UPDATE!

I'll cut to the chase here and then go into details. Good news, there was no additional bad news added to my plate. And actually some good news like an oncologist saying I can cure you and you have a very very good prognosis. Well, you really can't expect more than that. Ok so all breath a sigh of relief.

Now for details:

The PET scan showed the cancer in the tumor only. No where else. And they had scanned my whole body. Very reassuring really to see your whole body and know there isn't anything else wrong with you!

So, no cancer in the lymph nodes from what they can see. This does not rule out that there could be microscopic cancer, but there is only a 15% chance that there is.

The tumor is incapusilated meaning its a nice round tumor and not engaged with anything else, far away from the chest wall and far away from the lymph nodes and well just far away from anything that matters. Its well defined with no tentacles. This is very good.

Further news although it has grown its own blood vessels as cancer tumors are known to do which means it has a high probablility that it is floating around in my system, my cancer does not have these specific receptors. Forgot now what the dr. called them but, think of a tv anttena and there are four genes on it one of them is the HER2neu gene. Not only am I negative for that one but I'm negative for all four. Good news because this means that if the cancer is circulating around its not equipted well to grow somewhere else.

Ok so now for the course of action. We have decided to do neo adjuvant chemo. Which is chemo before surgery. Oncologist was very excited that I was open to this. He had talked to my surgeon and he said I understand you brought this up in conversation. Well, yes I did because it makes sense to me. Here's the deal, traditionally you cut out the tumor and then do chemo and well hope for the best because there is no way to gauge how the chemo is working. By doing chemo first, you have the tumor to watch and see how its responding to chemo. Now this in no way changes prognosis, but, 27% of the time, the tumor will be gone, pathologically completely gone. If this happens they know there is a very slim chance that the cancer will come back. If its not gone, well your prognosis is what it was which in my case is very very good. I'm hoping to land in the 27% because well, you can just breath easier or as the oncologist said you can put that dragon to bed. I didn't say anything but, was amused at the use of dragon! Draw back to this is that there won't be a definite knowledge of lymph node involvement as we won't be biopsying the lymph node since the chemo will kill any microscopic thing in there. Which means they can't actually stage me. Dr. Barth clinically staged me at IIA. But, I asked if this knowledge would alter his course of treatment for me and the answer was no. All actual staging does is gives you a diagnosis of survival rates and since we all know how I feel about those anyway I'm good with forgoing this. For those wondering anyway stage IIA has a 92% survival rate.

The other reason for chemo first is that it will shrink the tumor prior to surgery making it easier for the surgeon to get whatever if anything remaining with nice clean boarders.

So, I'm keeping the girls! Dr. Barth was very straight forward about this. His words I see no reason why you shouldn't have breast conservation surgery and Dr. Guerra is magical with what she is able to do.

I told him I don't want to make a fear based decision about surgery. If removing the whole breast or both is going to vastly improve my diagnosis I'm willing to do that but, I don't want to do that purely out of fear. The man looked at me with so much compassion and said, I admire you and that's smart and brave.

Well, since removing both of them is not going to do a darn thing towards improving my odds against anything why go through all that surgery. By shrinking the tumor the surgery will be less invasive and healing will be quicker.

It just makes sense to me.

So in a nutshell here is the course of action:

1. another needle biopsy, since Dr. Barth won't have the whole tumor from surgery and there are other test he wants to run, I'm willing to do another needle biopsy to get him the tissue he wants. He is going to talk to my surgeon over the weekend and someone will be calling me on Monday.

2. Start chemo (not sure when yet), I will have four rounds once every three weeks. Total of 12 weeks or 3 months.

3. Surgery will happen very quickly after that. Apparently the body bounces back pretty darn quickly from chemo and Dr. Barth assured me there are no additional complications just because you had chemo just before surgery.

4. Radiation. Because I'm having breast conservation surgery I will have 6 weeks of radiation. M-F. But, it only takes minutes and the side effect is sometimes a mild sunburn. Outcome between lumpectomy and radiation vs mastectomy is the same. Have read this for myself everywhere.

5. Possible more chemo, this will depend on many factors but, mainly if the tumor completely disapears or not. If not, more test will be done on the remaining tumor and see if I could benefit from further chemo.

6. Hormone blockers for five years. Pills.

The chemo is going to put me into an early menopause and my periods should stop. Been wondering how I was going to go through menopause now I know! 60% - 70% that will be it. All done. If not I'm suppose to let the Dr. know. Didn't get into big details but its because of the estrogen thing. They don't want me making that because the cancer is feeding off it.

I think that's it. Well, I know its not, I think I was in the office for over 4 hours. He was so excited that he had a patient that had read and could talk to him and understand medical terms and hell use medical terms back at him. This is really this man's life.

And my poor dad. Shit. I still feel bad. They took me back and said Dr. was going to do an examine and then when he was done they would get my family. Well, Dr. Barth came did the examine and then I wanted to see the PET and he pulled it up and we got to talking and looking at the pics and he was explaining and I was taking it all in and asking questions and honestly we both got really absorbed. Then he looks at me and says oh you can get out of that gown and put your clothes on. I'll step out and when your done just open the door. So I do and then when I opened the door I remembered my dad. I said OMG my dad is in the waiting room I need to get him. He looks startled and says go get him. So off I run. There is no one, no one left in the place it had been 2 hours! The poor man was sitting stiff as a board, eyes as big as golf balls. I said dad come on, its ok the PET showed only the tumor we are going to discuss breast surgery. I took ten years off the man's life. He says I thought you were discussing how to remove your liver and your lung and other body parts. Oh man. Two hours of living hell for my dad because I got so engrossed. He totally understands and says its ok. But, do I feel bad for putting him through that. Dr. Barth was great got him caught quickly and then went on to explain more stuff. Dad really likes him and feels good about the course of action we are on.

Much relief tonight. Not out of the woods and still have to walk through the fire but, I feel I dodged some major bullets today.