Yesterday (Thursday) morning was another 3-week follow up with the oncologist. Cha-Ching. Another $50 copay for a fairly quick blood draw and appointment, but this one came with continued good news. As the doc felt me up (it's amazing, I'm now about 45 sec from the end of the nurse's blood pressure/temp and closing the door to topless in my gown ("open in the front!") and on the exam table) he was impressed with how LITTLE he felt.
Bye bye Bertha!
There's scar tissue, and some glandular type "oddities" for lack of a better word, but so much progress from that nasty 6x2x3 cm mass that I started with. He was pleased to hear that treatments continue to go well, oral steroids prevented reactions, etc. He said "you're easy". Which, coming about 3.5 minutes after he had both hands on my boobs, made me smile.
As I was getting dressed (takes a touch longer), I was eavesdropping on him dictating into my chart on the computer across from the exam room. Don't worry, the door was closed, but I've learned the walls are thin and vents must be pretty open. Some of the better words I've heard in awhile...
"No palpable mass."
Alexis said when I texted her that, "English, please". Basically, what was Bertha is no more... there's not a "tumor" per se to feel. WAHOO!
Warning: Bit of a nerdy interlude upcoming
Talking with Mom on the way to work, she was even more pleased and excited than I. Ultimately got to the question of "so could this even mean no surgery?" which is a good thought, but, not really the case. The drugs are preventing the spread of the cancer, and "killing" the cells that are there, breaking them down. But there's still scar tissue and potentially lingering cancerous cells that should be removed (they just may not be a solid tumor palpable mass...or big enough to feel). Essentially, the chemo is changing the stage of the cancer in a beneficial direction. In my case, starting at Stage IIIa (larger than 5cm, nodal involvement), after the first big round, I was probably already to Stage IIb (larger than 5cm, likely no nodal involvement), then to IIa when it got below 5cm but greater than 2cm, and now am at Stage I.
Neoadjuvant chemotherapy (chemo pre-surgery) has this primary purpose of shrinking large or aggressive cancers (mine was both), which can hopefully increase the chance of breast-conserving surgery techniques, in other words a lumpectomy (portion of the breast) versus mastectomy (whole breast). And, the optimistic goal is that you can achieve pathological complete response (pCR) which has varying definitions but essentially means that there's no evidence of the invasive cancer in the breast/nodes/both depending on definition. This is really best assessed by the pathology report of the excised tissue during surgery; however, I would imagine that it could also be determined with MRI +/- biopsy. Essentially, the cancer would be "cured".
Not everyone will achieve pCR, but it's recently been suggested that those who do, may have better prognoses, in particular related to recurrence, long-term benefit etc. A few resources from the web:
Another Scientific Article, this one with before and after pictures.
Again, not everyone who gets the neoadjuvant therapy will achieve pCR. In fact, it may be only 10-20%. But, it looks like I could be one of those. So, good news now and good news later!
Interlude over
So I'm happy with that...I think my mom, family, close friends and coworkers were even happier. I just know that it's still a long process so am pacing my excitement.
The rest of the day was per usual, teaching, my last faculty Writing Across the Curriculum seminar (sucheen a great experience), and a long afternoon/evening of providing feedback on student work, grading, etc.
This morning I headed off for round 7 of 12 of my Taxol treatments. My regular nurse was back (had been off for the Thanksgiving treatment). Pretty standard, a bit quicker since blood was drawn at the doc appointment. More good news, my hematocrit continues to be on the upswing, which is great, as I'm almost not anemic anymore! Wahoo for increased oxygen carrying capacity of the blood! (I can't stay away from the nerdiness for too long you know...). Got a little work done, took a solid nap then it was back to campus for a lunch meeting.
Afterwards, I ended up meeting with a student regarding her research project and then ending up spending like an hour and a half working with her on the group's data in Excel.
As I called my mom on the way to Work 2.0 at the running store, I went off about some frustrations. Mostly just my insane need to be the best at things, and how I really enjoyed helping this student but was frustrated that I felt like the majority of the class wasn't having the same learning experience and brainstorming ways I could achieve that. I have to force myself to remember I'm a 3rd semester teacher and figuring some of this out takes time. Mom remarked "it's so great to hear you frustrated! Not that you're frustrated but that you're yourself enough to be and have the energy to get worked up about it!". Funny stuff, but I do know what she means.
So to tie this all together, I guess it's no surprise that I'm hoping I can continue to be the "easy" patient and that I achieve the "best" outcomes (even though I don't really think much of that is in my control...we have AMAZING drugs these days people. Science is cool. Support it. Go NIH. And to be honest, I'm actually pleasantly surprised with myself that I'm capable of keeping my expectations in check, as it is not my usual tactic. While chatting with Lex at the store, I recalled the teaching frustrations and mentioned something along the lines of:
"I just want to be every student's favorite teacher and have them say that they learned so much about so many things and had fun doing so. That they were able to apply the skills and things they learned to other classes and other aspects of life. Oh yeah, and that the girls want to be my friend and the guys want to date me".
Totally realistic, right?! :)
But really, I do set high expectations, and in closing, I'll express more gratitude. I'm grateful my expectations for treatment may even be exceeded and that I have the mental and physical energy to be myself and keep my professional expectations as unrealistically high as they normally are. I feel like I may have found my vocation (a fun and important concept we talked about in the seminar and I'm incorporating into my class next year to fulfill our institutional capstone requirement, the things you talk about at a comprehensive religiously-based liberal arts school!), that my calling to help others might just be to help them learn and grow and I have big plans for myself. Like I also said to Lex:
So incredibly happy for all the good news!!!
ReplyDeletePeace out, Bertha! #ByeBitch :)
Yeyyy!!! Such good news! So happy you can be the best at beating Bertha!! (not that I ever doubted you)
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