediately tell Chris that I saw a spot.  "What does that mean?" he asks.  "Well," I say matter-of-factly," if it's what I think it is, they will call and ask me to go in for a sonogram and biopsy. They probably will diagnose me with breast cancer."   With a doubtful look, Chris says "or it can simply be a cyst." "We'll see," I said.  "Either way they will call me for a recheck."