Friday, September 26, 2008

Weighing my options

I am still very much taken back by the alleged 'aggressive' nature of my tumor. It seems that it makes my survival more remote. I did troubling internet searches with hits saying that cures MAY be still possible despite grade 3... However, Steve bought me the new edition of Susan Love's breast book and said that a grade 3 tumor per se doesn't really affect the long term prognosis that much and the grading scale is very arbitrary. My small tumor size is still my best hope.

She does go into great detail about the epidemiology of breast cancer. I seem to fit the breast cancer patient profile: high bone density, tall, overweight, family history,dense breasts, hormone replacement therapy, and alcohol use. The last two factors are particularly under my control and are the most scary. Presumably a single drink while on HRT can cause the estrogen levels to spike 3x the normal rate. I have never read anything previous to this saying there is an extreme synergistic effect taking HRT while drinking alcohol. But HRT allegedly stimulates lobular carcinomas and mine is ductal. Although not so many studies in the US have been done on so-called bioidentical estrogens for replacement, European studies show the same increase in cancer with them.

I met with A for Happy Hour to get details about his wife's cancer to give me some idea on what I am in for. I'm not sure are situations are that close. Her tumor was about the same size but low grade. It took them 3 months to get their act together enough to remove it. Part of the problem was that there was no single point of accountability. They thought they saw lesions in her other breast and insisted on checking those out also before dealing with her primary tumor. They turned out to be 'nothing' but it delayed her treatment considerably adding to anxiety. Her tumor was close to her chest wall so they could not get 'clean margins' without digging into her chest muscles. Even though her nodes were negative, they thought she needed more than radiation to kill the cells that might be hiding in her chest wall so she was on at least 2 rounds of Adriamycin, which is terribly toxic and beyond feeling shitty, caused her hair to fall out. After she recovered from that, she went for 7 weeks of radiation finishing up a year after the initial diagnosis. It has been a year and she is fine. She got a wig. She didn't care for the support groups as some of the people seem to identify themselves first as a cancer victim and she didn't want that. The chemo seemed like overkill to me for a small, low grade tumor but my breastbook does say it increases your survival.

There is so much more info I need.

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