Whole New World, Part Five

. . .in which the Dealer allows the Joker into play.

When last we visited the pathology report, all was well — the tumor had been large, but self-contained; the margins were clear from Bangor to Cincinnati; the estrogen and progesterone receptors were receiving and strong.

There only remained the vexed question of the surveyed lymph nodes.  Pathology discovered that, of the four taken, one was positive (bad), one was negative (good) and two had tiny, tiny, ohsoverytiny, isolated amounts of cancer in them (oh, dear, now what?).

Given the Medical Rule for when to take All the Lymph Nodes, it was a tough call, what to do next.

The call has now been made — the lymph nodes need to go. There are two ways to do this — one surgical, one radiological — and I am being set up to meet with the surgical oncologist and the radiology oncologist.  Based on what little I have gleaned, I’ll probably just jump straight to radiation, since surgical removal has two gotchas — one, if any of the other lymph nodes are found to contain cancer cells, I’ll have to have radiation, anyway, in addition to the surgery.  Two, the chance of lymphoma arising from surgical removal is twice as high as removal by ray gun.

I will of course know more after I meet with the specialists, Steve attending both meetings with me via cellphone from the isolation unit we like to call our car.

So, there’s that.

16 thoughts on “Whole New World, Part Five”

  1. Fervent well wishes, good thoughts, and prayers headed your way… mix, match, and accept as desired.

  2. Sorry to hear this. Your analysis of the options sounds logical and I’m sure you’ll make the best choice, whichever it turns out to be.

  3. Hugs (germ free cyber variety), and thought and prayers. Your analysis sounds reasonable to me.

  4. I had hoped you could avoid this. I took the surgical option. Ask your doc about the possibility of lymphedema. As your doc about the possibility of physical therapy after you heal from the mastectomy. The U.K. routinely prescribes PT but the US does not. Radiology is not a piece of cake but it is simple. Sending you healing vibes and my best wishes.

  5. Yeah, I had hoped for a continued run of luck, myself. The surgeon tells me that the change of lymphedema (which I doubtless misspelled in the blog) is 20% for the surgical option and 10% for the radiology option, so my plan is to play the low odds. They gave me exercises to do when I came home, to avoid frozen shoulder. I am lucky, again, because I could lift my arms over my head immediately after surgery, and am generally pretty flexible. What I worry about with the radiation is the fact that I’m photosensitive, due to having taken two doses of Jungle Antibiotics years ago when I had a mystery infection that nearly took me out. But — we’ll see, I guess.

  6. Ack. So sorry you have to go through this. My sister had both surgery and radiation in 1993. I don’t remember that there was a way to only have radiation then. She did have subsequent problems with lymphedema from the surgery. Best wishes.

  7. Sorry you have to have more treatment. I had radiation after my lumpectomy 2 years ago. While researching on the internet I discovered that the women on the breastcancer.org site recommended calendula ointment or cream to help with the skin side effects. I bought a brand called Miaderm (developed by radiation oncologists) at the hospital pharmacy and where I used a sufficient amount of it my skin was in better shape than in the spots I missed. I hadn’t realized how wide the field was (when they said whole breast radiation, they meant it and then some) and definitely had some darkening of my skin around the edges.

  8. Had all my nodes on the left side removed but only the sentinel plus three on the right. I did the pt thing all the time every day even if it was only holding my arms at shoulderheight (sometimes braced). I escaped without a problem. I hope the same for you whether you choose the surgical or radiation option!

  9. When I had radiology 5 years ago, the worst part of it was the skin “rash” that developed from the burn near the end. It so severe that the radiologist discussed whether we ought to shorten the course of radiation I was under (we decided not). I had tried every lotion and cream recommended by the medical staff or by anecdotal posts I found on the Internet—including an expensive cream I could only purchase from a pharmacy website in Europe—and nothing seemed to actually, actively help. Thus, I am passing on my long story to you, for future reference:

    For a week, my burn had been blistered and openly weeping, but all I could put on it was Aquaphor. The Aquaphor kept it moist and sealed away from infection (a good thing) but did nothing to actively treat the wound—and got messy gunk all over my clothes and bedsheets. Finally the radiology staff offered to let me try something called a Medihoney (brand name) patch. “Really?” I thought. “This big city hospital is recommending a naturopathic treatment?” A firm cynic about natural remedies, I scoffed mentally and vocally, but was also desperate to try something other than the seemingly useless salves I’d been using.

    I was told not to remove the patch for 3 days, but it fell off after only 2. When I saw the area that had been suppurating, I was amazed to find that there was a vast, visible improvement. Upon asking the hospital for more of these patches, I discovered that one had been the last of a trial sample they’d obtained and there weren’t any more! Fortunately, I found some Medihoney “ointment” locally (not cheap!) and continued to apply it every day. What a relief! By the time I saw the radiation oncologist again two weeks later, I was no longer dressing the burn and the wound was barely pink.

    So I’m writing just to pass along my own anecdotal evidence for this product, which generically is called “active leptospermum honey.” Apparently it can also be purchased under the name “manuka honey” (from a plant indigenous to New Zealand) although some of this type of honey is tested to be better than others, and of course the brand name version has been purified and approved for medical use.

    I wish you the best, but prepare for the worst.

  10. I’ agree that radiotherapy is your best bet, but make sure that you’re told about all possible side-effects. I had radiotherapy for prostate cancer – 100 % sucessful – but it left me incontinent.

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