Today was the long awaited appointment to get the results from my operation which took place on the 9th November. I was scheduled in for 9.15am so luckily there was no delay and one of the breast cancer nurses called us through at the appointed time. She went to fetch the consultant (a different lady to the one we saw before) and we sat down to begin our discussion. First things first, a quick examination of the war wounds which were found to be healing well. “They look nice,” said the consultant. Not necessarily how I would have put it but good news nonetheless.
We then got down to the nitty gritty of discussing the surgery and treatment options. We were told that the lump, which measured 14mm, was removed. There was a little bit of in situ carcinoma around the edge which increased the size to 17mm. These are basically pre cancerous cells which would not normally show up on a scan, so good riddance! Annoyingly, as the lump was a bit close to the chest wall, it was not possible for more normal tissue to be removed. Two lymph nodes were removed of which one was clear but the other contained cancer cells. Then we were given confirmation that the type of cancer I have responds to oestrogen and Herceptin. This means treatment will include tablets to reduce oestrogen levels (for five years) chemotherapy along with Herceptin and finally radiotherapy.
A decision for us to still make is whether to have a lymph node clearance, i.e. another operation to have all of the nodes removed. There is no definite research that this is beneficial, in fact the procedure has a fifty per cent chance of being worthwhile. There are possible side effects to this surgery, such as lymphoedema (swelling of the hand/arm) and general pain which is impossible to cure. The alternative is to have radiotherapy.
I was told that I need to have a CT scan of my chest, abdomen, pelvis and bones to ensure that these areas are cancer free. We will have an appointment with the oncologist to discuss the scan results and to decide whether to have further surgery or not. The appointment should come through within two weeks.
The treatment plan is therefore far from definite but I am likely to start chemotherapy just after Christmas which is usually six to eight cycles given every three to four weeks. This is roughly equivalent to five months in total. Halfway through the chemo, I will begin Herceptin treatment for one year. This is given every three weeks. The first two sessions take place at the hospital and are given through the vein. After that, I will have this treatment subcutaneously (injections into my fatty bits!) and this will take place at home. Never thought I’d be grateful for having large thighs! Right at the end of these treatments, radiotherapy will begin. I am likely to need a booster due to the lymph node involvement, which will extend the time from the standard three weeks. As mentioned in a previous blog post, this takes place locally at a private hospital.
Going back to the decision about lymph node clearance. I was invited to take part in a trial called the POSNOC trial. The link below explains this in greater detail:
More things to think about!
I was also interested to know the staging of the cancer and was told that as with everything else, this system has changed. These days, cancer is staged using the TNM system. T relates to the size of the tumour, in my case this was small. N relates to the number of lymph nodes which contain cancer and M refers to whether the cancer has spread elsewhere. My results are T1, N1, and I suppose M will be confirmed when I get my CT scan results. In old money, it would have been stage 2 but whether that is 2a or 2b is unclear.
Other things I was keen to find out included, can I go to work? The short answer is no. Can I have visitors? Yes, as long as they are well. Can I go to the ice hockey? YES! Thank goodness for that.
Having discussed all of the above, we headed home to digest the news. There was a letter from the hospital waiting for me at home, inviting me in to have a CT scan next week – good job they already told me this at the hospital. Imagine if I didn’t know! Could have come as a bit of a shock. Who would have thought the NHS would be so efficient? Good for them. The letter states that if I am over 28 stone, I will not be able to have the scan at MK. Guess I’ll be OK then (unless I keep eating my Mum’s doughnuts!)
Time to think is needed now. My head is spinning with all of this information.
Hubby is looking a bit depressed. Anyone for Chinese takeaway?