Monday, September 19, 2011

It's official...I Have a Calendar!

This calendar is just for doctor visits, treatments, tests, etc...
It's official...I now have a calendar just for medical stuff!  I'm an organized person (or try to be), but the reality of having a mini-calendar just for medical related stuff is kind of hard for me to accept.  That's the point that I'm at in my life...

Friday morning, I had my appointment with my oncologist, Dr. Cheryl Jones, who practices at the Georgia Cancer Center - Macon office.  It was great to walk in and see a smiling face!  Adelia's best friend's (and my second son) mother is the receptionist there, but I noticed that everyone was treated like a "person", and not just a $ sign.  Walking into the cancer center, you knew that every person there was touched by the disease in one way or another.  I found myself wondering what their stories were... were they there due to a spouse, child, sibling, relative, friend, or were they the cancer patient?

My notebook from the Breast Health Center
Dr. Jones is highly recommended, and was very informative.  She asked me what I knew about my diagnosis...and I told her.  I've discovered that many cancer patients either know nothing of their diagnosis, know some, or are well-informed.  I realize that I am generalizing all people into a category, but that is my opinion.  I (just in case you doubted) fall into the well-informed category.  I can't imagine not knowing about the disease that is affecting your body and your family, but I know many who choose not to.  Plus, it's just part of my nature to know as much about something as's one reason why I chose my career!

Dr. Jones is a soft-spoken lady, but the wealth of knowledge behind her rimless eyeglasses is apparent.  After she reviewed all of my pathology reports, we found out additional information that wasn't apparent earlier.  ( Dr. Martin is a well-informed surgeon, with great knowledge about breast cancer, but Dr. Jones is my "cancer doctor", or oncologist.) Dr. Jones immediately saw my list of things to ask, glanced at it, and then handed it back to me.  (in the course of the appointment, she answered every single question on my list...and then some!)

Based upon my surgery and pathology reports, there are some major factors in my diagnosis that have changed. These factors will contribute to what weapons are used to fight my cancer.  The grade of my tumor, vascular & lymphatic status, lymph node involvement, staging and my HER-2 (human epidermal growth factor receptor 2) status have changed.  You can find out more about HER-2 from this website.  The core needle biopsy was just a "snapshot" of the tumor, whereas the mastectomy produced the entire "well-circumscribed 2.6 X 2.1 X 1.8 cm firm white mass". (page 4 of my 23 page pathology report)  This is why there are changes from the initial report.

My "doctor bag", which I now carry to all appointments!
The grade of my tumor is now 3. Grade 3 cells look very different from normal cells, as they grow quickly in disorganized, irregular patterns, with many dividing to make new cancer cells. (  As shown by the positive lymph nodes, the cancer had invaded my vascular system.  Of the 18 lymph nodes removed, only 2 showed a presence of cancerous cells.  One lymph node is considered  to have "extracapsular extensions", meaning that the cancer has spread outside the wall of the node.  My report shows the size of the largest metastatic deposit is 1 cm.  The fact that the cancer had spread to my lymph system is a "whole new ballgame". 

I asked Dr. Jones how to respond to my children when they ask, "Mom, are you cancer free now that your breast is gone?"  Her suggestion was to tell them, "the doctors removed all of the cancer that they saw, but that there could still be cancer floating around in my blood."  It's kind of a different perspective when you think of it that way, as opposed to be cancer-free when you breast is removed.  My cancer stage is IIb.  You can read about breast cancer staging here.  I am just over the IIa mark, with my tumor size.  Treatment really doesn't vary from IIa to IIb.  The suggested course of treatment for me is chemotherapy, followed by radiation.

Apparently when we thought I was HER-2 negative, the tests actually showed that additional testing needed to be completed.  Generally, you receive a score of 1-3 on this test.  1 being that you are negative for the HER-2 gene, and 3 being positive.  I received a 2.  According to Dr. Jones, both the FISH methods and IHC testing methods have come back inconclusive.  The report refers to "Because of a possible interference by chromosome 17 polysomy noted on the previous HER-2 analysis, the HER-2 analysis will be repeated by another method."  HER2-positive breast cancers tend to grow faster and are more likely to spread and come back compared to HER2-negative breast cancers. (  If it is found that my cancer is HER-2 positive, then it will involve a weekly infusion treatment of Herceptin, for one year.  As a friend of mine told me, that's just one more arsenal in my warehouse.  Cancer is a family diagnosis, but looking at weekly infusions for a year...that's just hard to imagine.  Hopefully the results will be back later on this week, but certainly by my next oncologist appointment.

Speaking of calendar is filling up.  Today, Jeff and I attended a chemotherapy class at the Cancer Center. Thursday is my two-week post-op and port insertion consult with Dr. Martin.  Next week, Adelia and I are attending a "Look Good - Feel Good" class at the hospital on 9/26, which focuses on scarves, make-up, accessories, etc. after chemotherapy hair loss.  Between now and my appointment on the 30th with Dr. Jones, I have to get a chest x-ray and will have an echocardiogram on 9/27.  I'm not sure where it will fall, but somewhere between my appointment with Dr. Martin and my first chemotherapy treatment (which can't be prior to 4 weeks post-op), I will have my port insertion.  As the day has progressed, I noticed that my surgical site and under my arm seems to be swelling, possibly filling up with fluid.  (Remember my surgical drain was removed last week.)  This is completely normal, but rather than waiting until Thursday to see Dr. Martin, I now have an additional appointment with him tomorrow.

Griffen in his new "Weeblo" uniform!
In the meantime, between my "calendar appointments", I'm trying to be normal: a mother, wife, daughter, sister and friend.  Friday night, I enjoyed watching Adelia and the awesome JCHS Marching Greyhounds perform pre-game and during half-time.  (The JCHS football team won, too!)  I've been doing my post-surgery exercises, visited a great wig shop (that deserves its own post, though!), put patches on a new scout uniform, and have read bedtime stories.  Everyday, my stamina is improving.  I have had such a great support system of my parents, husband and children, but it's nice that I can actually help to cook, fold laundry, and do dishes!  (I think I might still be too sore to clean the bathrooms, though- how long do you think I can use that excuse? :)



Dana said...

I know the plans I have for you," declares the LORD, "plans to prosper you and not to harm you, plans to give you hope and a future." Jeremiah 29:11
Shelby this scripture keeps coming to my mind for you...I know its a God thing!!!♥

tracy said...

Shelby, first let me say: Griffen looks sooo handsome in his new uniform! and kudos to Deedee's marching band success.

now on to the other scary stuff, u are the most informed person i have ever known, i think you so much for your blog. Because of our common age and due to the fact that i am WAY overdue for an obgyn apt. i am scheduling one post haste! I just never thought at our age we would have to worry about cancer, like you i nursed my babies, i don't smoke or drink, no family have proven to me that is just not smart to assume i have nothing to worry about. THANK YOU.

i am sorry that chemo and radiation have to be part of your life, i am sorry that you have to look for wigs. I am glad you have such an amazing group of doctors who are doing everything they can do for you. Mostly i thank God for your straight, faith and courage. love and prayers,

Anonymous said...

Shelby, I cannot thank you enough for sharing with us the real facts about breast cancer. I have a friend at church that recently underwent breast cancer surgery. Now I can, a little better, understand what she is experiencing.
In the meantime, remember that Jack and I love you and we are in prayer each day for you and your family.
Aunt Marilyn

Anonymous said...

Shelby, I cannot thank you enough for sharing with us the real facts about breast cancer. I have a friend at church that recently underwent breast cancer surgery. Now I can, a little better, understand what she is experiencing.
In the meantime, remember that Jack and I love you and we are in prayer each day for you and your family.
Aunt Marilyn