Wednesday, November 30, 2016

First Meeting with Medical Oncologist





Here is the summary that Windy provided from her phone consultation during my appointment with the medical oncologist (Dr. Graff) today.





1)      The tumor is very small, and Stage 1A.  This means it is curable



2)      The markers are sort of a dud, which means it will be more of a pain in the butt to cure.



3)      In order to keep this little bugger from coming back, you need systemic therapy.  This means chemo. Traditional chemo.  The kind you think of when you think of chemo. 



4)      You will also need surgery, but how aggressive the surgery is will depend on the MRI and the genetic testing.  



5)      Your medical team recommends chemo before surgery.  This has the advantages of starting to attack the tumor before the genetic markers are back, and giving us a chance to see (at the time of surgery) how the chemo is kicking the cancer in the butt.  No, in the ass. 



6)      Now, back to that chemo thing (wish we didn’t have to come back here, but we do).  Your doctor anticipates

a.       16 total weeks of treatment, with one infusion every 2 weeks (8 total infusions).  Each infusion will take about  6 hours.

b.       Halfway through they will switch medications (Adriamycin/Cytoxan first, then Paclitaxel)

c.       On the day after each infusion, you will return to the clinic for a shot that will help protect your bone marrow and prevent infections (Neulasta)

d.       There will be side effects. You will lose your hair (unless you do that freezy thing). (Freezy thing not going to happen. ☺)  You will have nausea.  Your fingers may tingle. Your team has lots of ways to help treat symptoms, and wants to know about them.


      7)   Radiation will be very targeted.  5 days a week for 3 to 6 weeks

8)      So, what is next?

a.       Because one of the meds (Adriamycin) can stress your heart, you will have an echo before you start so they have a baseline

b.       Since chemo is best in a big blood vessel, Interventional Radiology will place a port, which is an IV with the hub under your skin on your chest. 

c.       The MRI will happen soon, but will likely only impact surgical planning, and not chemo.  (Scheduled for December 1 at 8:15 p.m.)






This crappy little tumor will start getting its ass kicked on December 14, assuming all goes as planned. 



Some day your oncologist will fire you because you are too healthy.  You will cry then, too. 











9 comments:

  1. One small clarification to #6: After 8 weeks they will switch drugs (not in the middle of each infusion). Sorry to be unclear on that.

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  2. Sounds like you are ready to kick butt! Will be with you on your journey. Since pink looked so good on you last summer, I recommend a pink wig for special occasions!! Love and hugs and prayers!

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    1. Pink would be over the top...but a neon pink streak is well within the realm of possibility! :)

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    2. Glad to see that! One of Sara's first reactions included a suggestion that we get you a silver wig with a pink streak in it. She's already been researching it!

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  3. Barb, you have the strength and the best team to beat this, and you've got a good early start. Loosing your hair? That's nothing you haven't beaten before - remember the ringworm? Love you!
    Windy, How might the genetic tests affect surgery or treatment? I can't seem to find anything about that.

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    1. Hi Jim-
      If there is an inherited risk (BRCA is the most common mutation), then it increases the chance of an occurrence on the other side, and may incline the team to recommend double mastectomy instead of just focusing on the involved side.
      w

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  4. Windy, thank you for giving us such a clear , and concise, picture of the road ahead. I like the "curable" part best! Barb, and Gary, we've got your backs. Please let us know if there is anything you need/want. Go team Lammers! Love you all.

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  5. Thanks, Jim, for your question and Windy for your help with the medical info. Strong team all the way around!!!

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