Oncologist Appointment

This afternoon I met with my Oncologist (Dr. Y). I think we are going to like him. He spent probably an hour and a half with us and didn't rush us at all. He started by giving me a copy of my pathology report and going through all of the different aspects of the cancer. He told me that he will give me copies of all of my test results.

My pathology report (as we have discussed previously) stated that I have an Invasive Ductal Carcinoma of the Right Breast. It was focally weakly positive (barely positive enough to be called positive for estrogen receptors. It was negative for progestrone receptors. It was strongly positive for HER2 overexpression. The tumor was a grade 3/3, 1.6 cm with the smallest margin being 0.1 cm.

While we will have to wait until we find out my lymph node status to determine the final course of treatment will be, we do have an idea. Most likely, he will do six cycles of AC & T (Adriamycin/Cytoxan and Taxotene) every 2 to 3 weeks. The other option would be to do 4 cycles of AC followed by 4 cycles of T. I will also be put on a drug called Herceptin because of the HER2 status. The Herceptin will start once I finish the A part of the chemo. It's an IV drug that I will need once a week for a year.

Next we discussed side effects. He felt bad telling me about them, but we need to know.
- Hair loss. Will begin after first treatment, but will probably need a wig after 2nd treatment.
- Possible mouth sores. Not everyone gets these, but if I do he has a prescription that could help.
- Nausea and vomitting. I will get a drug during chemo to help with this. He said 70-90% of patients have 1 or less vomitting episodes per week.
- Heart trouble. The "A" has a 2% risk of weakening my heart. The Herceptin increases this risk to 5%. If we took them together the risk would increase to 16%, so we'll do it separately.
- Diarreah. I can take Immodium if needed.
- Numbness of hands and feet. Should be mild, but I'll have to let them know if it gets worse.
- Blood Counts. It will decrease both white and red blood counts. They will monitor it with weekly blood tests. If my white or red counts get too low, they have some injections to boost things back up.

After all of those side effects I asked about my fertility. He seemed really unconfortable talking about it. He said that my ovaries will definately be affected, but he can't really give me any statistics. It could be very minor and we'll have no problems or they could be permanently damaged. He said our only guarantee would be to save some eggs for afterwards. I don't think we're going to go that route. I'm not sure if our insurance would cover it and it would probably delay treatment by a couple months. He was also concerned about the fact that they would have to inject me with high doses of hormones that could cause regrowth of the cancer. I think we'll just wait and see what happens when we're done. At least we have Grace, so if that's it, we'll just have to deal with it.

Dr. Y went over the tests I have scheduled. He thinks it's a good idea to get a baseline of everything. He said the only thing they don't check is your brain. But he said that if I start showing symptoms, (headache, blurry vision, etc.) they'd check me out. I then mentioned that I get migraines. He said in that case, we'd go ahead and do an MRI of my brain just to be sure. He also wants to do a MUGA Scan to be sure my heart is in good enough shape to go through the chemo. Those are both scheduled for Tuesday, October 11th.

We also discussed time off of work. He said I'll probably be tired for the first week of each cycle. I just need to tell him what I want to do. He'll have all of the paperwork filled out for me. He said we'll probably do the chemo on Thursdays or Fridays.

In summary, he wants to see me again on Friday, October 14th at the office we'll do the chemo at. He wants me to see the office and meet the staff to be sure I'm comfortable. At that visit he'll give me handouts on all the drugs and finalize the treatment plan and my statistics for treatment. He's hoping he'll have the pathology results on my lymph nodes by then.

The plan is to start the chemo on Thursday or Friday October 20 or 21. Wow, that's soon. I think that one night this week, I need to start looking for wigs. I will be out of town this weekend and then have surgery next week, so I'm getting short on time. I'm not sure what the time frame is for getting one, so I want to start looking.