Wednesday 4th - General Update

This blog entry will be an email as well, so apologies for anyone who gets sent it more than once. It's a general update on what's happening.

I had my surgery last Friday, on the 27th of February. February sure has been quite a month for us! The latest operation was for 2 reasons:

1. A second W.L.E. (wide local excision) to make sure all the pre-cancerous cells are removed. They take a second 'wedge' from the breast, the tissue around where the first wedge was removed, so they can be certain that they got not only the cancer, but also the pre-cancerous cells around it.

2. The axillary clearance (I finally spellt that right). This is where they take the (breast) lymph nodes from under my arm. They did that because during the first operation they did a S.N.B. (sentinel node biopsy) and found that 2 nodes out of 7 had the potential to be cancerous.

It was an easier surgery in terms of knowing the 'drill' at the hospital, but definitely a harder surgery to recover from and get my head around.

Today (Wednesday 4th) was meetings day again at the hospital. We met with the doctor, a nurse, the main breast nurse, and the physio. They even seemed to be running on time and we never waited for longer than 10 minutes. Amazing!

Doctor Ben
Firstly, we met with our registrar, Ben, the one who gave us the bad news 2 weeks ago. He's a doctor of course, but I think of him as 'Ben' because I'm sure he's younger than I am! Plus he's so friendly and nice.

He told us that they are just waiting on the absolute clarification of my results from the second W.L.E (wide local excision). He reckons it's looking good, but they have to double-check with the pathologist and the doctor who did the surgery to be absolutely 100% sure. I am not holding my breath this time.

Axillary Clearance
The axillary clearance (removing the lymph nodes) was a success. In the first S.N.B. (sentinel node biopsy, at the time of the first operation) they took 7 nodes and 2 came back saying they had potential to have cancer. Apparently you only have to have 1 to get chemo. So when they went back this time, they took a further 18, that's 25 in total. Of the further 18, 0 came back with the potential to have cancer. So that means, 2/25 had it. So, that was kind of good news! Plus, it may mean that I won't have radiation therapy to my armpit, just to the breast. The radiation therapy to the armpit can increase the chance of lymphodaema, so it's good not to have to have it. Yay.

Type of Cancer
The type of cancer I have is called "Invasive Ductal Carcinoma", 30mm, Grade 2, and Ductal Carcinoma In-Situ (DCIS), which is the pre-cancer. They definitely removed the invasive ductal carcinoma during the first operation and were working on removing the DCIS with the second operation. The cancer I had is ER positive, PR positive, and HER2 negative. That means that it is one which can be treated with hormones. Something like tamoxifen but not herceptin. Herceptin is for the HER2 positive one. The good news is that it is a very common kind of cancer, so they know what kind of chemotherapy is good for it.

Drain
I also had my drain removed. Hooray! So great not to be carrying that little bag around with me, and I've already noticed that I have much more movement.

Physio
We saw the physio, Hildegard. She was great too - lots of down-to-earth sensible information about taking it easy but also getting mobile and doing my special exercises as well as normal everyday exercise. She said that my exercises should go to the point of discomfort but not pain. And that I should pat and touch my numb bits because eventually the nerves will respond. That was really good advice because until then I'd felt weird touching my numb bits. It may be a full year or so before I get (almost) full sensation back. At the moment it's very weird. She also told me to make sure that I get plenty of rest as well, to recover from the anaesthetic.

What about IVF?
That's still going ahead. I'm on the synarel, which puts me into menopause (yes, my breasts have shrunk even more!), and tomorrow I'll be starting the FSH (follicle stimulating hormone), so that my ovaries make lots of follicles which will make an egg each. It will be Hormone Hell for 2 weeks and then the egg pick up will be on 18th March. All very exciting.

What does it look like now?
Well, there is still a bit of swelling I'd say, but it still looks like a breast! Yay. At first I thought it was going to look really small, and it did seem really small and little compared with the other one. Kind of A cup on one side and D cup on the other! But now that the other one has shrunk because of the artifical menopause that I'm in, they almost look the same. I'm amazed. Apparently the doctor took over 25% of the breast.

Will there be further surgery?
I really hope not. I take my hat off to those amazing women who have gone through multiple surgeries. But I guess when it happens, we just do it and deal with it. If there is further surgery, Ben talked us through how the reconstructive surgery works. But we'd talk to the plastic surgeon about it in more detail if it came to that. Basically, there are 3 options after a mastectomy: 1. No reconstruction, 2. Immediate reconstruction that gives general shape but not definition, and 3. Later reconstruction which is more involved, taking muscle and tissue from other parts of the body plus nipple reconstruction, which would be several hours of surgery. Both surgical options are covered under medicare (which is amazing).

Is Radiation Therapy and Chemotherapy still on the list?
Yes. Next week, we'll find out for sure the results from pathology and move on from there to talk to the oncologist (which will probably be the following week) about the next stages of treatment.

Will it re-occur?
It is quite likely that at some stage of my life (because I have a fair bit more to live!), that I will deal with it again. I'll have yearly scans and mammograms from now onwards. I asked why scans weren't regular like pap smears, and it's because there are far more people who have cervical cancer than breast cancer (at the moment) and they do what their budgets allow them to do. In an ideal world, we'd have all kinds of tests, but we don't, which is why it's so important to keep an eye on your own body and inform someone about any changes. Girls, when you check, check in the mirror with your hands on your hips, at your side, and above your head. All angles please!

Dad
Dad comes to visit on Monday. Yay. He'll stay with Don, who lives only a couple of suburbs away from us. I might suggest to him to rent a car for the duration of his stay, because the bus/train connection between our two places isn't that great. It will be good to see him.

L
L has been fabulous, on the whole. A few hairy moments but we're working through it together. I'm sure he'd love to hear from you as well, just to see how he's doing. At the moment I'm so lucky in getting wonderul thoughtful emails and texts and presents and flowers, but he's not getting anything poor guy! He's going to work full time next week, except Wednesday, when we have our follow-up appointment at the hospital and also at Eve Health (fertility). It will be good to get back into a somewhat 'normal' routine again.

That's about it for now. Just waiting for next Wednesday and lots of resting but also my special arm exercises and gentle normal exercise.