Yippee!!!!

Yes, I had my final zap of radiation yesterday. Woo Hoo! I have finished a 28 day course of the entire left breast followed by a 5 day course to the tumor site. I am so happy I can return to my regular life now. Although I am red, spotty, and peeling; I am feeling fine, and I AM DONE! (tamoxifin to begin next week)

Not Quite

Can you believe I couldn't finish radiation yesterday because I was in bed with 102 fever?!!!!! I am better today, and plan to go to my last appointment at 4:30. Today is the day!

Two more left

I'm not quite sure how the number of treatments changed again, but I will be stopping at 33. Thursday, April 2nd is my last day of radiation.

They stopped treating the entire breast last Thursday, 3/26. Beginning last Friday they began shooting a lower amount of radiation to just the scar site. They call this a 'boost'. The purpose is to give the area of cancer occurrence just a little bit more radiation.

Overall, I am feeling ok. I haven't the tiredness I expected....a good thing. My skin in the area of treatment is darker. Some areas are pink, some red, some brownish (the external skin has died) and some areas are raw from the skin peeling off.

I see Dr. Paneras tomorrow to receive a prescription for the estrogen inhibitor -tamoxifen- that I will begin taking soon. I think the worst may be over.......

The 17th of 37 treatments

It's hard to believe that I'm not even half way through with this. It feels like such an established routine! I leave work at 3:30, walk home. Get in the car and leave the house at 3:45. I get there at 4:20, leave at 4:45 and am home around 5:20. Weird.

Still, the only side effect I've noticed is that the area being treated is turning pink, like a sunburn. There is no pain, and I don't think I am any more tired than usual. Thanks for the thoughts and prayers. All is well.

Finished 9 of 37 treatments

All is going well. I am feeling fine and I don't notice anything that I can really attribute to the radiation treatment. I am a little more tired, but that may be because I am getting up earlier to get to work earlier so I can leave at 3:30 to go to my 4:30 appointment. Finding 2 hours in my day to do this is definitely the challenge.

If the machine continues to work each day, my last appointment is April 9th. It's going to be a long March.

Day 2 done

Don't worry, I won't be posting every day :). I just wanted you to see this machine (I added a happy face about the size of my head, so you could get perspective):

1 down, 37 to go

Well, the planets and stars aligned and I have been radiated :)

Very similar to having an x-ray. Not a big deal. I was home at 5pm.

My wonderful co-workers all wore pink ribbons for me today (and ate pink m&m's) and gave me a nice card. It was very emotional to see that kind of display - thanks to you all.

Broken Machine

The Radiation Tech called this morning and canceled my appointment. The machine is down. We'll try again tomorrow. These delays are beginning to be comical - I doubt I will ever really begin radiation.

'Dry Run' went fine

All went well today. Getting me on the schedule is going to be tough - They are very booked. Right now my appointment next week M - Th is at 4pm each day. Beginning Fri I change to 4:30. They have me on a 'wish list' for 3:45. The good news is I don't have to miss school.

What a BIG machine.

Radiation Appointment

Well I'm pretty well healed from the last surgery. Today I went back in to prepare for the radiation treatments. They felt the best thing to do was repeat the set up because shape and size changed (slightly) due to the surgery. They WERE able to use the tatoos they did last time....that was good.

I go back on Thursday at 2:15 for a 'dry run'...still no treatment. As of today I will begin radiation on Monday, Feb 16th. Time is still TBD. I asked why they couldn't begin on Friday and they said they usually want at least 2 treatments before the weekend recovery period. Just one treatment would be ineffective.

Oncotype DX results

Dr. Paneras called. NO CHEMO!!!! WOOO HOOOOO!

My Oncotype DX score is a 13. Any number under 18 is considered a low risk for cancer recurrence and Chemo is not prescribed. Radiation here I come!

Surgery check up

Saw Dr. Cole this morning. He said the incision looked good. There were no cancer cells in the skin that was removed last Friday. It's about time we had some good news around here.

Still awaiting the results of the Oncotype DX test (should be this week or next). Next appointment is Feb 10th with the Radiation Doctor. I expect to start radiation treatment that week pending oncotype.

Surgery went well

Much better than last time. We did a local anesthesia and a sedative that put me to sleep - much better than general anesthesia. I felt and heard nothing... and I didn't throw up for hours after!

Now the doctor's have all the margin they needed. I am still awaiting the results of the Oncotype test. I will see the surgeon for follow-up on Thursday. I have an appointment with the Radiologist on Tuesday, 2/10.

Ok, I'm back to moving forward. I feel better now.

More Cutting

Dr. Cole said that he needs to remove an elliptical piece of skin at the scar site. This is to ensure that enough of the flesh around the tumor is gone. They have specific protocol for the amount of margin they need based on certain pathological information that they don't know until after they examine the tumor. All Dr. Cole could tell me was that the pathologist changed his mind about how aggressive one of my tumors was. Because of this, he now needs to take more margin and the only margin left is the skin. It is still considered a stage 1 cancer. I need more information so I am requesting the pathologist's reports. What made him change his mind and when?

This will be a simple procedure under local anesthesia with a sedative. It is outpatient and will occur at St. Jude Friday, 1/23 at 3:30pm. Terry is taking me. No grafting or drain is needed.

Dr. Dolkar's office said to schedule an appointment in 2 weeks to begin radiation (pending Oncotype). She's not sure she can use the same marks that she made on Monday so I may have to go through that again.

That's it for now.

Going back to see Dr. Cole

I spoke to Dr. Paneras around 3pm on Tuesday. He has me scheduled to meet Dr. Cole (surgeon) Wednesday-today at 1:45 to talk about removing more skin. Apparently, this cancer board is directing my treatment, not the doctors I am meeting with. The positive twist is that groups tend to make better decisions than individuals. The board is also showing itself to be more conservative than Paneras. I'll check back later today, but don't be surprised when I give you a date and time for the skin removal surgery.

Terry keeps reminding me that this will all be done in a couple of months.

From bad to worse

Appointment with Dr. Dolkar went well this morning. They spent about an hour adjusting, taking pictures and poking at me. She didn't like that the Oncotype test hadn't come back and said that she would be calling Dr. Paneras to discuss. When I left there at 11am I was scheduled to return for a 'dry run' on Wednesday with radiation beginning on Thursday.

Dr. Dolkar called at 6:30 tonight. She told me that my case was presented to 'the cancer board' today (a group of doctors in my medical group specializing in cancer who discuss the group's cancer cases and make recommendations). She said they discussed and decided a few things:

1) One of the 2 tumors was more aggressive than the other, they want to make sure that the Oncotype testing is occurring on THAT tumor.

2) They are concerned about not having taken enough margin (I thought that had been answered) and they want Dr. Paneras to discuss this with Dr. Cole. They may want to remove skin to ensure enough margin.

3) They do not want to begin radiation without the results of the Oncotype test so my appointment Wednesday will not happen.

Dr. Panaras left a message for me to call him in the morning. I will provide an update tomorrow after I speak with him - hopefully he will have spoken to Dr. Cole by then.

How am I? I have been better. I am glad Dr. Dolkar got involved and I am glad my case finally got before the board. I am not happy about much else. I will lose a whole lot of confidence in Dr. Paneras if I need skin removed, and/or if I need chemo. For the last few days, I have really liked knowing my course of action. I am now back in the realm of the unknown and my anxiety is increasing.

Just not going smoothly....

Results not in....in fact they never even got approval from the HMO to run the test. Incompetence that affects my life is a whole new, unpleasant thing. After my fuss, Dr. Paneras and I decided that we should go forward with radiation next week. We will still look at the results of the Oncotype test when it comes in - he will call me. I don't have an appointment with him again for 6 weeks.

He stated today that he really just ordered the test to confirm what he believes to be the case, so he is pretty confident that I won't need chemo. If chemotherapy is indicated, we will now do that after the radiation - not ideal, but better than not starting treatment now.

I will see the radiation doctor again on Monday and will begin treatment on Wednesday. I spoke with the scheduling people today and while they can't schedule my treatments until after my Monday appointment (they won't know which machine I need until after they measure me) they assured me that they will work hard to accommodate my work. Have a great weekend everybody!

Consultation with Radiation Oncologist

I met with Dr. Dolkar today. She explained about my radiation treatment. Because 2 lumps were discovered, the entire left breast must receive radiation - I can't just have the localized treatment. I will need to go for 20 minutes per day, M - F, for 5 1/2 weeks.

Although we are still awaiting the results of the Oncotype test, she agreed to meet me on Mon 1/19 to begin setting up the mechanics of the therapy.....tatoos, programming, imaging (they need to minimize the radiation to my lungs and heart). If the oncotype results indicate the need for chemo, I will cancel this appointment and delay the radiation treatment until after the chemo is completed. If no chemo is needed, I will probably begin radiation treatment on Wed, 1/21.

I will meet with Dr. Paneras, oncologist, on Thursday 1/15.

All is well.

Next Step

Happy New Year Everybody!

I met with Dr. Paneras, oncologist, yesterday. He was great and spent about an hour explaining things to me. He said I will see him every three months for the next three years! He thinks Dr. Cole took out enough margin so they don't need to go back and take skin.

He wants to perform an Oncotype DX test on the tissue that was removed to determine my propensity for cancer recurrence. This test gives a recurrence score based on genes and proteins and helps determine whether or not I will benefit from chemotherapy. The results will take about 1 to 2 weeks during which time we do nothing. He referred me to a Radiation Doctor although Dr. Paneras doesn't want to begin radiation until after we know about the results of the Oncotype test. If chemo is recommended they prefer to do that before radiation.

Because I am still pre-menopausal, they recommend that I take tamoxifen for the next five years (I will switch to a different med post-menopause). I begin this after the other treatments.

What's next? Consult appointment with the Radiation Doctor on Jan 12th, then next appointment with Dr. Panares on Jan 15th.

How am I? Fine. Physically? normal numbness at the incision sites. Some tenderness radiating down the arm and back from the site - I will call Dr. Cole about this. Emotionally? just dandy. This is just an inconvenient blip in my life. I respect it, but I don't fear it. I will do everything possible to ensure its demise. Here's to 2009. Cheers.

Appointment Set with Oncologist

The oncologist's office called today and the next available appointment is Wednesday, Dec. 31st at 9am. I knew the holidays would cause more delays.... I asked if there would be much delay in beginning radiation and they said it should move quickly. My personal goal is to begin radiation the week of Jan 5th - that's 4 weeks from the surgery date. From what I've read, you should begin radiation within 4 - 6 weeks after surgery to allow for recovery but without waiting too long. Apparently, waiting longer than 6 weeks diminishes the effectiveness of the treatment.
More waiting.....

Merry Christmas Everybody!

Good News!

Drain is OUT!!! That has been such a focus that I almost forgot about the other questions to be answered today - here goes: The cancer was stage 1 (Yippee). The more official test of the lymph node showed no cancer (Yippee).

I will meet with an oncologist next week to discuss the next treatment. Dr. Cole said they want the area to heal for 4 weeks before they begin radiation, so I won't begin that treatment until after Christmas.

Two interesting things: There were actually two lumps of cancer, not one. They were close together, but separated by normal cells. Also, the lump was very close to the skin so the surgeon is not positive that he took enough margin (flesh around the lump). To take more means to take skin. He will discuss this with an oncologist and let me know if there is more to do.....I hope I won't need another drain!!!

I am still 'with drain' :(

Dr. Cole got called to the ER and he had to cancel my appt. There was no one at his office who was qualified to take the drain out and I ended up having to reschedule my appt for Wednesday.

Those two sentences sound nice and calm.....I was not. I totally overreacted to the poor girl behind the counter (they had tried to call me at 1:30 and I never heard the phone). It wasn't the inconvenience of going to Fullerton for no reason - it was the idea that I have to spend another 24 hours attached to this plastic bottle!!!! I think I really hate this thing. It has truly replaced the lump as my current object of disdain.

The Cake

Nothing new...I feel ok. Can't wait for Tuesday.

Many comments about the pink cake my boys made. I decided to share it with you.

Proof of feeling better

(and way too much 'sitting around' time.....)

Click here to see what I mean!

Make sure your sound is turned on.

Feeling Pretty Normal

Well except for the drain, and some slight site pain, I feel fine. Back to school today!

I called the doctor's office yesterday - he is at a conference in Boston until Dec 15. I have an appointment to see him on Tuesday, Dec 16. My hope is to get the drain out and set up some radiology times. Let's hope his goals align with mine :)

Feeling good

Hi all! Things are going well. I am feeling good and not in very much pain. I am reading, watching movies and working on my digital photo albums. I will do some internet Christmas shopping later today. I appreciate all of the comments on the Blog - thank you all.

All is Well

Hi everybody! We got home last night at about 6pm. The boys surprised me with a homemade pink cake (what great kids!).

It looks like I have 2 scars...one for the lump, and one for the lymph node (so they could sample for cancer). I also have this drain that I'm not exactly fond of. I have no restriction on movement and can move my left arm with only a little pain. I think I should be ok to teach on Tuesday.

Except for slight pain under my left arm, and occasional nausea, I feel normal - much better than I expected I would feel. I love that the cancer is out and that it wasn't found in the lymph nodes. My anxiety is down for the first time in weeks. What an ordeal. Thanks for all the love you have sent our way!

Surgery is over

Hi All, Terry here. I just talked to the surgeon (1:15pm on 12/5) and he said that Marie's surgery is over and that all went well. There was no indication that the cancer had spread outside the lump so just the lump and some surrounding tissue was removed. This is VERY GOOD news. I'm sure Marie will have an update later today or tomorrow but I wanted to get the word out that things are fine.

PS, I'm sure Marie would like to hear from you, if you can, please leave a comment by clicking on "comments" below.

Pre-op done

I went to the doctor's office today for a Pre-op EKG and blood work. While there, I got copies of the Radiologist's mammogram report from 12/07 (pre-detected lump) and 10/08 (post-detected lump). Both reports were identical. They noted that the breast tissue was dense. They showed nothing noteworthy.

Wow! The cancer I have in my breast did not show up at all in the mammogram. It could very well have been there for other mammograms. It may have been growing for years undetected! Of course last December I also had a physical breast exam that didn't turn up anything, but how accurate is that? I have lost confidence in mammograms for me. I wonder what my alternative will be?

This week can't go quick enough for me. I'm done with this lump.

Date for Lumpectomy

After a bit of back & forth, I have decided to have the surgery on Friday, December 5th at 12:50 pm at St. Jude Hospital. Unless something different happens than expected, I will be home that evening. It is not at the outpatient center because my surgeon goes to different venues on different days. His Friday venue is the hospital.

If there is no lymph node cancer I should be back to work in a few days. If the surgery has to be more extensive, then I may be home for up to two weeks. That's not gonna happen.

I am good with this. It gives me a little more time to read more stuff about breast cancer. Michelle spent this last weekend walking at the Susan G. Komen walk in San Diego. She brought me a "Cancer Sucks" button and a great, new statistic: Breast Cancer caught early has a 96% survival rate!! What a great number!!

The Waiting Game

The person who schedules surgery was not in today. An assistant checked the schedule and it shows a tentative date of Friday, December 5th for my surgery. The assistant told me that the scheduler will be in on Tuesday, Nov 25 and will call me. It's further away than I had hoped, but it we'll see what happens tomorrow. I'll let you know......

Thanks to everyone for treating me in such a normal manner. It's still just me - Marie

MRI Results

Good News! Dr. Cole just called and said that the MRI shows that the cancer cells are only in the area of the lump, not in any other part of either breast. Cancer may still have moved to the lymph nodes, but we won't know that until the surgery.

We have decided on a lumpectomy. He is setting everything up. The office will call me on Monday with information on the date and time. It will be soon.

The rest of the biopsy results

We have been awaiting the second set of results from the biopsy. I thought these results were to determine if the cancer has spread outside the walls of the lump. I was wrong....they show if the cancer has moved outside of the cell wall. Conclusion - the cancer has spread outside the walls. It is called Invasive Ductal Carcinoma, Grade 1. This is in addition to the Ductal Carcinoma-in-SITU, Low-grade, Cribriform Type. What this tells us is that the cancer may have moved to the lymph nodes. We won't know until he has pathology done during the surgery.

The MRI results were still not available. These results will tell us if there are other spots of cancer on either breast. Dr. Cole is hoping to have this answer in the next 24 hours.

We will probably opt for a lumpectomy followed by radiation, but the course of treatment won't be solidified until more is known. Mastectomy, chemotherapy and hormone treatment are also possibilities. Surgery will either be next week or the following week.

Terry and I spent about 30 minutes drilling Dr. Cole this morning. He was humorous, informative, compassionate and very dedicated to treating the whole patient. He spoke about this being a stage of life that we go through that makes us better people (that's the short version). Terry and I were both very comfortable with him and came away feeling good about being treated by him and his organization.

Thanks, Michelle, for sending me to the Susan G. Komen website. There is great information there.

MRI

I did it! I was able to lay in the tube for 30 minutes without freaking out! I was on my stomach - that helped a lot - I just pretended I was at the beach :)

No Music, no MP3 player.....they DID provide earplugs thank you very much. The noise resembled an automatic weapon.

They gave me an IV so they could add contrast. Any mass that shouldn't be in my breasts will show up. My doctor will have the images when Terry and I see him in the morning. By 10am I hope to know exactly what we are dealing with.

Humbling technology!

Results of Biopsy

I met with Dr. Cole to get the results of the biopsy. His phrase was "the results didn't come back the way we had hoped." Interesting...he never used the "C" word, but carcinoma was all over the report. He gave me a copy of the biopsy report. Here are the words:

"Atypical Epithelial Proliferation, highly suspicious
for infiltrating ductal carcinoma. Associated
ductal carcinoma in situ, cribriform type.
Hormone receptor and HER2 stains pending.
Expert consultation pending."

We are still awaiting the results of the test to determine if the cancer has spread outside the walls of the lump.

He said the next step is to have a Bilateral Breast MRI to see if there are any other lumps that we can't see or feel. This, and the results of the test to see the spread, will help us determine what to do next. He guesses the course will be surgery, radiation and hormone treatment.

Our boys took the news ok. We are reassuring them that although this is cancer, breast cancer is very treatable these days. If I stay upbeat and positive the boys do well.

MRI is scheduled for Wednesday, November 19th. Terry and I will meet with Dr. Cole on Thursday, November 20th to hear the recommended course of action.

Ultrasound guided needle biopsy

I went to the St. Jude Breast Cancer Center for the biopsy. I didn't think it would be that big a deal. I was wrong. It wasn't painful, but it was scary. Each time they took a sample they positioned and then 'shot' a hollow metal tube into the lump. I did not like the noise of this tool! They took about 5 "string-looking" samples, each about an inch long. I was very happy to get home around 6pm.

They measured the lump again. Today it was 2.2 x 1.3 x 1.3 cm.

Meeting with Surgeon

I met with Dr. Cole. He felt the lump and looked at the ultrasound. He said we won't know what it is until we have the results of a biopsy. He set the biopsy for November 4th.

Breast Ultrasound Results

Dr. Murashige called on Thursday with results. I wasn't here, so he spoke to Terry. He said that the pictures show something there, and that I would need to met with a surgeon to move to the next step. He said that only a biopsy can rule cancer out - the technicians had spoken out of turn. Frankly, I liked being misled......it didn't cause me as much worry.

Breast Ultrasound

On Monday, Oct 20th I went for the breast ultrasound. This technician also felt that my lump did not fit the cancer profile. She brought someone else in who agreed and said she felt lots of lumps in that same breast. We could barely see the lump and she had a hard time registering it. I left feeling pretty good that this was not cancer. Awaiting official results.

Mammogram Results

The phone call I received regarding the results was confusing to me. The technician said that I needed to go for a biopsy, but that it was not an emergency status. I said to her, "does that mean it's not cancer?" She said it was not cancer.

Because of her answer, I agreed to wait almost 2 weeks to have the breast ultrasound. At least it was two weeks thinking I was cancer-free.

The letter that I received in the mail a few days later regarding the mammogram said that I needed to follow up with my doctor.

Mammogram

Mammogram occurred on Monday, October 6th. Yes it was a long weekend. The tech and I looked at the digital images and could see nothing. We compared them to the last ones from Dec 07. The new ones looked no different. The white paint splotch that we expected to see if this was cancer did not appear. I felt some relief....but we needed to await the Radiologist's report.

I found a lump

On October 1, 2008 I found a lump in my left breast. I am good about annual mammograms, but not about monthly self exams. My last mammogram had been Dec '07 with normal results.

Not sure what made me physically check for lumps, but I did. I was lucky to get in to see my doctor the very next day (thank you, Terry).

Dr. Murishige told me that he did not like the location, the size, or the fact that it felt solid. He thinks it's about 1.5 cm (the size of a marble). He ordered a mammogram and an ultrasound. Those tests will then indicate the need for a biopsy.

He said that breast cancer, if that's what it is, has come a long way in the last 10 years. It is generally very treatable.