The Oncologist

I spent yesterday morning at The Healing Nest, having my first massage as a client. I never thought I would be going up the stairs of that beautiful place for anything other than a tour. It was always me sitting downstairs in the kitchen yakking with those crazy women while my daughter went up for treatments. As I lay on the massage table, with soothing music playing and warm loving hands rubbing away the tension, I was so very grateful. Grateful for the incredible beauty of these volunteers who give so much to ease the pain and worry of women going through treatment for cancer. After treatment we were served a beautiful lunch and shared our cancer stories.

In the afternoon my husband and I met with the oncologist that my surgeon recommended. I liked him immediately. He sat right down in front of us, looked me square in the eye and began to explain all of the details of my pathology report. He said that I have the best combination of results - estrogen/progesterone positive, HER2 (human epidermal growth factor receptor 2) negative. This means that hormone suppressing drugs can be used to prevent the cancer from recurring. The HER2 gene makes HER2 proteins. HER2 proteins are receptors on breast cells. Normally, HER2 receptors help control how a healthy breast cell grows, divides, and repairs itself. But in about 25% of breast cancers, the HER2 gene doesn't work correctly and makes too many copies of itself (known as HER2 gene amplification). All these extra HER2 genes tell breast cells to make too many HER2 receptors (HER2 protein overexpression). This makes breast cells grow and divide in an uncontrolled way. This is not the case with my cancer, and that is a good thing. HER2 positive cancers are more likely to spread and/or recur.

The doctor recommended chemotherapy, followed by radiation five days a week for six or seven weeks and then hormone therapy which will continue for 5 - 10 years. He explained two different chemotherapy regimens that he feels would work for me. The first one is twelve weeks long, with an infusion every three weeks. The drugs used would be taxotere and cytoxan. I immediately ruled out the second regimen that uses drugs which can cause leukemia among other problems, and would be twenty weeks long with treatments every week. Typical side effects of each regimen are fatigue, increased risk of infection, nausea, neuropathy, sores in the mouth and hair loss. I really don't like to consider suffering from any of these maladies, but if it will increase my chances of survival I will do it.

I asked the doctor for some statistics regarding what benefit chemotherapy will offer me. He stated that with no chemotherapy my cancer is about 30% likely to recur. With chemotherapy it is only 22% likely to recur. So I can go through twelve weeks of poisoning myself to gain another 8% chance of no recurrence. If he had said 50%, even 25-30% I'd say it's a no brainer. I am just not sure that 8% is enough gain to justify all of the crappy things that go along with chemotherapy.

I need to completely heal from the surgery before starting chemotherapy, so I have some time to think about it and do some more research. He wants to see me again in four weeks. I left his office feeling empowered. I was armed with information that will allow me to make decisions about my treatment that are based in fact and not just fear, which is tough because either choice scares the crap out of me.