This Week in Cancer - July 26th to August 1st

This week began with the knowledge that I was going to need a second surgery. During the first surgery, a lumpectomy, it was discovered that the mucinous carcinoma had invaded the chest muscle. Further tests found that the invasion extended to my sternum and or rib. Not only were further tests going to be needed, but the second surgery would require three surgeons: my breast cancer surgeon, a plastic surgeon and a thoracic surgeon.

A CT scan was ordered for Monday. I visited the thoracic surgeon on Tuesday for the first time, and he let me photograph one of the scan views. In the image below, the part that is within the rectangle is the part of the cancer that has invaded the area near my sternum and rib. The good news is that they still think this cancer is localized and has not spread to other parts of my body. Until they literally are doing the surgery, they will not be able to determine if the cancer is just wrapped around my sternum and rib, with the possibility of just being scraped away, or if it has invaded the sternum and/or ribs.

On Wednesday, I visited the oncologist who has been assigned to me. He already had been given a "heads-up" that I was not a fan of chemotherapy or endocrine therapy. So here is how the conversation went:

Me: I value quality of life over quantity of life.

Him: You want to know what poor quality of life is? Bone cancer. Both chemotherapy and endocrine therapies can have bad side effects, but medicines can be changed and symptoms controlled. In no way do those issues compare with bone cancer.

He told me they were waiting for the results of an "oncotype" test. This test will tell them what the odds are of my individual cancer returning within a certain timeframe. It would also tell my doctors whether my cancer would be responsive to chemotherapy or endocrine therapy.

I told my daughter that I feel like I'm a fish who has been hooked and is now being reeled in slowly. I started this process with one set of assumptions that are constantly being challenged. Their arguments do make sense.

The thoracic surgeon mentioned the possibility of either a PET scan or bone scan to verify that, in fact, my cancer is localized. He also said a PET scan would give him additional information about the chest wall muscle before surgery.

So what to do as the final pieces fall into place -- my Dad always said that when he spoke with his sister that she was either dying or going on vacation. Taking a page from my aunt's playbook, Bill and I left from the oncology appointment and traveled north for a few days of biking the Ohio to Erie Canal. I'll discuss that in the next post. Thanks for sharing this ride with me.