Thursday, June 30, 2011

Make mine a double

I'm a Wobbly Weeble here tonight. DI and I saw my oncologist (Dr. Y), and my hunch was right: he is a mastectomy proponent. This gut's been right more than a few times in my life . . . but this afternoon I felt it drop to my knees.

Turns out there are a lot of abnormal cells throughout this right breast - a concerning number. More than one person has told me "there's a lot going on in there." Dr. Y confirmed that those cells have a much higher-than-average risk of turning into invasive breast cancer. In fact, there is a very slim chance that there is actually a small invasive cancer, right now, lurking in that breast - because the biopsies were only a small sample, they're not sure. So leaving the breast there makes me a great candidate for Cancer, Round III, which is a battle I'm not keen on fighting. Therefore, the safest, most risk-averse route is to remove the whole shebang. If I do this, barring finding anything invasive, that'd be it for "treatment."

Then yes, there is a lumpectomy + radiation + hormonal therapy option. And actually, I could do tamoxifen for hormone therapy again . . . good news? Yes and no. I felt like crap on tamoxifen and it really interfered with my quality of life. But you can take it if you're pre-menopausal. We discussed the aromatase inhibitors - the class of drugs I mentioned before that I'd need to be post-menopausal to take. The doc is not keen on shutting down my ovaries, either with drugs or by removing them - he's never been a fan of this for me - there are huge quality of life implications, and then also big-time bone-density concerns for someone who's only 42 and already has osteoporosis. So if I did the lumpectomies, it'd be 5 more years of tamoxifen.

Net-net, and I'm keeping this simple: when pushed to the wall, he recommends mastectomy. And a double, while we're there. He will, of course, support any decision I make, but he thinks that even though it's major surgery, with emotional baggage attached and risks associated, my quality of life soon afterwards and in the long run will actually be significantly better than if I go the lumpectomy + rads + hormone route.

There's more thinking, talking and research to do, but I have to say, I tend to agree.

So ended another surreal afternoon in Suite 9A. Despite the bad news, Dr. Y reminded me of why I adore him. I am so, so thankful he hasn't retired yet, so he can be my sherpa through Round II. Normally a gentleman, he admitted that when he heard the news of the new cancer, his response was "oh shit." He sat, as usual, unhurried, and hashed out all the possibilities with us. He acknowledged that this is a crummy set of choices, but also reminded me that if I have more questions, at any point, he's here for me. This is why I chose him, 10 years ago. He might run a bit late, but he's worth the wait. He saved my life once, and I'm gonna trust him to do it again.




  1. Sarah, I am so saddened that your gut was right again. I can hear our conversations at the playground replay in my mind as I type. It just sucks. And I am sorry, sorry, sorry that this is what you learned today. Thank goodness you have Dr. Y and the confidence that he is looking out for you and is going to care for you. He sounds wonderful, Sarah. Well, crap. I don't know what else to say. This is just not what you wanted to type tonight or and not what any of us of wanted to hear. I know you are one strong woman, but please lean on us for whatever you need. I am here for you always. Sending much love your way....I will call tomorrow.

  2. Sorry to hear this was the outcome. I don't know if it helps to have a recommendation on the table - hope it makes the choice a little easier and maybe shortens the option-weighing period. We are thinking of you and are here if you need anything!

    Love you - Jean

  3. That just sucks!

    I am just a phone call or a short drive away. If you want to bounce around ideas or just talk. I'm here for you, whatever you need.


  4. Wow, once again the similarities between our cases are striking. I know how it feels to hear this particular news...give it some time to sink in. I have said it before...with mastectomy comes a certain peace of mind which is quite freeing. The good news is that you have LOTS of reconstructive options if you choose mastectomy. The tricky part is figuring out what works for you. I am around this weekend if you need to pow-wow and bounce around ideas. Coffee? Gin & Tonics? Scotch? I've got you covered!


  5. John and I have our fingers and toes crossed for you, Sarah!

  6. I want to hug Dr. Y. And you.

  7. Sigh! So sorry you have to go thru this. Sucks! Know we are here for you whatever you need sistah! - love ya Pepin/DiPace Crew

  8. Just remember that the part that makes you "YOU" - and the parts that are so special are on the INSIDE!! No matter what they take off your outside, you'll always have your amazing heart, soul, and spirit!! That cannot be taken by anyone and those are the reasons you are so loved and respected. The other parts are just decorations.

    Love and admiration,

  9. We're thinking about you and are saddened that the choices are what they are (crappy). Also, we are so thankful that your spirit, your intellect and your capacity to rebound will get you through this round as well.

    Please count on us as well for love, admiration, toddler giggles and whatever else can ease the journey and steady one at weebly moments.

    Love from Tito, Tita and Aurora.