Today has been a whirlwind of doctor appointments and information dumping. I got a call from the breast surgeon this morning and the MRI showed the cancer that we knew was there, plus three inflamed nodes. It doesn't necessarily mean they are cancerous, but they are suspicious. Luckily, nothing seems to be outside the region of the left breast and the right breast was OK. I will have a PET scan on Thursday and that will help detect cancer anywhere in my body, including those suspicious lymph nodes.
I met with the plastic surgeon and...I don't have enough fat for the DIEP reconstruction I was hoping for. I should be thrilled that someone told me I don't have enough fat for anything but "A" cups and I've had lots of offers from potential fat donors ;>) It looks like my reconstruction will be done using tissue expanders. Here's a link that explains the process:
It makes the whole surgery thing much easier - that's the upside. One or two nights in the hospital and then about two weeks for recovery. You go back weekly or bi-weekly for fills until you get to about the size you want. The implants last about 15 years on average. I guess at that point I won't care.
After the PS appointment, I went to see the breast surgeon. She showed me the MRI and we talked about a surgery date. It will be either next Wednesday, 4/13, or the following Wednesday, 4/20. During the surgery, a port will be installed for administering chemo.
Then she walked me over to an oncologist who is also a radiation oncologist right there at the hospital. I was in her office for 2 1/2 hours. A nurse took my history (please let us have digital medical records soon; I'm so tired of explaining the deaths of my siblings and my dad), took my vitals, weighed me, etc. After a wait, the oncologist came in. She already had quite a bit of information and had read the existing pathology reports. She asked me a lot of questions and answered mine, she spent a lot of time talking about how we would control glucose levels (and really got into the whole diabetes thing). She tried to reassure me that everything I have done so far to take good care of myself would lead to a better outcome than a diabetic who has not been cautious. She knew about the metformin trials and felt that it could still be doing its job of fighting the cancer. She made a point of saying it might be worse if I hadn't been on it. So she recognized that it has benefit. She also noted that diabetics on metformin usually have a good pathological response to chemo.
This is the hard part...her chemo protocol is even more aggressive than the other onco's. She wants me to do 8 rounds of chemo (one every 3 weeks). She gave me options - 4 rounds before surgery, followed by surgery, followed by 4 more rounds; or do the surgery first, then do the chemo. She leans toward doing chemo first because, as she said, she's an onco and it tells her if it's working. But both protocols have the same end results and she understands if I want the cancer removed immediately. I said that surgery first would provide the pathology so we know what we're dealing with, and she agreed with that. There are tumor marker tests and PET scans to determine that the chemo is working. I really don't want this aggressive beast hanging out one minute longer than necessary.
After chemo, there will be radiation - probably 33 rounds. Once I am healed from the radiation, there will be an outpatient surgery to switch out the saline implants for silicone, and I'll probably have my port removed.
If all goes well, I will be finished with treatment by Christmas. Tough to swallow.
Time to arm the battle stations.