I bet you all thought that things were on a predictable, even course now, didn't you? Well, so did I - wrong again!
I showed up Monday morning for the mammogram and ultrasound, secure in the knowledge that a tumor that can no longer be felt must have responded well to chemo and so I had little to worry about. The good news is that I was right about that part - the original tumor is barely visible anymore. They can still see the edges of it, so the measurement doesn't seem to have changed much, but it is all hollowed out and kind of sucked in, indicating that most of it has disappeared. So that's the good news.
They also found several calcifications on the mammogram that were either not there in November, or were barely visible, and now they are brighter and bigger. One of these areas is in a cluster, which is evidently more likely when there is cancer. The radiologist (who was the one that I like, so that was good) said that she thought it looked very suspicious and her first reaction was that the breast needs to go. Later she kind of backpedaled on that and said that the surgeon and I would need to talk about it - I'm guessing it's not her place to make that call. She did say that if I was not already a cancer patient, this was an area that they would biopsy for sure. As I read all about calcifications online Monday afternoon, it looks to me like this is just the kind of situation that had me skipping mammograms in the first place. Eighty percent of the biopsy's that they do on these end up being benign. On the other hand, if they really have changed this much in 4 months maybe that is a more ominous sign. I'm still wondering if perhaps something else was different this time - I forgot to ask whether the calcifications in the area of the tumor look brighter now too. The radiologist commented several times that this is extremely rare, and if it is a new cancer that started growing during chemo, it also isn't good. So, welcome to roller coaster ride that is my life, is your seat belt securely fastened?
As I tried to process this news, which isn't really solid news, just new doubts and speculations, I watched the weather forecast develop into a winter storm warning for Tuesday and Wednesday, with a foot of snow predicted. My PET scan was scheduled for Wednesday morning, and I did not want to miss or delay it, so I called the clinic to see how often they close up due to bad weather. Almost never, was the answer, they hadn't closed so far this winter despite some major storms.
So, secure in the knowledge that my appointment would go on if I could get there, I headed to Fargo last night so I could be here this morning for the test. The Weather Channel was even here. If you want to experience surreal, try walking back to your hotel with lightning flashing and thunder rumbling, getting pounded by wind driven sleet pellets, past The Weather Channel guys who are huddled in their van next to a little blue tarp-tent over their camera on the sidewalk. What a glamorous job they have - kind of like a fisheries biologist!
This morning it looked like 8-10 inches of new snow had fallen overnight and several of the major highways were closed. I was sure I had made the right call coming early. Then the cell phone rang. It was the PET department. It seems that the radioactive sugar that they inject for the test is made in Grand Forks, and since the roads were closed they could not get it to Fargo in time for my test. I asked if later today would be a possibility, but she didn't think so because the solution has such a short shelf life they would have to start over and make a new batch. My options for rescheduling were Monday or early tomorrow morning. I picked tomorrow, wanting to get some of this uncertainty cleared up. I would really like to have more than a day to mentally prepare for whatever surgery I will end up having. Although, the PET scan will have limited value for that, since PET scans are not very good at detecting early breast cancers, however it will show if there is anything still going on in my lymph nodes. Since I have to check in at 6:30 am, I decided to just stay here in Fargo for another day and get some work done, rather than spend today driving back home, walking the dogs, and being distracted all day.
So that's where things stand right now. I haven't talked to the surgeon yet, so I don't know what his advice will be regarding a biopsy or perhaps to go straight to mastectomy. It's kind of funny because initially I was all ready to prepare mentally for mastectomy, but over time the doctors kept insisting that lumpectomy was going to be possible and eventually I completely bought into that. To switch gears back to losing my breast now, less than a week before it would happen is not easy. Another lesson in the benefits of living in the moment and not jumping too far ahead of yourself I guess, but that doesn't make it any easier to adjust to right now. And on top of that the question still remains very much open as to whether this is what will happen. How will I feel if I get a mastectomy and then find out that these calcifications were benign? Do I really want to have another biopsy before having surgery? Is this just a preview of what I am if for with future cancer screening? I'll bet it is. Not to mention the more ominous questions, like: Is this a second cancer that was there all along but got missed at first? And, what would it mean if a new cancer has started growing during some of the nastiest chemotherapy out there.
Well, I hope this post doesn't bring you all down, but why should I have all the fun alone, right? And, as I keep reminding myself, I really don't know anything yet, so I'm back to practicing patience with not knowing what tomorrow will bring. Hopefully it brings some radioactive sugar to Fargo by 6:30 am.
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