Turn the Radio Off!!!

Thursday and Friday were the big follow-up appointment days as I stated before.  We saw Dr. Ahmed, the oncologist, on Thursday.  She and Deb went over the pathology report (which Deb got a copy of on Tuesday) and discussed the genetic testing results (which she gave Deb a copy of) and much of it was med-speak and if it didn’t go over my head, it certainly scraped my scalp.  But I do feel that I caught the gist of it.

First of all, Dr. Ahmed stated that while it was up to the radiological oncologist to confirm, she didn’t feel that radiation would be necessary given all of the pathology results.

Let me just skip ahead at this point and say that we saw the radiation oncologist, Dr. Yao, on Friday and she told Deb something to the effect of “Nice meeting you, but I got nuthin’ for ya.”  No, that wasn’t exactly what she said, but you get the idea.

Let me repeat myself here.  No radiation. 

This is definitely a load off of our minds.  I didn’t want to run the risk of her turning into She-hulk.  That would be bad.  Green isn’t her color.

So going back to Thursday, the other subject of talk with Dr. Ahmed was the remaining course of therapy.  Deb will be going on Tamoxifen for the next 5 to 10 years.  That much is a given.  Everything else is in flux.  The current accepted protocols for chemotherapy and other treatment rely on things like the size of the tumor and whether there are receptors on the cancer cells that respond to estrogen, or progesterone, or HER-2 (Human Epidermal Growth Factor Receptor 2 – yeah, I had to Google that).  Deb’s tumor size was right on the decision line, and she was estrogen receptor and HER-2 positive but progesterone receptor negative, which is apparently out of the ordinary.

It isn’t that the research says to do this or do that for someone of her age with her pathology, it’s that the research doesn’t exist.  Part of this is that it is unusual for a diagnosis like this to be made so early – her tumor size was small because her monitoring was so often that it was detected very early. 

And chemo comes with the risk of some potentially nasty side effects – not just the short-term annoyances of hair loss and weight gain (surprised to hear gain instead of loss – I expected the other way around), but neuropathy and cardiomyopathy (Google those yourselves if you wish).  

Next week are second opinion appointments, and genetic counseling is still to come…and we’re hopeful that then we’ll have a clearer path to making a decision.  But those decisions will still likely be very difficult.  How do you know where to place the cut-off point on the risk/benefit chart?  What is the point of diminishing returns?  Which risks are simply too great?  How many licks does it take to get to the Tootsie-Roll center of a Tootsie-Pop?  (The world may never know.)

Meanwhile, healing from surgery continues.  Fatigue and some pain and soreness remain the biggest nuisances she faces.  And a new torture has been instituted in the form of in-home PT to improve arm range of motion.  At least I can truly sympathize with that.