Tuesday, July 6, 2010

Onco visit...my head is spinning

We had a long, informative consultation with the oncologist who is unquestionably recommending 4 sessions of chemotherapy for my aggressive Grade 3 tumor.  We still don't know the HER2 status or anything else, really, as the Pathology Report remains incomplete.  More waiting sucks...

He put the facts we have available at the moment into a computer model (Adjuvent! Online) and came back with the answer to the math question using currently available information, in graph form.

Assuming surgery, radiation and clear nodes,  ten year survivals look like the following for a 60 year old, average-health person (damn that diabetes, guess that I don't qualify for really healthy person status...lol):

For every 100 women with breast cancer:

With no additional treatment:

62 will be alive
7 will die of other causes
31 will die of cancer

If you add just hormone therapy:

an additional 8 will be alive (that makes 70 alive)

If you add just chemotherapy:

an additional 7 will be alive (that makes 69 alive)

If you add both chemotherapy and hormone therapy

an additional 13 are alive (that makes 75)

Bottom line...adding chemotherapy adds 5%

Chemo seems a lot to endure for only a 5% statistical edge.   Hormone therapy is not in question.  I will absolutely do that.

The Oncotype DX is still in the works and I told him I had to see that report to make a final decision on chemo.   A low score (which he feels is unlikely) would make him feel more comfortable with a "no chemo" decision.   A score above 20 makes me feel more comfortable with a "suck it up and do chemo" decision.

He answered my 20 questions and more.  One of my biggest concerns with chemo is the steroids that are administered.  He said he typically reduces them by about 2/3 for diabetics.  

He gave me his card, including his cell phone number.  Relationship-wise, I think he's OK.  I haven't talked to anyone who has been his patient, so I don't know how he ranks around the area.  I am having to trust the breast surgeon on this referral, at least for now.   He certainly got the picture of just how damn scared I am, and how much I don't want to do chemo if there is just a tiny benefit.

So that's today's medical adventures...I'll be seeing the radiologist tomorrow.  I think that will be a tad easier...there is no decision here, it's a forgone conclusion.



  1. Do you know why the Pathology report is taking so long? Is this normal? I'm sure you mentioned to the Dr. that you need all the information before you can make a firm decision. 5% help from chemo doesn't sound like that much help. Good luck with the Dr. visit tomorrow. You will continue to be in my prayers.

  2. Gosh Michelle...that DOES suck that you can't get the pathology report. I'm sure you've read up on chemotherapy and what it does to the body. I haven't, so I can't make a call on that, only 5% more sounds good to me. The thought of 7 more people living is immense, in my opinion. My swim teacher's husband only had a 50% chance in just the first round of chemotherapy, and he's doing well. The cancer is gone from his groin. He did lose a lot of weight. If you want, I can ask her about the problems from the chemotherapy he has had. I know he has gone through about 7 chemotherapy rounds. I'm going to send a note off to my school friend that had breast cancer and find out if she did chemo. Like I said, she's traveling, but once in a while, they hit the computer somewhere in their travels.

    You have a lot of important decisions to make.

  3. Michelle,

    You have such tough decisions to make right now. Mine was pretty easy....no surgery, not able to work soon and soon be incapacitated.

    Have surgery and decide tissue valve...possible second surgery in 10-15 years but no Coumadin or mechanicle valve, with coumadin therapy and risk of bleeding.

    You have my best hopes and prayers for treatment and successful outcome.


  4. But the main thing Michelle is you are very strong to make these decisions. You go girl!!!


  5. Thanks, everyone! I'm really trying to wrap my brain around chemo. Trying really hard. Little by little, one thought at a time.

  6. You know Michelle, everyone is different with what they can tolerate. I have known people who have had chemo and feel crummy for a couple of days, and then bounce right back; I know people who have had chemo and have felt pretty good after their treatments; and I have known people that spend the next week in bed feeling like crap. Most of them go through it because that is what their specialists recommend and they want to give themselves the best chance. I know someone who went the no chemo route, and is doing just fine at year 3 of being cancer free. I know someone who went through chemo but had a patch and said he felt fine and had no bad side effects from the chemo. This is a tough call and I guess the only thing you can do is digest as much information as you can and make this decision with Rick.


  7. Don't know why your head is spinning, Michelle. LOL. Mine would have left my body by now.

    Chemo is very frightening for anyone. Anything to do with the big C is frightening.

    At the moment, as Elaine said, digest all the information you can get your hands on.


  8. Whew! Hope your pathology comes back soon, so you can toss all the dice and make a choice.

    My biggest prayer for you today is for a good night's sleep.

  9. Michelle, my heart goes out to you. I can't imagine how you are dealing with all of this information. We probably all know at least one person who has been through this, but each one of us is unique and there is no "one-size-fits-all" protocol.

    In the end, only you and your family can make the decisions that are right for you. You are all in my prayers.