Toronto, 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.