The Oncologist
On Thursday January 10th I had my first official cancer-related doctors appointment. My relationship to Alice Mammoser apparently has more perks than just free iridology readings. Alice has some great contacts in the medical community and was able to get me in to see one of the top oncologists in the WNY area with only 3 days notice.
I was really anticipating my 2:00 appointment with Dr. David Dougherty. I was excited that finally someone with some medical background could tell me what my radiology results meant. Yes, I knew I had Invasive Ductal Carcinoma and that it was "architecturally well differentiated" and "intermediate nuclear grade", but what did these things really mean? It was hard to figure out just by Googling the terms.
The first thing I learned about oncologists is that they are very busy. My 2:00 appointment ended up with me being called into the office at 2:45 and finally being seen closer to 4:15. What could I say? It is nearly impossible to get any priority or special favors from an oncologist, after all, ALL his patients are dying! I didn't mind the wait so much because I had an entertainment entourage with me. My husband and my Dad's girlfriend had accompanied me to Dr. Dougherty's and they didn't fail to entertain. Who knew you could have so much fun stuffed in an exam room? We spent the last hour and half wetting the cotton balls that were in a dish on the countertop and flicking them and trying to stick them to the items on the walls. When Dr. Dougherty finally came in we shamefully hid the wet cotton balls we were holding under our thighs so he didn't know what we were doing, but I think he figured it out when he bent down to pick up all the wet cotton balls on the floor between the door and his chair. Busted.
My visit to Dr. Dougherty's office resulted in the best news I had gotten in a long time... He said I was boring. This is a wonderful thing for an oncologist to say. Dougherty told me that the IDC that I have is a run of the mill cancer and very common in 60 and 70 year old women. He said it was treatable all day long and with removal of the tumors, I have a 92% survival rate to look forward to. Being told that my cancer is boring was about the biggest relief we all could have gotten. What did intrique him is that I have 60 year old cancer but I am only 37 and have no genetic history of cancer in my family. I always thought that cancer can happen to anyone and it comes out of nowhere but apparently that isn't so very often. Yes, it can happen... it happened to me, but more often there are predictors such as a history of certain cancers in the family or a genetic mutation of the BRCA and BRCA2 gene. Dr. Dougherty ordered a genetic test on me to see if I had that genetic mutation because that would at least explain why I contracted this cancer so young. A BRCA mutation would also be a huge predictor for future similiar cancers such as ovarian cancer.
Dougherty continued to explain to me that "architecturally well differentiated" refers to the shape and spread of the cancerous tumors. The more differentiated the tumors are, the easier it is to remove the tumor whole and get out all the cancer cells. The less differentiated the tumor, the more it has spread into nearby tissues and the harder it is to get it out whole without other cancer destroying methods such as radiation and chemotherapy.
Doctor Dougherty also told me that my cancer was Estrogen positive and HER2 negative. I learned that this meant that my tumors were actually being fed by Estrogen, so if I were to cut off my Estrogen supply, my tumors would die. Sounds like an easy solution, right? Unfortunately, a lot of who I am would die too and I would likely start what is called induced menopause. If other treatments don't work, we may end up resorting to that. HER2 is a gene present in the chromosomes of the cancer cells that determine how fast the cells are reproducing. If the cancer sells show too many copies of the HER2 gene, it will grow very aggressively. These cancers are called HER2 Positive. My cancer is HER2 negative, meaning the cancer cells are growing and spreading at the same rate as my healthy cells and not overly aggressive.
Removing Breast Tumors - Surgery Options
Dr. Dougherty explained to me that the first step to curing my cancer is to have the 3 lumps removed. I will need to have surgery for this. There are 2 types of surgery available to me: a lumpectomy and a mastectomy.
A lumpectomy is a process where the surgeon would remove each of the lumps and the tissue immediately surrounding the lumps. A lumpectomy would leave most of my breast in tact and would likely need to be followed by radiation therapy in the exact locations where the lumps were removed. A mastectomy is where the entire breast, or in my case both breasts, are removed. When a mastectomy is performed, breast reconstruction is performed at the same time or shortly after, so no longer are mastectomy patients flat chested. Where a lumpectomy with radiation sounds less invasive, it leaves behind a lot of breast tissue. When there is breast tissue, there is a chance for a recurrence of breast cancer. Mastectomy, although more radical in nature, would result in the total loss of all breast tissue thereby reducing my chances of a recurrence (in my mind), and will in many cases not require radiation therapy. Dr. Dougherty insisted that a lumpectomy with radiation is just as effective as a total bilateral mastectomy, but I was really not convinced.
Given that my tumors are well defined and not growing very fast, Dr. Dougherty was relatively certain that with a lumpectomy and radiation or with a mastectomy I will be rid of my cancer for good with little to no chemotherapy. He felt that keeping to Alice's diet and herbal supplement regime would only help my predicament, so I decided to give it a go. Before I left, I was scheduled for a PET scan and the BRCA genetic test. The PET scan was to see if this cancer was growing anywhere else in my body. And so I left his office with my entertainment entourage with a smile on my face (After I picked up the rest of the wet cotton balls off the floor, countertops, and walls).
Next step - arrange for surgery.
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