Is It Working Yet?

Now that I've had surgery and a couple months of chemo, some friends are asking me whether there's any way of telling if it's working. I think this would be a good chance to clarify my situation and offer reassurance.

The cancer was about the size of pea, caught early, and removed by lumpectomy (breast-conserving surgery). Based upon the pathology report, there is every indication that the cancer was completely removed (wide, clear margins), and that it hadn't moved to my lymph nodes (4 sentinal nodes removed for biopsy). The lymph system is one way that cancer cells travel to other parts of the body, so the fact that my lymph nodes were clear is an excellent indicator against future occurrences. Furthermore, other markers indicate that the cancer was not the most aggressive form, and that it is of a type that will be vulnerable to hormone therapy later. However, because it occurred before menopause, it has some likelihood of recurrence, and so we are aggressively treating me preventively, to get the 10-year recurrence odds down to the smallest of the single digits.

Lumpectomy is done with the agreement that radiation treatment will follow. The two treatments work together to treat the local tissue in case there are any cells remaining. Chemotherapy treats the the entire body systemically, in case any cells have travelled, because the mechanism for metastasis is still unknown. My odds were good enough to begin with that the doctor let me decide whether or not to have chemo. I chose to hit this with all the big guns. The other systemic treatment will be hormone therapy, following chemo and subsequent radiation. I will take oral medication for 5 or 6 years to block estrogen that tries to "feed" any stray cancer cells in my breasts. Let me say here, that all of us have cancer cells in our bodies, but our immune systems routinely take care of them. Estrogen-reducing treatment will help protect me over the longterm.

I'm incredibly fortunate that I don't have to juggle a job with all this treatment. Most women do, and I honestly don't know how they do it. I can take 7 or 8 months to devote all my energy to treating this thing and getting it behind me. I have good insurance and excellent doctors, my daughter is in a safe place, and my younger child is well cared for when I don't have the energy. I have family and friends (and new friends, too) who offer rides and help and even reassurance by just being there. There could be no better pocket of time to deal with this.

I believe that after chemo and before radiation I will get more mammograms. I'm not sure when they do other scans for cancer, maybe at the one-year point? Which every year will land during Christmas/New Years.

When chemo and radiation are done, I'll hopefully be working toward getting back some of the conditioning and muscles I worked so hard for last year, and I'll be able to take off the last few pounds I want to lose. The fact that I lost 30 pounds last year really works in my favor against future cancer recurrence, since being overweight is a significant risk factor. Naturally, this motivates me to get back to the point that I can rejoin the gym, my weight loss program, and be a Elliptical Training Demon once again.

Other cool things:
- taking a shower with a bald head is an amazing sensory experience
- it takes no time to get ready in the morning: no shaving, no daily shampooing, just shower with soap. I don't do makeup when I'm just at home.