Next Up, Chemo

So, chemotherapy it is. After doing a lot of my own research, I went to see the oncologist today determined that no matter what he recommended, the decision was mine to make. I knew that if my cancer recurred later, I wouldn't want to look back and regret not having done everything I could to prevent it. But I also knew that if I agreed to chemotherapy, I wanted to be confident that I had asked all my questions and received satisfactory answers. I had it settled in my own mind that I wouldn't hesitate to seek a second opinion if I felt the need to. And of course I had prayed, and asked friends and family to pray, that I would be able to make the wisest and best decision.

I didn't want to lose my hair or spend several months suffering miserable side effects, but these were not good enough reasons to refuse chemo. In fact, nothing temporary or cosmetic was a good reason to decline chemotherapy. What I did want to be sure of was that I wasn't risking other long term medical problems that might potentially outweigh the long term benefits of reducing the risk of my cancer recurring. 

In particular, I was concerned about the risk of damage to my heart and I learned which two chemo drugs carry that risk. I discussed all this with Rick and we were of one mind when we went to the oncologist together armed with a list of questions.

I think we had very good respectful communication with the oncologist. He seemed to understand that we weren't going to say yes to chemotherapy just because he recommended it. He answered all our questions and gave us copies of my pathology reports, surgery notes, Oncotype DX test results and information on the chemo drugs with their risks and side effects. In the end, we were convinced, and having been convinced, saw no need to delay.

Some of the pertinent facts, which won't mean much to anyone who doesn't have experience with breast cancer: my tumor was 3.3 cm., invasive, strongly estrogen receptor positive and moderately progesterone receptor positive. My Oncotype DX number was 21. My cancer turned out to be Stage 2A, Grade 2. The fact that at the age of 57, I am still not post-menopausal was another factor.

Of the two drugs that can cause heart problems, I clearly won't need one of them, because it is only used for cancers that are HER2 (Human Endocrine Receptor) positive and mine was not. Maybe the doctor decided not to recommend the other one because he knew it would be a hard sell, although he probably figured that I didn't necessary need that one either. 

My chemo will be administered in four cycles, once every three weeks. After that twelve weeks, if I have tolerated it well enough, I'll probably have two more cycles, so that would be another six weeks for a maximum total of 18 weeks. It will administered through a medi-port that will be surgically implanted under the skin in my chest. Tomorrow I'll talk to my surgeon's office and get that scheduled. Once that's been done, I'll have my first treatment, probably as early as next week.

Since I've had a week to consider the possibility of chemotherapy, I already took some steps that I figured wouldn't be wasted in any case. One was simply vain. I had permanent eyebrows tattooed in place. I've considered this for a long time, since I over-plucked and decimated my eyebrows earlier in life anyway.  I've just never felt justified in doing this before, but now I did and am pleased with the outcome. (Yes I will lose my hair, all of it.) 

I also called the dentist and had them move up my appointment to get my teeth cleaned. That's not something you want to do during chemo, when there is a greater risk of infection. 

Today after leaving the oncologist's office, I called my sweet hairdresser who worked me in to go get my hair cut very short tomorrow. I expect to lose my hair within two to three weeks of my first treatment.

 I had already checked to see if my medical insurance would cover the cost of a wig. Some do, but mine doesn't. I wasn't too disappointed, because I can't really see myself wearing one, but who knows? I may change my mind about that. For now, I've found an online source of hats that I think I'll like and that are designed to cover hair loss. Ordinary hats and caps don't cover the whole hairline, or former hairline, I guess I should say. I've never been into scarves much, although I think they look great on other people.

I will still be having radiation treatments, but not until after I've completed chemotherapy.

I expect to have a good cry anytime now.