Milestones

It seems that I have been getting lazy about blog posts. Rest assured that no news is good news - it just means I haven't been sitting around the house at the computer. I am now done with chemotherapy, having had the final Taxol treatment last Monday. I followed that up with a little x-country ski getaway with some girl friends up at Maplelag. Great ski conditions, great food, great company - it was a really nice break. I managed to not overdo it too much, although it was tough to have to come back early to rest in the afternoon. At least I had the brains not to force myself to keep going and get too worn out.

My hair is officially growing back! I've been seeing signs of growth for several weeks, but in the last week or so it has become noticeable and I have a full head of fuzz filling in the gaps between the stubble of the hair that never fell out. Last weekend I finally got the clippers out and buzzed off all except the very back (where it sticks out below a hat). And this morning I saw that a couple of eyelashes are sprouting. I am down to just a handful of eyelashes now, and have been reminded of my older sister's baby dolls when I look at my eyes. When she was little she used to pull out the eyelashes on her baby dolls, so maybe she would like this new look of mine. At any rate, it seems that I won't have to sport it for too much longer, and I'm just happy that by the time the weather warms up I will no longer be bald. Hats have been fun in the winter, but warmer weather would be much less comfortable.

Now it's time to move on the next step in this journey. I will meet with my Naturopath this week to review how things are going and change up my supplement plan, since I won't need to take some of the things that I have been taking to help with side-effects from the chemo. I'm looking forward to hearing her thoughts on the surgery and the Tamoxifen, which are both coming up for me. It's been so helpful to me to have someone on my team who can give me another viewpoint on treatment options. Surgeons believe deeply in surgery, radiation oncologists believe in radiation treatment, and so on (at least I hope they do, or they wouldn't be doing it). Everyone has their biases, including me, and including the Naturopath. I'm just trying to ensure that the decisions I make are fully thought out and mine, so I won't look back and feel that I was pressured into doing this or that.

I meet with the surgeon on the 17th, and I'm not sure what the schedule will be after that but I expect (and hope) that we will get on with surgery soon after. Since I can't even feel the lump anymore, I expect that a lumpectomy will be possible. How do they do a lumpectomy without a lump, you may ask? Well during the biopsy they put a small titanium clip in to mark the site of the tumor. I was quite distressed over that at the time, as I have never had good luck with metals, at least against my skin. Earings, necklaces, even a watch would irritate my skin and give me a rash. But it seems that this piece of metal has been benign, and indeed the chemo shrunk the tumor to the point where they will need this marker to find the right spot to take out. Then there will be lab work to see if there are still cancer cells active in there or not.

The big question mark for me on the surgery surrounds the lymph nodes. The docs recommend a full lymph node dissection, which means they open up the armpit and take out all of the nodes that are easy to get to. Then the lab sorts through them looking for cancer cells, and the ratio between the number of nodes with cancer and the number without cancer helps them predict the risk of recurrence and spread of the cancer down the line. Supposedly, taking the lymph nodes out also reduces the risk of recurrence and spread of the cancer, but if this is so, then why does the pathology of the nodes that have been removed still predict that risk? The other part that gives me pause, is that there are lymph nodes that showed up on the PET scan as having cancer in them behind my collar bone. Those can't be removed surgically, on so we are counting on the chemo and radiation to get the job done with those. I am feeling pretty strongly that my risk of recurrence or progression is tied to factors other than cutting out the armpit lymph nodes. And the lymph node surgery is far from benign - I won't go into all the details, but when the surgery is done and followed up by radiation, the risk of lifelong side effects is very high - 20% at the lowest, with some studies that look out 20 years finding as high as 70% of women having problems. I can get on board with that if I really believe that it will have life saving benefits for me, but I'm not there right now.

So, we'll see what the next few weeks brings. Maybe there will be more tests that will change my mind. I'm trying to keep that balance between staying open to various options, but still making the best decision for me. I know I've changed my mind numerous times so far, so stay tuned for the next chapter.

And my other big challenge for the next couple of weeks will be to get my head back into my job, with all this other stuff swirling around my brain. I'm feeling better physically, but focusing on work has been challenging to say the least.