Meetings with Oncology

Today, our first appointment was with Oncology. The Oncologist just affirmed that the decision to have surgery first is the best one, in his opinion. He said that there are certain cases where pre-surgery chemotherapy is probably the best, but with our case, he feels surgery is best. Being that I have at least two and possibly three different types of cancer going on, the chemotherapy treatment would leave one type of cancer not being as targeted by the chemotherapy. If we wanted to pursue pre-surgery chemotherapy, he would pick the regime to treat the HER2+ cancer, being that it is the most aggressive type I have going on. But during the time frame (around 5 months) we would be doing pre-surgery chemotherapy, there is the risk the non HER2+ cancer could progress, compromising my prognosis. I am more comfortable taking the risk that possibly the lymph node biopsy was wrong, then I am waiting 5 months doing chemotherapy and hoping some of my cancer isn't spreading.

At this appointment, we also ran thru what the probable chemotherapy regime could be for me. It looks tough. It looks like I will probably be doing a couple different "chemotherapy" drugs (approx. 5 months), a year of a HER2 specific drug, plus up to five years of a hormone receptor drug. A lot of the side effects of these drugs are terrifying, but I know they have to be done. One day at a time...

Our second appointment was with radiation oncology. We went over some of the post surgery scenarios that may require me to also need radiation. With the information we have now, it looks fairly unlikely I will need radiation. I would be just fine with never having to visit the radiation oncology department again! :-)

We also met with a genetic counselor. Due to the fact I have bilateral breast cancer at such a "young" age, there is a greater then 10% chance that I may have one of the BRCA gene mutations. We feel it would be wise to test for this gene mutation to better know how to deal with my case, and to hopefully better inform our children and other first degree relatives of certain medical conditions to screen for. If I indeed have one of these gene mutations, there may be a significantly elevated risk of me also developing ovarian cancer, and we could start screening or take preventive measures now.

We are proceeding with our scheduled surgery date of January 29th.