Surgical Oncologist # 1

Bottom line: mastectomy, chemo, and perhaps radiation too.

I just got back from my first appointment with a surgical oncologist. These are the facts he presented as I understand them. Along with updating all my wonderful friends it is also a means of keeping track of what each doctor tells me in once place – aren’t you all lucky you get to read my new cancer notebook. If anyone actually reads all this and sees something I missed or has a question PLEASE feel free to say so – the more eyes the better.

Because the tumors are far apart, large and multi-focal he recommends a mastectomy, with reconstruction if I choose.

It is possible I may need chemo before the surgery to shrink the tumors. New preliminary studies have shown that increases survival rate with tumors of a certain size. I will need chemo after the surgery. NOTE to self, if I have it before do I still need it after, too – I think so, but double check.

He felt more masses, tho obviously they didn’t show up on the mammogram or ultrasound. For them I need a fine needle aspiration (not the same as the core needle biopsy I had, so my understanding is they feel more cyst like – forgot to ask if the fluid removed is biopsied, NOTE to self, remember to find that out.

An MRI was advised initially to pick up anything a mammogram might have missed, except according to an MRI expert he asked since I am lactating even if I stop nursing today it takes months to “clear up” and therefore an MRI is useless for now. I’m wondering if there’s a fine line between totally useless and just not as accurate. NOTE to self, remember to ask next doc that.

My cancer is estrogen receptive – apparently that was in the report but we missed it. That means my ovarian function needs to be permanently ceased, either thru drugs or removal. Instant menopause. He clams this is good news, as with suppressed estrogen it puts odds in my favor in terms of reoccurance rate after mastectomy and treatment, barring other as yet unknown factors.

The Her2 test results, to see if it’s an aggressive growing type of tumor, has not come back yet. NOTE to self, make sure we get that from the lab ASAP.

He wants me to contact a gynecologist to get a medication to dry up my milk. Instant weaning. Apparently, according to him, the hormones involved in the process of making breast milk may influence the growth of the cancer. I asked him if I could at least take two weeks, and he said yes, that would probably be okay. Then I asked if I were his wife what’s the longest he would advice me to take to wean my son, to which he replied, “If you were my wife you wouldn’t still be nursing my two and a half year old son” Asshole.

I have a phone call in to a lactation consultant; I’m wondering if this medication that dries up the milk would still allow Daniel to suckle – even if he gets no milk out. During toddler hood they get very little actual milk anyway, some, but not necessarily cups full, more like a spoonful here and there…so much of it is habit and comfort and bonding. I’m afraid to hope.

I’m also wondering if by some miracle when my breasts no longer make milk if he could even suckle on the remaining one whilst I undergo chemo – assuming there’d be no danger of chemicals being transmitted thru a milk-less breast. That might actually help him wean less drastically. I’m afraid to hope for that, too.

The doctor used the word cure. Assuming the cancer wasn’t beyond the lymph nodes. That won’t be known until the sentinel ones are removed (that’s the first few) If cancer shows up there they remove all of them. Assuming cancer isn’t in all of them, the word cure is the one thing he said that made me not want to punch him in the face. That and, despite his attitude towards breastfeeding, he seemed to be extensively knowledgeable and very informative.

However, unless somehow the other two surgeons are infinitely worse, this is not my doctor. Even if I go with every protocol he suggests, it just didn’t feel 100% right.

There’s more….thoughts and feelings. But I can’t go there right now. Frankly I am so tired I just want to some Xanax to take the edge off.

I will post again, soon.