B: We’ve gotten happy news lately, and we’ve completed the neo-adjuvant chemo.  Ironically this hasn’t been just butterflies and light.  From what I’ve seen,  P has been so focused on getting done with Chemo, that she kinda lost sight of the ball.  We’ve had to deal with a lot more, and different, side effects this round than any previous — even the first round.  It didn’t help that the doctors scheduled tests immediately after the treatment.  So, days that should have been spent in bed were spent fasting and traveling to and waiting for tests, some more than an hour drive from home.  Sure, the Oncologist dropped the happy bomb, that the cancer appears to be dead, but, she really didn’t help us understand what that means. I think that created a bit of false hope for P.  Similarly, the alternative health care providers were too quick to jump on the good news and encourage us to question everything, all of which distracted us from the path we knew we were on.  Point in fact Oncologists and Surgeons speak different languages.  Many Medical doctors are not holistic in their treatments and it is unreasonable to expect them to be. Alternative health care has its contribution to make, but perhaps should remember that Surgeons and Oncologists are professionals too.

I think we are settling down and getting back on track but the past week hasn’t been easy.

P: Reference has been made to my being something like Winnie the Pooh… so when I see a hive dripping with golden honey, I’m there.  Shiny things do that for me too.  Brother #3  has consistently told me to keep my eye on the ball since I was diagnosed.  He and our sister in law went through this about 9 years ago… B was right.  I stopped looking at the ball and was distracted by the glitter.  Almost like I was ignoring what I could see and feel.

We now have a bit of understanding that the PET scan (oncology ordered) looked at whether we eradicated the cancer.  It looked at my whole head and trunk to see that nothing responded to the radioactive dyes they injected an hour before the “shoot”.  The oncology ‘sight’ is set on this target.  Did she prescribe the right ‘treatment’ for this intruder?  Her exam confirmed the PET results.  What she was feeling must have been scar tissue.  From what we now understand, the PET results give no information to the surgeon except that progress has indeed happened.

A side note:  Did you ever have a really weird day or a headache and think  ‘I swear I must have a tumor the size of Chicago in my brain’ or something like that?  Well I have no excuse now for those moments.  We know that there is nothing growing in my brain (including new brain cells from what I can tell today).  I’m grateful to know that I apparently don’t have a brain tumor.  I doubt that PET scans will ever be routine as sonograms now are for pregnancy (don’t get me started on that one), but some people might like to know.  OR perhaps not knowing is better.

We know that the surgeon ordered the MRI to see what exactly she was now dealing with.  It is her job to get whatever we don’t want in there out.  Her exam had a very different flavor than the oncology exam.  Her feeling something still there and seeing the shape still somewhat distorted, though much more normal, gave her the first inkling that she still had a job to do.  As we looked at the ultrasound pictures from before and after, and at the radiologist comparison of the two MRIs, we came to understand more.  They were so specific to this breast cancer.   Is what is left benign or malignant?  How much lymph node involvement is there?  We don’t know from the slices of images that the miracle of MRI gives us.  We DO know that the radiologist saw a 4.2 centimeter mass in August, and now sees a 7 millimeter thing that may be the shrunken mass, or may have been obscured by the original very concerning mass.  We do know that chemo eats away (in a swiss cheese sort of way) at the cancer, and this has happened successfully.   The mass is more hole than cheese, so to speak.

One other thing that has became clearer is that the lymph nodes are a significant factor in the future of treatment.  A biopsy occurs during surgery.  The nodes get sent to the lab like a hot potato and analyzed to inform how many she should remove while I’m still on the table.  She may get all the information she needs at that moment, or it may have to be sent for analysis, results in 3 days.  Then she may have to go back in.  SO reconstruction at the time of surgery would not be the best choice, because once a beautiful job is done, it would have to be cut open again.  Once this analysis is done, we will know whether radiation is necessary after surgery.

I am writing all this down to hear myself think, and to give you some idea of how much we know and don’t know still.  Each case is so unique.  Kudos to all the patients in these waters and all of the people supporting them.  Kudos to oncologists, surgeons and alternative practitioners.  And kudos to whomever can help all of us navigate the seas between.

Surgery is scheduled for Nov 10.  This gives my body time to settle down from the chemicals.  I am grateful to think that I’ll be more than 14 days away from the last infusion a week from today.  It’s been 8 weeks since I’ve had a day 15, if you know what I mean.