Dealing with Cancer...
My poor mom...she doesn't handle aging and the scary stuff well. If you ask her how she's doing she says "I'm ok." Sometimes it's with shaky voice or near tears. Other times it's normal sounding. If you ask her if she's alright she answers "Not really, no." It's all about how you ask a person a question. I recognize that I do the same thing...obviously I learned it from her....
Anyway, we arrived to the Cancer Center a half an hour early and they gave her a paper to fill out. When were finding a place in the waiting room to sit I asked her "Where do you wanna be?" "Home." And her eyes well up with tears. *sigh* I said that I knew that but WHERE in the waiting room did she want to be and we picked a spot with a little chuckle. I told her that I think it's the first time I've ever heard her rather be at work.
We barely sat down in the chairs...less than 10 min....and they were calling her back to take more images with a mammogram and then an ultrasound.
We didn't see her again until 10:15. *yawn* My dad took a nap, I wished that I could have but was afraid that if I fell asleep and they came out quickly, I'd be worse off than before. (I only managed to sleep 4 hours last night.) While we were waiting I asked my dad how she was really doing and he said she was ok. She has a friend who has had cancer and is a nurse who had walked her through a lot of what would be happening in the coming weeks, etc. Having an idea of what to expect helped her, he said.
We cracked some jokes about her & I being flat chested and this being her chance to get a boob job and his enjoyment of such reconstruction. That was pretty funny. And apparently my brother has been teasing her, too. So it's definitely genetic, this tasteless sense of humor we have.
She came back out and we headed up a floor to where we would meet with the surgeon. We didn't wait long in that waiting room either and then were in the exam room waiting for the Doc. That wasn't too long of a wait, either before the Surgeon's Resident came in and asked some questions gave us a bit of general info and then did an exam on her. Clearly, she & I do not share the same pain tolerance. Granted, she's had a biopsy and mammograms, etc. But you could hear her discomfort. And EVERY person that pokes her says "I'm sorry does that hurt?" The poor woman is bruised from everything. It's the most ridiculous question.
Anyway, he left and we sat there talking. They gave us some timed agenda that made it so we would have to return at 1pm to watch an orientation movie and then have another appt with the surgeon, so we didn't know how long we were going to be there or what exactly was coming next but we'd have 2 hours for lunch if they wrapped this first part up quickly. Otherwise "there is a cafeteria and a bagel shop on site for your lunch needs before the movie". I told Mom that we had time to go outside the building for food...they didn't ACTUALLY lock us in and say "All your boobs are now belong to us." She thought that was hilarious. I left out "except the ones we keep." She said that going out would be better than what was in the cafeteria...
Me: "Right! Because it's either 'mystery meat' or 'chicken enchilada'....would you like door #1 or Disease #2? Salmonella or E. Coli (hand motions).....'we have a complete care system!...come with one disease, get the next two for free! We can treat 'em all!! (Only 19.99 for LIFE!)'"
*giggle* It was good to hear her laugh for real.
At that point was when the surgeon actually came in to talk with us. He did another exam but quit fairly quickly since she was in pain. It was good to see him pay attention to that.
And here's what we actually found out:
Right now it's diagnosed as DCIS which is what they term "Stage 0" cancer because it's non-invasive and it's pretty easy to treat.
There are two ways to treat it:
1.A mastectomy: Pro - it's gone completely with no further treatment necessary. Con: Obvs. But they can do reconstruction during or after the mastectomy should you wish.
2.A lumpectomy with radiation treatment for every day for 6 weeks after: Pro - You have your boob, albeit with probably a dent from the missing tissue. Con: Risk associated with radiation plus the daily hassle of treatment, albeit it's only 20 min total door to door.
Also during the surgery, he's going to remove the filtering lymph node (found by a dye injection the day before) so they can do a biopsy on that to make sure it hasn't spread further into the lymph system.
Now....here's the rest of what he had to say:
The in-house pathology report from her biopsy was still pending. He was working off of the original pathology report from St Joes/Chelsea, but was waiting for HIS pathology guy to report to him his finding.
So...there's actually THREE possible scenarios of how this will go:
1. Comes back as the same diagnosis. Remove Lump. Pathologist will be present during surgery to make certain that they have a decent margin of negative tissue to be sure they got it all. Lymph node removed. Both biopsied to be certain it's simply DCIS. Then radiation for 6 weeks if it is.
Alternate scenarios BECAUSE she actually is an exception to the standard: Turns out that DCIS is usually found on a mammogram as calcification, NOT normally present as a lump. A lump usually means just beneign cyst or invasive cancer. Rarely is it DCIS. But it's an exception which means it could simply be DCIS in odd/rare form....but not likely....
2. His pathologist says "It's actually nothing...doesn't appear to be anything but a beneign lump." Remove lump anyway. Leave lymph node. Biopsy lump to be CERTAIN it's not actually cancer. Live long and prosper if all findings are beneign.
3. His pathologist sayd "Not actually DCIS. More invasive cancer than that." Remove lump and lymph node. Biopsy both. Continue on with next steps whether it's more surgery for more nodes, chemo, or what.
So....yeah....he says it's very likely we are dealing with a more invasive cancer than the original report came back as. OTOH, he warns, "I have to tell you this to prepare you and hopefully we're forget this conversation when we're cheering & celebrating that it's actually just a rare presentation of DCIS."
Next up he tells us that he has a scheduler that will call to set up the surgery appt because it has to coincide with the pathologists' schedule, but that surgery shouldn't be much farther out than two weeks or so. He asks if we have any more questions and tells us that we're done. We tell him that we've been told that we're supposed to come back for a movie. He says that they have copies of it on DVD that we can take home, unless we want to stay. Obvs we don't, so we celebrate his news.
He leaves to get the DVD and the check-out papers. We sit there and joke about how a lumpectomy on my mother or I could be nearly the same thing as a mastectomy, depending on how much tissue they need. I joke to my dad that I guess he'll just have a handful and a half now. To which he jokes that that's all he had to start with. "Well...then a handful then, I guess." Again we all chuckle and relieve our stress in the best way we can.
The surgeon comes back in with the materials, shakes our hands. Asks us again if we have any questions. "Well, please take my card from the desk. You can call or email me directly should you think of something." I know that this goes a HUGE way toward making my mom feel even better. We definitely all like this guy AND his resident who was there the whole time. So this makes us feel a bit more...at ease?
Now we just hurry up and wait some more. If the pathology report comes back same or less, they will probably just mail the report to her and when they set up the appt they'll tell her if they're taking the lymph node or not. If the pathology report comes back with a more intensive diagnosis, then they'll call her to set up another appt for discussion about chemo, etc, as well as set up the lumpectomy.
Overall, I feel...ok....I want more definitive answers. I WANT that the pathology report was already processed and we weren't dealing with "possibly's". I like and trust her doctor. I like the setup of the Cancer Center and the feel it has to it. I WANT the appt to be schedule already so we know when we're doing this next part. But wanting will not really get us anywhere, so we just deal.
Anyway, we arrived to the Cancer Center a half an hour early and they gave her a paper to fill out. When were finding a place in the waiting room to sit I asked her "Where do you wanna be?" "Home." And her eyes well up with tears. *sigh* I said that I knew that but WHERE in the waiting room did she want to be and we picked a spot with a little chuckle. I told her that I think it's the first time I've ever heard her rather be at work.
We barely sat down in the chairs...less than 10 min....and they were calling her back to take more images with a mammogram and then an ultrasound.
We didn't see her again until 10:15. *yawn* My dad took a nap, I wished that I could have but was afraid that if I fell asleep and they came out quickly, I'd be worse off than before. (I only managed to sleep 4 hours last night.) While we were waiting I asked my dad how she was really doing and he said she was ok. She has a friend who has had cancer and is a nurse who had walked her through a lot of what would be happening in the coming weeks, etc. Having an idea of what to expect helped her, he said.
We cracked some jokes about her & I being flat chested and this being her chance to get a boob job and his enjoyment of such reconstruction. That was pretty funny. And apparently my brother has been teasing her, too. So it's definitely genetic, this tasteless sense of humor we have.
She came back out and we headed up a floor to where we would meet with the surgeon. We didn't wait long in that waiting room either and then were in the exam room waiting for the Doc. That wasn't too long of a wait, either before the Surgeon's Resident came in and asked some questions gave us a bit of general info and then did an exam on her. Clearly, she & I do not share the same pain tolerance. Granted, she's had a biopsy and mammograms, etc. But you could hear her discomfort. And EVERY person that pokes her says "I'm sorry does that hurt?" The poor woman is bruised from everything. It's the most ridiculous question.
Anyway, he left and we sat there talking. They gave us some timed agenda that made it so we would have to return at 1pm to watch an orientation movie and then have another appt with the surgeon, so we didn't know how long we were going to be there or what exactly was coming next but we'd have 2 hours for lunch if they wrapped this first part up quickly. Otherwise "there is a cafeteria and a bagel shop on site for your lunch needs before the movie". I told Mom that we had time to go outside the building for food...they didn't ACTUALLY lock us in and say "All your boobs are now belong to us." She thought that was hilarious. I left out "except the ones we keep." She said that going out would be better than what was in the cafeteria...
Me: "Right! Because it's either 'mystery meat' or 'chicken enchilada'....would you like door #1 or Disease #2? Salmonella or E. Coli (hand motions).....'we have a complete care system!...come with one disease, get the next two for free! We can treat 'em all!! (Only 19.99 for LIFE!)'"
*giggle* It was good to hear her laugh for real.
At that point was when the surgeon actually came in to talk with us. He did another exam but quit fairly quickly since she was in pain. It was good to see him pay attention to that.
And here's what we actually found out:
Right now it's diagnosed as DCIS which is what they term "Stage 0" cancer because it's non-invasive and it's pretty easy to treat.
There are two ways to treat it:
1.A mastectomy: Pro - it's gone completely with no further treatment necessary. Con: Obvs. But they can do reconstruction during or after the mastectomy should you wish.
2.A lumpectomy with radiation treatment for every day for 6 weeks after: Pro - You have your boob, albeit with probably a dent from the missing tissue. Con: Risk associated with radiation plus the daily hassle of treatment, albeit it's only 20 min total door to door.
Also during the surgery, he's going to remove the filtering lymph node (found by a dye injection the day before) so they can do a biopsy on that to make sure it hasn't spread further into the lymph system.
Now....here's the rest of what he had to say:
The in-house pathology report from her biopsy was still pending. He was working off of the original pathology report from St Joes/Chelsea, but was waiting for HIS pathology guy to report to him his finding.
So...there's actually THREE possible scenarios of how this will go:
1. Comes back as the same diagnosis. Remove Lump. Pathologist will be present during surgery to make certain that they have a decent margin of negative tissue to be sure they got it all. Lymph node removed. Both biopsied to be certain it's simply DCIS. Then radiation for 6 weeks if it is.
Alternate scenarios BECAUSE she actually is an exception to the standard: Turns out that DCIS is usually found on a mammogram as calcification, NOT normally present as a lump. A lump usually means just beneign cyst or invasive cancer. Rarely is it DCIS. But it's an exception which means it could simply be DCIS in odd/rare form....but not likely....
2. His pathologist says "It's actually nothing...doesn't appear to be anything but a beneign lump." Remove lump anyway. Leave lymph node. Biopsy lump to be CERTAIN it's not actually cancer. Live long and prosper if all findings are beneign.
3. His pathologist sayd "Not actually DCIS. More invasive cancer than that." Remove lump and lymph node. Biopsy both. Continue on with next steps whether it's more surgery for more nodes, chemo, or what.
So....yeah....he says it's very likely we are dealing with a more invasive cancer than the original report came back as. OTOH, he warns, "I have to tell you this to prepare you and hopefully we're forget this conversation when we're cheering & celebrating that it's actually just a rare presentation of DCIS."
Next up he tells us that he has a scheduler that will call to set up the surgery appt because it has to coincide with the pathologists' schedule, but that surgery shouldn't be much farther out than two weeks or so. He asks if we have any more questions and tells us that we're done. We tell him that we've been told that we're supposed to come back for a movie. He says that they have copies of it on DVD that we can take home, unless we want to stay. Obvs we don't, so we celebrate his news.
He leaves to get the DVD and the check-out papers. We sit there and joke about how a lumpectomy on my mother or I could be nearly the same thing as a mastectomy, depending on how much tissue they need. I joke to my dad that I guess he'll just have a handful and a half now. To which he jokes that that's all he had to start with. "Well...then a handful then, I guess." Again we all chuckle and relieve our stress in the best way we can.
The surgeon comes back in with the materials, shakes our hands. Asks us again if we have any questions. "Well, please take my card from the desk. You can call or email me directly should you think of something." I know that this goes a HUGE way toward making my mom feel even better. We definitely all like this guy AND his resident who was there the whole time. So this makes us feel a bit more...at ease?
Now we just hurry up and wait some more. If the pathology report comes back same or less, they will probably just mail the report to her and when they set up the appt they'll tell her if they're taking the lymph node or not. If the pathology report comes back with a more intensive diagnosis, then they'll call her to set up another appt for discussion about chemo, etc, as well as set up the lumpectomy.
Overall, I feel...ok....I want more definitive answers. I WANT that the pathology report was already processed and we weren't dealing with "possibly's". I like and trust her doctor. I like the setup of the Cancer Center and the feel it has to it. I WANT the appt to be schedule already so we know when we're doing this next part. But wanting will not really get us anywhere, so we just deal.