The Plan!

IMG_0307Toronto, December 29, 2015 — We  left the appointment with Dr. Pinchuk today with a plan and a clear sense of direction!  And as we exited the hospital, my daughter Sabrina made an interesting comment based on what we learnt from our meeting with the doctor.  She equated breast cancer treatment with a flowchart where the options are generally quite straightforward depending on the type of cancer you have.

If you have invasive ductal carcinoma, are estrogen positive and HER2 positive (as I am), then the treatment generally calls for chemo, surgery, radiation and hormone therapy.

If you are estrogen positive, but not HER 2 positive, then there is a different, “standard’ treatment option.

If you are neither estrogen, nor HER2 positive, then the treatment is typically just a lumpectomy (or removal of the lump).

In a strange way, there is comfort in knowing that breast cancer research has advanced to a stage where there is almost a cookie-cutter approach to how it is treated.  This is in stark contrast to what I experienced with lymphoma and myeloma, where the treatment was more like a complicated spider graph with all kinds of equations and computations.

Unfortunately, my case is anything but usual so the standard option does not apply.   We all chuckled when Dr. Pinchuk said that the medical oncologist, Dr. Robson, used the word “unique” at least 10 times in his report to describe my history and his recommendation for a treatment plan specific to my situation (in consultation with Princess Margaret Hospital).  Specifically, the doctors are reluctant to give me chemo because it would weaken my bone marrow and may compromise my second stem cell transplant, which I will need when the cancer from the multiple myeloma comes back (hopefully, not for a few more years).

So the plan is for me to have surgery on January 26, 2016 (a lumpectomy as well as the removal of all the lymph nodes from my armpit).  This will be followed by radiation, five days a week, for 5 weeks, one month after surgery.  There is a possibility that I may still require chemo and we will know this for sure after the results of the biopsy from the surgery.  I have been told that the surgery itself is non-complicated, and that I will be able to come home the same day.  Woohoo!  However, I have been forewarned about the discomfort and side-effects from the removal of all the lymph nodes from my armpit.

With the incredible medical care I am receiving and the encouragement and support from family and friends, I’m optimistic and ready to begin treatment!  The timing is great and, if all goes according to plan, the surgery and radiation will be completed by April 2016.  This means I can look forward to going to New York in May 2016 to see Sabrina graduate from her program.  And that is something wonderful to look forward to and celebrate.

— Munira

19 Comments

  • Anonymous , April 1, 2016

    Munira, I am not sure if you will remember me, but I was a ‘colleague’ that came to be involved in your case as you were trying to ensure that your transplant went well. You subsequently came to speak at one of our meetings in Montreal and we were able to meet. It was truly inspirational! Every year I come to your blog to ‘check up on you”. I was so shocked to see your most recent news… You are fortunate to be surrounded by a great group of Physicians, friends & family. I am truly amazed once again at your outlook and resilience!!! My thoughts are with you.

  • Anonymous , January 5, 2016

    Munira, please know that you are in my thoughts and prayers always. May the love of your family and friends keep you strong and help you through this journey. Love to you and all your support team. Sandy

    Sent from my iPad

  • Naz Kanji , January 4, 2016

    Hey Mukhiani, just got back from Mexico, so glad for all the positive feedback from you. Our prayers are with you as always, you really are an inspiration! Please let me know if you want me to accompany you for your treatments, as you know I am retired and have all the free time and would love to spend time with you.

    Love from the Kanjis

  • Dave and Erika McMullen , January 3, 2016

    Munira. it sounds like your plan is a great one, and well thought through. We wish you total success.

  • Gulshan Harjee , January 2, 2016

    Munira I believe your Oncologist has discussed genetic testing with you ? Sending you good wishes for another quick recovery

  • Anonymous , December 31, 2015

    shukar and may mowla give you shakti

    • Munira Premji , January 2, 2016

      shakti is good! amen to your prayers!

  • Noor , December 31, 2015

    Positive vibes coming your way for now and the foreseeable future Munira. You are inspiration to many.!

    • Munira Premji , January 2, 2016

      I feel those positive vibes Noor! Happiest 2016 to you and your family!

  • Begum Janmohamed , December 31, 2015

    Mowla is with you and our prayers too. You know how to take care and fight the cancer. Thank you for keeping us updated and aware about different kind of cancers and treatments. Very proud of your family who are with you all the time

    • Munira Premji , January 2, 2016

      Thanks so much Begum! It has been great having the family around. Sabrina left for Nairobi today and I miss her already. Shayne takes off next week. Happy 2016 to you and your family!

  • Alnoor B Kassam. , December 31, 2015

    Thanks for sharing this step by step insight toward good hope. Even as “hope takes root,” I pray all others’ dedication to you blends into unbound devotion, and resolutely strengthens faith.

    • Munira Premji , January 2, 2016

      I so love hearing from you Alnoor! I am feeling really hopeful and strong in faith. Would love to connect in person!

  • Nimet & Karim , December 31, 2015

    Wish you the best for 2016 – we pray that the new year brings you new beginnings with the best of health and happiness!

    • Munira Premji , January 2, 2016

      Hello Nimet & Karim! Prayers for you and your family for a spectacular 2016 as well!

  • Elizabeth Lancaster , December 31, 2015

    January 26 is in our calendar so meditation that day is devoted to you. And light and love for every step that leads to a phenomenal celebration in May.

    • Munira Premji , January 2, 2016

      So, so touched by your comment. Wishing you a beautiful new year Elizabeth. May light and love surround you and your family everyday!

  • Anonymous , December 31, 2015

    Your positivity inspires me :). You are amazing

    • Munira Premji , January 2, 2016

      Thanks! I love the smiley face!

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