Surgery Follow-up

Mom and I met with Dr. Engel today to review the pathology report from my surgery. Here's the lowdown, some of which is a repeat from last week's conversation with Dr. Perera:

The tumour was 1.4 cm in size (unspecified type of cancer). The report showed that there were clean margins taken around the tumour up to 1.1 cm. Pat, the Nurse Practitioner, noted that this was a very good sign.

I had a grade 2 tumour, which means that the cells of the tumour were moderately different than normal cells - it was growing somewhat faster than normal cells. So, not slow and not very fast.

16 lymph nodes were removed from my armpit. Only 1 tested positive for cancer with tiny microscopic deposits. Pat, commented that it there was so little cancer in the lymph node it almost didn't count as spread! Another good sign. Also, there was no lymphatic or vascular invasion, meaning it has likely not spread to other areas of my body.

Mom asked why 16 lymph nodes were removed. Why not less, why not more? It turns out that everyone has a different number of lymph nodes in their armpit. We are all unique. The number of lymph nodes taken is determined by how many appear between the tumour and the incision under the armpit. They only take the lymph nodes that are in that section. In my case, 16. Very interesting!

The cancer cells tested positive for both estrogen and progesterone receptors. Hormone receptors are like ears on breast cells that listen to signals from hormones. These signals "turn on" growth in breast cells that have receptors. Cancers that are either ER (estrogen) or PR (progesterone) positive or both, tend to respond well to hormone therapy. So likely after chemo and radiation I will be on some sort of hormone therapy that will reduce the estrogen/ progesterone in my body or keep these hormones away from the receptors. This will be just another treatment that will ensure my good health in the future.

Another test was done on the cancer cells, looking for a HER-2/neu gene. This gene helps control how cells grow, divide, and repair themselves. The HER-2 gene directs the production of special proteins, called HER-2 receptors, in cancer cells. Cancers with too many copies of the HER-2 gene or too many HER-2 receptors tend to grow fast. They respond very well to treatment that works against HER-2 (called anti-HER-2 antibody treatment). The first test they conducted (ImmunoHistoChemistry test) to determine if my tumour had this feature was equivocal. Meaning it may or may not be positive. So a further test has been ordered (more expensive and not done on everyone because the first test usually works). It's called a Flourescence In Situ Hybridization test or FISH for short. So basically they've gone fishing and will get back to me on this one.

Ultimately I have been diagnosed with Stage II cancer, which means that the cancer started in the breast and has spread to one or more lymph nodes. That's it in a nutshell.

Basically, we have received the best news possible once again, given the circumstances.

Next Friday will prove even more interesting when Sean and I meet with Dr. Potvin, the chemotherapist. At that time, I will be presented with my options and suggestions for treatment. Once I have decided on treatment, chemo will probably begin fairly soon (within 1-2 weeks).

Dr. Engel indicated today, that given my age and the fact that the cancer has spread, I am an ideal candidate for both chemo and radiation. At my age, they want to give me all treatments that will ensure that I live and long and happy life.

Yeah, me!

Love CJ

Make-Up Tips

Yesterday, I attended the Look Good Feel Better Workshop at the cancer centre at Kim's suggestion. This is a great program for women with cancer who want to look their best while going through treatments.

First of all we each received a box of over $200 worth of cosmetics. Everything from toner, cleanser to lipstick....probably more make-up than I will use in my lifetime.

The first part of the session focused on make-up tips - how to apply make-up. I think this is the first time I have ever received professional instruction on how to put on make-up (not that this would surprise anyone). This does not count the numerous times that Dawn did my make-up when we were kids with the dreaded blue eyeshadow.

Then there was a presentation on all the different kinds of wigs. Even wigs with human hair. That was kinda creepy. If I do lose my hair I think I'm going to be more of a hat/scarf person. But then again you never know. I might not like the Magic 8 Ball look. Time will tell.

Love CJ

Tetanus Shot

This weekend was pretty quiet, just hanging out with the family…until I went into the shed.

Sean and Sydney were in the backyard playing in her kiddie pool and I ventured into the shed to get the umbrella out to put up for some shade over the pool. In order to reach the umbrella in the back corner I put my hand on the back on the shed and directly into a nail. Yowsa! Of course, hysteria then set it.

After having any of your axillary (armpit) lymph nodes removed, you are more at risk if you get an infection of any kind. Hence, my hysterical reaction to the nail going into my hand. Normally I just would have put on a band-aid and gone to the doctor the next day for a tetanus shot.

So I rushed down to Urgent Care (I was on the only one in the waiting room) and they took care of me right away. I was given a special antibiotic cream that I have to put on three times a day for 10 days. This will ward off any potential infection. Then I got the good old tetanus shot.

You'll be happy to know that this shot also inoculates me for whooping cough. So take that one off the list of things I can get now.

Ah, the fun never ends.

Love CJ

Chemo Consult Booked

I'll be short and sweet today....

More good news. I have a chemo consultation with Dr. Kylea Potvin (spouse of my family doctor, Dr. Warsh) on Friday, July 7th at 3:00 p.m.

Carrie, can we squeeze in a matinee of Pirates of the Caribbean earlier in the day?

What a relief!

Love CJ

Early Pathology Results - I'm Cancer Free!

Today I went in for my second cat scan as a part of the study that I am participating in with Dr. Engel (surgeon) and Dr. Perera (radiologist). What an unexpected day this has become.

During my cat scan the technician asked how my surgery went and how my results turned out. I told her that I was still waiting for the results and I wasn't meeting with Dr. Engel until next Friday (the 30th). She seemed surprised, but neither of us commented further.

About an hour after I returned home from the hospital, I received a phone call from Dr. Perera. Apparently the tehnician had told him that I hadn't received my results yet, so he checked the system and called me personally to tell me what they were. So here goes:

1. The breast tumour was 1.4 cm in size, which turns out to be slightly smaller than they originally thought from the ultrasound (2 cm before).

2. The margins around the tumour were clear so Dr. Engel got it all. No further surgery - yeah!

3. The appearance (or aggressiveness) of the tumour was median - so not slow and not too fast - right down the middle.

3. Dr. Engel removed 16 lymph nodes (I thought I only had 12 before, but from the reading I have been doing apparently there are 30-50 in your armpit). Only 1 lymph node had a very micro mestastatic deposit (a fairly tiny gorup of cancer cells) less than 2 mm in size. This is very positive also.

I thanked Dr. Perera profusely for calling me and letting me know. A huge weight has been lifted.

I explained to Dr. Perera that Dr. Engel was planning on referring me to Dr. Potvin re: chemo treatment next week. Dr. Perera kindly offered to send the referral in today, which will hopefully cut down on my wait time to get into see her.

Dr. Perera also gave me some direction/options for radiation therapy, but at this point, I think I need to meet with Dr. Potvin re: chemo before I make any decisions on that front. But I do know that radiation will take place for 6.5 weeks after a 3-4 week rest period after chemo is complete.

I will still meet with Dr. Engel to go over my pathology report in more detail next Friday.

Thanks again to everyone for their love and support!

Love CJ

Magic 8 Ball

Last week I had a vivid dream.....wait for it....about Tommy Lee and Pamela Anderson. No, this had nothing to do with their (ahem) online video that is available.

In my dream, I was visiting with Tommy Lee (drummer for Motley Crue) and Pamela and they were giving me a tour of their new home in Ontario (not sure where). Tommy was also recounting a story about the first time he met Pamela. At any rate, it was time for me to leave and of course I needed to ask Tommy one last burning question. I asked "Is it true that Aerosmith will be touring with Motley Crue this fall?"

Tommy replied, "Yep, we're touring with Aerosmith and we're coming to Toronto on August 28th." And I woke up.

A couple of days later I went to the Aerosmith Fanclub website and lo and behold they confirmed that Aerosmith and Motley Crue are touring this fall and the first date that I saw was September 5th. Not in Toronto, but not bad psychic abilities, eh?

I felt the need to e-mail the proof of my dream to my fellow rock 'n roll buddies. Several funny and sarcastic e-mails have since been sent around. Apparently I have been dubbed the Magic 8 Ball (remember that fortune telling toy....you'd make and wish and give it a shake and the "spirit slate" would give you the answer?). This name will be even handier should I lose my hair during chemo.

Sean's hoping I come up with the next winning Lotto 649 numbers. Stay tuned.

So if anyone wants to make a wish......just give my head a shake and I'll provide you with the answer. Or leave a comment and I'll see what I can do.

Life is too funny!

Love CJ

You Can Cry if You Want To

Today was our second session with the breast cancer support group at Wellspring.

I am happy to report that this session was much more informative than the last. Although, I wasn't sure it was going to be that way at the very beginning.

Of course, I was prepared for the lighting of the candle, as our facilitator indicated last week that she begins each session this way. I was unprepared when she asked us to sit back and listen to a song. At this point, I am thinking once again....this isn't going to be for me.

So the song begins...very nice, rhythmic drumming, no words yet (no it was not Aerosmith).....then the woman starts to sing "cry if you want to". Yadda, yadda, yadda. Again, I was sitting beside Kim on the couch not looking at her at all.

Well I made it through the song and was hoping that would be the end of the touchy feely bit. And it was. Today, we were just asked to share our stories about being diagnosed and our experiences during that time. It was very interesting to hear each person's story. Some had similar elements to mine and others quite different.

I guess there will be certain things about the group that aren't my style, but ultimately if they continue to be informative and helpful, I will continue to attend.

Earlier this week I enjoyed my first shower in 11 days. It was a beautiful thing!

Love CJ

Let 'R Rip!

Yesterday I had my drain removed. Whoo hoo! I was below the 30 ml in drainage yesterday afternoon, so the VON nurse came back and removed it so I wouldn't have to sleep with it one more night.

I was a bit nervous about having it removed. It's kinda like being pregnant. When it actually comes close to the time when you know the baby's gotta come out, you think "no, that's okay, we'll just keep it in there". I was having similar feelings about the drain.

I remembered Kim's vivid explanation of her having her squeeze box removed. "It's like having 100 ft. of garden hose removed from your armpit." Not a pretty picture. (Note that Kim was hoping I had forgotten about this).

But alas, it was okay. It turns out that my drain wasn't lodged too far under the armpit. Another, whoo hoo!

So now I am to let the two incisions continue to heal (one from the tumour removal and one from the lymph node removal) and the hole from the drain to seal up.

Step one complete.

Love CJ

Movie Day

Yesterday, Kim and I went to our first breast cancer support group meeting at Wellspring.

Wellspring is this wonderful oasis in downtown London where people with cancer and their families and friends can go for support. They have a resource library, various support groups, different therapy sessions, reiki, peer support, etc. It is a great place to go.

Having said that I am not sure that I am cut out for the "support group" thing.

There were six participants and one facilitator in this lovely room at Wellspring. It was set up like a living room. Very cozy.

When the facilitator first started, she explained that she likes to begin each session by lighting a candle to symbolize.... (well I have to admit at this point she lost me). I just kept thinking that I couldn't look at Kim or I might start laughing. Not to be disrespectful in any way, but again this isn't my type of thing.

The session was more about the sharing of feelings than the sharing of information. I am an information junkie so I guess I was hoping that people would talk more about what kind of cancer they had, their treatments, side effects, what to expect, etc. This would have been more helpful to me.

I am fortunate enough to have my family and friends to share my feelings with and I've never felt that I have had to hide my feelings (good or bad) from them. So the "feelings" part of the support group for me isn't what I need.

Kim and I chatted afterward and decided that we would give it one more week. If the group doesn't turn into something that we find useful, it makes sense for us to bow out and perhaps let 2 others join.

So our "support group" might turn into movie day after all.

The VON nurse is coming again today to check me out. Yesterday my drainage was down to 32 ml so maybe I can get this thing removed by Friday. We'll have to see what today brings.

That's all for now folks.

Love CJ

Hanging In

Just a quick update to let everyone know that things are going fine.

I am a bit slow moving from the "squeeze box", as Kim would call it. So far Sydney hasn't even noticed.

Today's drainage was the same as yesterday, so I think I will have this lovely attachment for longer than I would like. The drainage has to be less than 30 ml...and I'm at 75 ml.

VON was here yesterday to check on my dressings. All looks good. They'll be back on Monday to check again.

At this point, my follow-up appointment has been scheduled for June 30th. Dr. Engel's assistant indicated that the pathology report wouldn't be back within 2 weeks, even though that's what the nurses told me and what Dr. Engel told Sean after the surgery. I'm going to call again on Monday and see what I can do to get this appointment moved up.

Mom asked Dr. Engel when I would be starting chemo and he told her in about 5-6 weeks. So I think I need to get in to see him myself so I can get the story straight. A tad frustrating.

I have been having a couple of naps a day. Recovering from this surgery business is exhausting. Who knew?

Off to bed shortly. Nighty-night.

Love CJ

Home

All went according to plan today. Surgery started promptly at 9:30 a.m. and I was home by 3:30 p.m.

Dr. Engel indicated that the surgery went well and the tumour was localized, which is good news. He didn't have to take all of the lymph nodes. I will get more details on everything when I meet with him again in 2 weeks. Date yet to be set.

When I woke up from the anaesthetic I had an oxygen mask on my face, and all I kept repeating was Pookie. The poor nurse. In my haze, it suddenly dawned on me that she had no idea who Pookie was and that I wanted to see my husband. They let Pookie come into the recovery room, which is not normally done. I guess I was in a state.

At least I wasn't asking for Steven Tyler....THAT would have really thrown everyone.

Thanks again for everyone's well wishes.

Love CJ