Plastics and Oncology

We met with my reconstructive surgeon this morning. He was thrilled with how well the incisions are healing up. He feels it is best to delay reconstruction until we are finished with the "hard core" chemotherapy drugs (first five months), as the risks of healing complications and infection is too great otherwise. We are in no hurry to complete reconstruction and he said we could wait years if we wanted. Right now, we are leaning towards doing reconstruction within a month or two from "hard core" chemo completion, but that could change to become a longer time frame if my body needs more time to recover from chemo.

I was correct about the cause of my range of motion issues in my shoulder (see previous blog). I mentioned my concerns to my reconstructive surgeon and he immediately sent me to a physical therapist. It sounds like the therapist I saw specializes in range of motion issues with post mastectomy/lymph node dissection. She confirmed my suspicions, and I indeed have what she referred to as "cording", otherwise known as axillary web syndrome. She took the time to demonstrate and explain a few stretches that may be beneficial for me. She said the cording will resolve itself, and sometimes the stretching helps and sometimes it can make it worse. So I will use my own judgement as to if and how much stretching I do, based on the results I see. I don't have to worry about my range of motion being permanently damage, she said it always resolves itself.

We didn't learn a lot new at our Oncology appointment. Treatment stands pretty much the way they thought it would based off pre-surgery information. Pathology tests reconfirmed the fact that my invasive cancer was her2/neu positive, therefore the drug Herceptin is an excellent treatment choice for me. I did learn today that I had more then just one location of invasive cancer on the left side. Pathology found several separate locations of invasive cancer in my left breast. The good thing is testing showed that the cancer did not reach my lymphatic system or my blood system. We are proceeding with the following chemotherapy treatments as more of a preventive measure then anything:

8 weeks of Adriamycin + CTX (administered every other week intravenously)
12 weeks of Taxol + Herceptin (administered weekly intravenously)
9 months of Herceptin (administered every 3rd week intravenously)
5 years of Tamoxifen (I think this is oral)

Seeing as I will be having approximately 14 months of intravenous drugs, I will be needing to have a port inserted. I don't really understand how this procedure works, but I imagine I will find out soon. Essentially, a port gives a site to have my chemotherapy administered without having to locate and correctly enter a vein every time.

I was told that I will lose my hair with my chemotherapy... they said around two and a half weeks after my first treatment. So I got a prescription for a "cranial prosthesis" (wig) and went to the hair and skin center at the hospital at Mayo. They have a program that gives a free wig to cancer patients. So I received a wig that is exactly the same color as my hair and a similar length. I need to have it cut (layered). Essentially, I can use this wig, and if I decide I am a wig person, I can use my prescription and purchase a nicer, more styled wig. If I decide wigs aren't my thing, then the free wig was a learning experience.

It sounds like I won't have to return to Mayo until my reconstructive surgery (which should be late summer, early fall). Next Thursday, we will make a trip to the Cancer Center to meet with the Oncologist who will be overseeing my treatments at our local hospital. Chemotherapy should start shortly after that.