Go For The Burn

So, I'm three for three on the cancer docs.  I met The Burn for the first time today, and we really clicked.  She's my radiation oncologist -- the chick in charge of my remaining treatment, once The Dutchman finally breaks it off with me.  Nothing we talked about, this morning, will firm up until The Dutchman says so, but I expect that my date with him on April 29 will be our last.  Assuming that's true, here's what else I can expect.

Thanx to the hefty hogans, I'm in for 30 radiation treatments.  That's 25 for the booby, and 5 for the scar.  (If I had a reduced rack, it would have been only 20.  Quel dommage.)  Radiation technicians apparently work bankers' hours, 'cause it'll be five consecutive days, with weekends off for good behaviour.  My rusty math says that's six weeks in treatment.

Once I'm officially done with surgery, I can start on the daily 20mg of Tamoxifen, as The Burn doesn't mind if I take it during treatment.  Bring on the hot flashes and the weight gain:  pseudo-menopause at its finest, unless I'm one of the lucky ones who doesn't experience those side effects.  Seriously, this is me:  what are the chances?

And only after The Dutchman signs me off can I schedule the beginning of 'rads' (listen to me, all down with the medical jargon).  But The Burn says between six and eight weeks post-surgery I need to be under the beams.  And I'm the girl who does what she's told -- at least by her doctors.  That's how I ended up here, remember?  The first appointment will be for a CT scan, and to design my treatment plan.  After that, we go live.

Looks like I'm guaranteed a sunburn, this summer.

Gimme a "T"!

Mortification.  I forgot to shave!  I realized that two minutes before The Pusher walked into the exam room, this morning.  It's not like I didn't shower, or apply deodorant.  I just couldn't present him with the ne plus ultra of feminine underarms.  And on first meeting, too.  I was certain he'd be revolted.  Honestly, the stuff that goes through my head!

But, I got over it.  And, of course, The Pusher never said a word.

But he sure spouted a lot of numbers.  1.2 cm was the size of the largest site of invasive cancer The Dutchman removed (in the first surgery).  That makes me a T1C:  a tumor greater than 1 cm in diameter, but less than 2 cm.  My cancer is grade 1 -- so it can print the alphabet and knows its numbers up to 100.  There are four grades;  four is the nastiest, so I have a decidedly un-nasty kind (I believe "low grade" is the correct terminology).  I have a strong estrogen receptor positive expression, but only a 20% progesterone positive expression.  I showed no lymphovascular invasion (hence, the decision not to take further nodes in the next surgery).  And I'm HER-2 negative (the HER-2 protein is not causing my cancer):  woo hoo!

So, with a relatively small, low-grade tumor that's estrogen receptor positive in a HER-2 negative patient, the prescribed treatment is -- wait for it -- Tamoxifen.  And no chemo.  Officially.  It's The Pusher who would order that.  But he didn't.  Ahhhhhhhhhhhhhh.

It turns out only post-menopausal babes qualify for aromatase inhibitors;  so it's Tamoxifen for sure, and for five years.  Side effects?  Increased risk of uterine cancer and blood clots in the legs, leading to pulmonary embolism.  But the ones most likely to affect more women:  hot flashes and weight gain.  Why is it weight loss is never a side effect?!

Though I left with a 'scrip, it's actually the radiation oncologist who'll determine when I begin to take it.  Apparently, some of them prefer the patient to wait 'til radiation's concluded before they begin the drug therapy.  I'll get that news a week from Friday, when I meet with The Burn.

But one way or the other, I'm gonna be one hot mess in a matter of weeks.

The Four Appointments of the Apocalypse

The Dutchman's assistant provided my next four appointment dates, this week.

First, a sign that my time with The Dutchman is nearly done:  a date with a medical oncologist to talk about Tamoxifen (or an aromatase inhibitor) on April 6.

Second, another attempt at an MRI on April 11.  I've got a prescription in hand for 3 mg of Atavan; we'll see if the extra two make a difference.

Third, a first appointment with a radiation oncologist (aka The Burn) on April 16.

Fourth, a date for my next (not yet "last", just in case) surgery:  April 27, with timing to be confirmed soon.

Not much of a social calendar, but a girl's gotta do what a girl's gotta do.