Cancer Diagnosis: A Change in Direction

I had finally made a decision regarding my unilateral vs bilateral mastectomy and was ready to get surgery scheduled. Then the results of my latest biopsy came through and forced a change in direction.

The "suspiciously enlarged" lymph node came back positive for cancer. Obviously, not the result we were hoping for. What does this mean for my treatment plan? It means we're on hold for the mastectomy surgery until we complete chemotherapy. Matt and I both hopefully asked how long the chemo treatments would last, thinking we'd only be delaying surgery a few months. 

Matt: "alright, so we do like 4 to 6 weeks of chemo?"
Oncologist: "uh, a little higher, closer to 20 weeks" 
Me: "oh. Well, shit"

So, yeah. I'm still learning more about the upcoming schedule and how often I'll be receiving treatments, but I thought I'd explain the reasoning behind getting the chemo, before surgery, in case anyone was curious. 

I'm still not a candidate for a lumpectomy or to save the left breast whatsoever. I never will be. But, now that we have seen that the cancer has spread to a lymph node in my left armpit (close proximity to my tumor) we have a reason to aggressively target the spread of anymore cancer cells. I had another choice to make. Chemo before surgery or after. 

If I went immediately into my mastectomy surgery, before receiving any chemo, the surgeon would be more likely to need to remove many more lymph nodes to ensure they are getting any nodes that might be impacted. With each node that is removed, your chances of complications (including lymphedema) increases. Results/complications from the removal of lymph nodes is more problematic than I was realized). Then, after surgery, it would still be recommended to receive chemotherapy to help decrease the chance of recurrence and help kill any cancer cells that weren't removed in surgery. Then, I'd have to have to go through several weeks of radiation treatments. After I heal from all that, I'd begin reconstruction. A lengthy process and with more risk of complications. 

If we do chemo first, there is a greater chance that the lymph node that currently has cancer in it could be "cured" and would no longer show signs of cancer. Which, of course, means it would not need to be removed - obviously, that is ideal. Additionally, the chemo has the potential to shrink the tumor, making it easier to be completely removed in the mastectomy surgery. Which would hopefully eliminate the need for post-surgery radiation and I would be able to move right on to reconstruction. 

So, I've opted to do the chemo first. If I'm going to have to have chemo at some point, regardless, then yes, I'd rather do it now and get it over with. Apparently, "this will actually be the worst part of this whole journey". Which, honestly, I can totally see that being true. By the time I get to surgery day, I'll have gone through feeling crappy from the chemo and I'll be ready to move on from surgery to the recovery stage. 

So, what's next? I have my Chemo 101 class on Friday (I'll report back what I learn). We're scheduling to have my port placement surgery next week after some pre-chemo testing is completed (including my first EKG). We are anticipating chemo starting early in February. 

How am I handling this change in direction? It's surprisingly comforting to know I finally have a complete treatment plan, even if this isn't the plan I had hoped for. I've cried and I'm sure I'll continue to cry, but it's not helping change anything. Chemo is, plain and simple, going to suck, but it's time to put on my big girl panties and kick this cancer's fucking ass. 

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