Ugh - Oncologist Update

My first reaction after our meeting with the oncologist was "Oh Sh#$%*"


Long ago and far away (OK, it was a little more than 2 weeks ago), when we first met with the breast surgeon and the oncologist, the clinical diagnosis was very encouraging - small-ish tumor (1.1 cm) and unlikely there was anything in the lymph nodes. Do surgery, a little  endocrine therapy - life is good.  Here we are a few weeks later and things are a bit different. Here is a summary of what we learned today:


First, we learned that Julie will have to do another surgery. It appears from the pathology report that there is still some cancer that apparently wasn't removed - they call it margin positive. Cancer cells are still within the "margin" that was left behind and they must be removed. 


Second, we learned the stage of the cancer - It's stage IIB (not as good as Stage 1, not as bad as Stage 3). This is based on two main facts.  One, the tumor was twice the size that they estimated in the original biopsy. The biopsy put it at 1.1 cm, and pathology showed it was 2.2 cm (.86 inches). Two, the cancer has metastasized into her lymph node(s) (as we found out during surgery). The good news is that her HER-2 Status was negative (HER-2 is a gene that can predict growth - too many HER-2 receptors on the cancer cell means they likely grow faster); and they only found cancer in the one lymph node - no other sentinel or axillary nodes were cancer positive. And, the one that was positive showed negative for extracapsular extension (meaning it was only in the node, not into the rest of the tissue - good news).


Third, we learned a lot about chemotherapy and endocrine therapy options, including the potential for Julie to participate in clinical trials. The statistics are scary. For starters - based on her grade and stage, there is a 45%-50% chance of cancer coming back in the next 10 years without any post operative therapy. This of course goes down with chemo and endocrine (hormonal) therapy. There was so much information that we both felt overwhelmed. We have a meeting to go over all the details in two weeks.  We will likely start chemo the last week of August - there will probably be 6 sessions, each session done every 3 weeks. 


So, here are the next steps

• Meet with plastic surgeon tomorrow to hopefully get last two drains out. Drains out = ability to shower = good!
• Meet with Genetic Counselor tomorrow - discuss history and determine if/when we should perform genetic testing
• Meet with Dr. Green tomorrow to review pathology report, try to schedule the surgery to get the rest of the cancer out. We will also try to schedule insertion of chemo port at the same time so she doesn't need yet another surgery.
• Schedule chemotherapy sessions. We have a follow up session with Dr. Kim in two weeks.

Needless to say, this was very difficult news for us. Afterwards, we both say in the car and cried. Actually, the first thing we did was pray, then cried. OK, we cried while we prayed. There is an amazing team behind us, the cancer nurse coordinator Cindy is amazing, and she and Dr. Kim are huge cheerleaders for us. This is going to a marathon - it will probably be a year before things get back to "normal". Make that "new normal". God's presence is  very evident. His peace comforting. We will take this one day at a time. Its the only way we know how.

One more important thought - there as so many, many people who have gone before us and will go after us in the fight against cancer. We are just one small story, and by no means the most difficult or aggressive, or painful. We learned of a friend named Kari who has already had a lumpectomy, and just  found out she has brain cancer. Another friend's young daughter has been through chemo hell for a large tumor in her leg. Another friend's husband has 6 brain tumors. If you are praying for us and the Lord brings it to your heart, please pray for them, and so many others who are suffering!

Specific prayer requests:

• Healing - please pray for every cancer cell to be removed and to never come back
• Peace - this is fairly overwhelming for both of us, and I am sure our girls also (who are being very strong, but are concerned). There is so much unknown, but it is so helpful to know how many people are praying and supporting us, and of course that none of this is a surprise to God.
• Minimal side effects of therapy - this is a huge prayer request!
• Scheduling and minimal hospital stay for the follow up surgery
• Wisdom - for the doctors who are treating her, and for decision to be made on treatment and type and frequency of therapy.
• Joy - that we may have joy in the journey, despite the pain.
• Hope - that we never, ever lose hope
• Love - that we can share God's love with others as we walk through this.

Thank you all for your prayers! We covet them.

Blessings to all