Posted by: Sarah | March 21, 2005

Meeting the Oncologist

Today I met with the Oxford oncologist (Alexander #1).

I liked Aleksandr the oncologist. He could not talk precise treatments etc. until we know about the lymph nodes, but he did an exam and felt my armpit VERY thoroughly (warning me that I might be sore and achy as a result tonight), and said that he does not feel anything that is a concern to him in my lymph nodes. Obviously, that is not a guarantee of clear nodes, but since he elaborated by saying that I have a “very skinny armpit” compared to many women he sees, he did not feel anything and that was not because of extra tissue in the way, but because it’s distinctly possible that there’s nothing there. Which would be very good!

He did not want to discuss anything to do with the So-Fired-it’s-not-even-funny surgeon’s failure to check my lymph nodes at the time of the lumpectomy. But he was fine with the idea when I mentioned the Jackson surgeon.

He never once used the word “incurable” or anything like that. He talked a lot about curing the cancer and moving on. He said he would be treating me aggressively and that he doesn’t believe in giving up (in other words, it’s not that my case merits super aggressive treatment…but that he would treat a 70 year old woman aggressively as well, because he doesn’t believe in giving up). I asked about potential chemo regimens and he said it depends on the whole lymph node thing, but we very well may consider the dense-dose chemo that Meg’s friend did (every 2 weeks vs. every 4 weeks).

The biggest shocker of the appointment was talking with the genetic counselor, who said that–based on my in-depth family medical history I gave him today–the odds of my having one of the mutations of the breast cancer gene have gone from 75% to 90%. He strongly suspects BRCA1.

If I do have BRCA1, this means that if I do not do the double mastectomy, I have as much as a 50% chance of having breast cancer again in the future, and as much as a 40% chance of having ovarian cancer down the road. The boys have a 25% (I think?) chance of having prostate cancer (and a 10% chance of having male breast cancer), if I have the gene and if they got it from me.

Hoooleeeee mackerel.

p.s. Oncologist scheduled me for a PET scan for a week from tomorrow, which might could give us more answers WRT the lymph node issue


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