Still no radiation, next steps, post-surgery report, and physical therapy rocks
No rads!
Regarding not needing radiation, after looking more at the pathology report, there was one lymph node that had some tumor cells. From a little internet research it appeared that there were too few to "count". Apparently that is true, as confirmed by my oncologist as well as the surgeon, so phew.
Next steps!
The next step was to decide between two types of hormone blockers. Since my tumor cells had receptors for estrogen, meaning estrogen causes them to grow, any treatment that either (1) blocks production of estrogen (2) breaks down estrogen or (3) blocks the receptor on the tumor cells will help keep any nascent cancer cells from getting the estrogen that stimulates their growth. Option for number one is remove ovaries or block their production of estrogen. I don't have any predisposition to ovarian cancer (read: BRCA positive), so I get to keep those. Chemo seems to have fried my ovaries (temporarily or permanently remains to be seen), but I could still be producing estrogen. In other words, being premenopausal can overwhelm the class or drugs that blocks the production of estrogen (aromatase inhibitors). [As a side note: I can't wait to tell my students that a doctor used the words "competitive inhibitor" in our discussion of a drug. Yes, understanding enzyme function and inhibition is important.] So that brings us to number three, blocking the estrogen receptor on the tumor cells, which is what we're aiming for at this point. The drug prescribed is called tamoxifen, and has been in use for over 40 years! It's been described as the first targeted cancer therapy, since it acts on a specific type of cancer cell (estrogen receptor positive). It's slightly less effective than aromatase inhibitors (1% relative), but I'm not that high risk (yay), and using it would require drugging my ovaries to sleep in case they are functioning, so the doc thinks it's my best option. A pill a day for 5-10 years; there are some side effects, but as I've learned with chemo...roll the dice, they might be few and mild or not. We shall see and reevaluate- I see the oncologist again in three months for that.
Post-surgery report!
Speaking of docs, my surgeon did an amazing job! I hope no one reading this ever needs a breast surgeon, but if you do Lydia Hernandez with Cincinnati Breast Surgeons is great. I've only heard good reports on the other surgeons in that practice as well. What do I mean by amazing job? Well, I have a pretty flat chest, and the scars are fairly even. More importantly, she eliminated all the invasive and non-invasive abnormal cells (clean margins as they say). Good thing too, as apparently there were many invasive little bastards (not just the one we caught). However, the tumor had shrunk from 1.5 cm to 0.5 cm (read: responded to chemotherapy), so that is more really good news. Pain wasn't bad, and drains were out in a little over two weeks. Those things....annoying. There was no infection; that might seem like a low bar, but one thing microbiology has made me somewhat paranoid about is hospital acquired infections, because those bugs are terrifying. What else makes her a good surgeon? She is compassionate, funny, straight forward, and has a game plan, but listens.
Physical therapy rocks!
I had my first PT session Friday morning, and that was great. I didn't know what to expect, but I spent over an hour with the PT, and she measured, prescribed and monitored exercises, stretched me, talked, answered questions, reassured me, kept me from kayaking (that's sad), and scheduled me for a few more sessions. I have some swelling (I mean, understandable, right?) that she is going to help with. No lymphedema in the arms, but she is going to show me techniques next week to help prevent that and deal with some of the swelling. It was a great experience- mainly because my range of motion increased just after that one session and I was reassured that I'm making good progress.
Now off to do my PT homework....
And then take the dog to the dog park...
And then nap ;-)
Regarding not needing radiation, after looking more at the pathology report, there was one lymph node that had some tumor cells. From a little internet research it appeared that there were too few to "count". Apparently that is true, as confirmed by my oncologist as well as the surgeon, so phew.
Next steps!
The next step was to decide between two types of hormone blockers. Since my tumor cells had receptors for estrogen, meaning estrogen causes them to grow, any treatment that either (1) blocks production of estrogen (2) breaks down estrogen or (3) blocks the receptor on the tumor cells will help keep any nascent cancer cells from getting the estrogen that stimulates their growth. Option for number one is remove ovaries or block their production of estrogen. I don't have any predisposition to ovarian cancer (read: BRCA positive), so I get to keep those. Chemo seems to have fried my ovaries (temporarily or permanently remains to be seen), but I could still be producing estrogen. In other words, being premenopausal can overwhelm the class or drugs that blocks the production of estrogen (aromatase inhibitors). [As a side note: I can't wait to tell my students that a doctor used the words "competitive inhibitor" in our discussion of a drug. Yes, understanding enzyme function and inhibition is important.] So that brings us to number three, blocking the estrogen receptor on the tumor cells, which is what we're aiming for at this point. The drug prescribed is called tamoxifen, and has been in use for over 40 years! It's been described as the first targeted cancer therapy, since it acts on a specific type of cancer cell (estrogen receptor positive). It's slightly less effective than aromatase inhibitors (1% relative), but I'm not that high risk (yay), and using it would require drugging my ovaries to sleep in case they are functioning, so the doc thinks it's my best option. A pill a day for 5-10 years; there are some side effects, but as I've learned with chemo...roll the dice, they might be few and mild or not. We shall see and reevaluate- I see the oncologist again in three months for that.
Post-surgery report!
Speaking of docs, my surgeon did an amazing job! I hope no one reading this ever needs a breast surgeon, but if you do Lydia Hernandez with Cincinnati Breast Surgeons is great. I've only heard good reports on the other surgeons in that practice as well. What do I mean by amazing job? Well, I have a pretty flat chest, and the scars are fairly even. More importantly, she eliminated all the invasive and non-invasive abnormal cells (clean margins as they say). Good thing too, as apparently there were many invasive little bastards (not just the one we caught). However, the tumor had shrunk from 1.5 cm to 0.5 cm (read: responded to chemotherapy), so that is more really good news. Pain wasn't bad, and drains were out in a little over two weeks. Those things....annoying. There was no infection; that might seem like a low bar, but one thing microbiology has made me somewhat paranoid about is hospital acquired infections, because those bugs are terrifying. What else makes her a good surgeon? She is compassionate, funny, straight forward, and has a game plan, but listens.
Physical therapy rocks!
I had my first PT session Friday morning, and that was great. I didn't know what to expect, but I spent over an hour with the PT, and she measured, prescribed and monitored exercises, stretched me, talked, answered questions, reassured me, kept me from kayaking (that's sad), and scheduled me for a few more sessions. I have some swelling (I mean, understandable, right?) that she is going to help with. No lymphedema in the arms, but she is going to show me techniques next week to help prevent that and deal with some of the swelling. It was a great experience- mainly because my range of motion increased just after that one session and I was reassured that I'm making good progress.
Now off to do my PT homework....
And then take the dog to the dog park...
And then nap ;-)
Comments