Final Pathology and a Plan

Today has been a pretty good day. This morning at 11:15 we had another meeting with Dr. Y, my oncologist. I still really like him. He took alot of time with us again. He gave me a copy of my MRI and MUGA results. Both were normal.

He also had a copy of my pathology report from surgery. Later after we came home, there was a message from Dr. L on the voice mail saying that the final pathology was in, so we must have reviewed the final report. The report shows that all 5 lymph nodes were negative for cancer. They did find some cells of "in-situ" cancer in the re-excision area. They got it all though and the new margins are 3mm. So it was a good idea to take more from that area.

We then went over the survival numbers from a software program the doctor uses. Using all of my data, it calculated that with no further treatment, 19 out of 100 patients would die from breast cancer in the next 10 years. Using hormone therapy only, 6 of those patients would be saved. In my case, he thinks that number is a bit high because I am not really positive for the hormone receptors. The Estrogen Receptor was focally weakly positive, so he thinks it would only be 1 or 2 saved in my case. Using chemotherapy only, 10 of the 19 patients would be saved. Using a combination, 10 or 11 would be saved. This means with chemo and maybe some Tomoxiphen (we'll discuss later) I have just over 90% survival rate for the next 10 years. However, because I am HER-2 positive, there is another treatment called Herceptin that I can take. In studies it has shown to decrease recurrence by 52%. This means that my survival rate should go up to about 95%.

So our treatment regimen will be as follows:
3 cycles (every 3 weeks) of 5-Fluorouracil (5-FU), Epirubicin, and Cytoxan
3 cycles (every 3 weeks) of Taxotere
Starting during Taxotere cycles, Herceptin via IV once per week for 52 weeks
After chemo, 7 weeks of radiation (5 days per week)
After radiation, possible Tamoxiphen (1 pill per day for 5 years)

We still have to discuss the Tamoxiphen. It appears it may only improve my chances by 1 or 2%, but we have to decide if that's worth it to us. I'm really concerned about recurrence, so right now I'm thinking I'll throw whatever may help at this. I'd rather be here and healthy for Grace than leave 2 babies behind, so I don't want to let the fertility issues weigh to heavily.

After we were done with the doctor, the nurse came in and gave us sheets on all the medications. They also gave us some prescriptions to have filled before we begin. I'm supposed to bring everything back with me. Most of the prescriptions are anti-nausea drugs, so they'll tell me when I need to take them.

My first treatment will begin around 9:30 a.m. on Thursday, October 27. They expect it to take 3 to 4 hours. They'll start by giving me an anti-nausea drug. After it kicks in, they will give me the 5FU by IV(about 20 minutes), then the E by IV(20-40 minutes), then the Cytoxan is on an IV drip that takes 1 to 2 hours. I can bring books, or a computer, or even videos to keep my busy.

That's it for now.