The long and winding road - more and more treatment

Only one more radiation, and my skin is doing very well. Hallelujah! Tomorrow, Ryan and Tessa will go with me, and we'll visit the piroshkie man (his name is Dimitri), and then I will be DONE with all this radiation business, and can get on to healing from radiation.

But I'm not even close to being "done."

Today I met with the gyn.-onc., Dr. Paley, and I liked her instantly. There are no easy fixes, though (and I'm learning that lesson over, and over, and over in my life) and it seems that I must have a laproscopically-aided vaginal hysterectomy and salino-oopharectomy. (Pardon me if I have spelling errors here...!) What this means is that I will have incisions made at my bellybutton, pubic hair line, and over each ovary (four incisions each an inch or so long), and then they'll remove my ovaries, tubes, and uterus, pulling the whole thing out my vagina. They will rinse my abdominal cavity (using a "wash" technique) and then collect the fluid from the rinse to test for ovarian cells with abnormalities. If this sounds unattractive to you, just imagine how it makes me feel. Sigh.

Surgery is scheduled for March 30th. I will be in the hospital (Swedish) overnight at minimum; recovery is a few weeks.

Today the doctor told me that she thought, based on the data, that I had between a 40% and a 60% chance of getting ovarian cancer before I turn 80, unless I have this procedure. Lovely. I have also read in several places that shutting down my ovaries permanently (and there's no more permanent way than this) reduces my chances of recurrant breast cancer by 60%. Needless to say, I am not debating this procedure: I see it as something that I absolutely must do.

I was hoping to get away with a simple oopharectomy, but the evidence is against it. My doctor co-authored a study at UW when she was a resident there that found that there was a relatively high risk of ovarian cancer in the leftover tubes if only the ovaries were removed. This study has been replicated widely at other centers. The only way to remove the entire tube is to remove the uterus the tubes connect to...so it all goes.

The good news is that ovarian cancer, when caught early, is highly treatable. The bad news is that I have a 10-17% chance that they will actually find trace amounts of ovarian cancer when they open me up. These numbers are new to me, and I'm horribly disheartened at the thought that I may, at this very moment, have ovarian cancer lurking in my body. Hopefully I fall in the 83-90% of my population (young her2/neu+ ER+ women with breast cancer and a family history of breast cancer) who does NOT have early or late stage ovarian cancer. Only the surgery will tell. If microscopic amounts are found, then nothing in the surgery will change. If larger amounts of cancer are found, then I'll get an incision from my bellybutton to my pubic hair line, and who the **** knows what they'll actually remove...and then I'd do chemo again. Let's just hope that I don't have to find out what that would be like! The odds are in my favor that if cancer is found, it would be microscopic in nature, and I'm hoping that they don't find a single awful cell.

I meet with yet another plastic surgeon on Wednesday, and then I will make a decision about which plastic surgeon to use, and I will book the surgery to do my prophylactic mastectomy with immediate reconstruction. I need to wait one month after the hysterectomy, and I'll get in as soon as possible after that, so I'm looking at the end of April for that surgery.

This road goes on, and on, and on. I really want a break. I had it in my head that I'd be temporarily (until after the 3-Day) done when Easter came around, but that is not the case...I will be recovering from the hysterectomy and getting ready for the even bigger reconstruction.

Femara continues to treat me well - no joint pain, no side effects. So far, my heart continues to respond well to the every-three-weeks Herceptin, as well. I am attacking this damn disease on every front, and I intend to be victorious, but what a major, major pain it all is. Enough already!!!

Physical therapy is going well, and I'm working on upper body to get back mobility in my left arm and loosen up my (very tight) shoulders; I'm also working on core strength the prepare for surgery. The more fit I am, the easier the surgery should be for me.

And speaking of being fit...a positive ending for this sort of negative posting. After losing 23 pounds, my jeans weren't fitting very well, so I went shopping between medical appointments (I had 4!) today. I tried on a dozen pairs of pants, and (drumroll, please!) I AM A SIZE 8!!!!!!!! Just for fun, I tried on a number of cute dresses, and since a few that I liked were only available in size 10, I tried them on, only to find out that they were most definitely too big. This is FABULOUS news! I bought two pairs of jeans - since jeans are my "uniform" and I'll be wearing them non-stop as these are the only pairs of pants that I own that will truly fit me right now - and I'm wearing them with pride. This was most certainly a bright spot in an otherwise cloudy day.

Love,
Kristina