I’m not the only one in the family with cancer. Troy’s 84-year-old step-dad, Russ Kearby, is also struggling with liver cancer. Today was bad for him. He has been in the hospital for three days for what was supposed to be a one day visit. They were supposed to re-do stints that were draining his liver, but on the first day only managed to do one. The second day, they did the other, but it wasn’t working well. Today, they tried again on that one and he has now developed sepsis. Troy & I are at the hospital right now. He’s been battling very low blood pressure and a very high fever. The doctor had Jan (Troy’s mom) sign papers for a ventilator and they made sure his “Living Will” was in place. At one point, they told us he might not make it through the night, although in the last 1/2 hour or so they seem to think he is doing better.
So, we are here. And we wait.
As for me, I had a visit with my oncologist this afternoon. It was fine. I didn’t learn much, except he admitted they don’t know what they are doing when a 34-year-old breast cancer patient shows up! I asked about the possibility of delaying hormone therapy after chemotherapy, allowing me time to have a baby. He thought for a while and said, “I think we could do that. I don’t see why not. Although, I don’t think I’ve ever had that question before.”
My prognostic indicators are mixed, which I had figured out from reading my pathology report, but thought maybe I was reading it wrong (since I’m not a doctor). But I was right. My tumor size is officially 2.2 cm, which isn’t great, but isn’t the worst it could be either. The characteristic of the tumor is poorly differentiated, which is really bad. Really, really bad. However, there is no cancer in the lymph nodes, which is good. There is cancer in the blood vessels and lymphatic channels which go to the lymph nodes, which is bad. My hormone receptors are estrogen and progesterone positive, which is good for treatment options. It’s bad because of my age — ER and PR positive people under 35 have a worse prognosis than ER and PR negative people.
The doctor mentioned a site in passing where you can plug in indicators and get ideas of prognosis. He wasn’t telling me to go there, but I did because I was curious. With surgery to remove the tumor, I have about a 75 percent chance of surviving the cancer for 10 years. With chemotherapy, the chance raises to about 82 percent. With hormone therapy it raises to about 88 percent. As a point of comparison, if I had a well-differentiated tumor with these other indicators, my odds of survival for 10 years go very close to 100 percent. A well-differentiated tumor that is ER+ and PR+ is very common in older women, which explains the very good odds with breast cancer survival these days.
I unfortunately did not get clear answers about surgery, radiation and reconstruction options. I will need to call my surgeon again tomorrow to clear up some things. I did find out that I will be having chemotherapy for sure, probably for six months. I will probably not have radiation, but that depends on how close to the chest wall the tumor is located. And whether I can have reconstruction during the mastectomy depends on how close the surgeon thinks it is, because it’s not a good idea to get reconstruction THEN have radiation. The preferred method if it is close to the chest wall is chemo, radiation, then reconstruction, which means I’ll walk around with one breast for 18 months or so.