Friday, February 5, 2016
The Cancer Journey, 2
Am I the only person tempted to say "Beetlejuice" three times?
With a diagnosis of cancer comes a lot of reading material. A lot. I have a pamphlet for every little procedure and possible pathway on this journey. Most will need to go on a shelf and wait for another day, and hopefully will be of no more use to me than as resource for future writing, but if I need them, I have them. And I can pretty well answer the question of "Where does the American Cancer Society spend all that money it doesn't spend on research?"
It's spent on education, on these pamphlets, on classes, and on resources for the Newly Diagnosed.
My next step was to get an MRI which would tell the doctor if there were any other developing trouble spots. In an MRI, for the person who has never been through this, you are put into a tube and subjected to loud banging noises. To protect your ears -- unless you are the unfortunate child who is getting an MRI of her head -- the technicians give you headphones to cover your ears and pipe in music that will not be heard over the banging. And then, to examine just the afflicted part, it is elevated away from the rest of the body. But when the afflicted part is something soft and squishy that is not easily elevated, then gravity is used. I had to lay down on a special frame and pretend I was Superman. The worst part of the whole thing, easily, is that the technicians failed to start the IV (for contrast) on one side, and so had to stick the other side as well.
The next day I went to see the plastic surgeon. He was a very affable man. He told me all about the various kinds of implants I could receive if I had a mastectomy. One can get saline implants, silicone implants, or even a new solid natural shape silicone implant. And then he said the words that pretty much sealed up my opinion of getting reconstruction: "The second surgery will be outpatient and will take place a few weeks or months after the first."
It seems that after the mastectomy, which removes all the tissue above the muscle wall, the plastic surgeon comes in and places a spacer under the pectoral muscle. (So you're sore both above and below that muscle.) Then, over the course of several weeks, the spacer is inflated with saline. When it's big enough, the spacer is removed under general anesthesia and the implant put into its place. "It's outpatient surgery."
No! (Have I told anyone how surgery phobic I am?)
And then, because implants wear out over time, and I'm such a young woman, I could expect to have the implants replaced every ten years or so.
Of course, the other option is flap reconstruction, where muscle and fat is taken from the belly or buttocks, and a new breast is molded from it. Advantage -- it never needs replacement and never feels hard, and can be done completely at the time of the mastectomy. Disadvantage -- you end up with two big surgical sites instead of just one, and if the tissue is taken from your belly, you end up with a weaker abdominal wall than before.
Dear God, no, just get me out of here!
And then the plastic surgeon pulled up the radiologist's report from the MRI from the night before -- thanks to open access of records he could see what had been posted in my chart -- and gave me the news that the MRI had confirmed a singular lesion of not particularly large size. I was likely go for the lumpectomy.
Thank God. Finally, a bit of luck my way.
On Friday I went back to the Breast Surgeon and got the results of the cell tests. Estrogen positive, Progesterone positive, and HRER negative. What this means is that the cancer cells are fed by hormones, so I will need to take a hormone blocker for years to prevent recurrence, but I do not have certain genes that predispose me to developing cancer. So my prognosis for survival is pretty good -- barring a zombie apocalypse, an ecological collapse, or a wayward asteroid.