Oncology Appointments

Whew! I'm tired!

It's been a VERY long 2 days, seeing 2 different doctors. Here we go......

Dr. Hunt, Radiation Oncology

Radiation is typically done after a lumpectomy and Dr. Hunt explained that radiation goes one step further than chemo in fighting any remaining cancer cells. He said I would have radiation treatments for 7 1/2 weeks, Monday-Friday, and that each treatment would last about 15 minutes.

I will schedule an appointment for a mold to be made of my arm raised above my head. That is how I will lie in the radiation machine. I will then have a dummy scan so they can point the radiation in the area of the tumor. The first 5 weeks of radiation will be a little more broad. The last 2 1/2 weeks will be directed in the exact spot of the tumor.

He said it's very easy and there is no pain whatsoever. The only side effects will be a skin rash and tiredness. He said the tiredness would be similar to being out in the sun all day; I could get up and do things and go places, but I'd rather just stay home and rest. He said both side effects would gradually get worse as I went along and they would gradually disappear once I finished radiation. He also said they can give me creams to put on the rash to help and that it was more uncomfortable than painful.

I will begin radiation treatments after chemo........

Dr. Yardley, Medical Oncology

This appointment is the one that really wore me out. Thank you to Jennifer Mumphrey and Greta Ward for sticking it out with me.

I arrived at Tennessee Oncology (at the Sarah Cannon Cancer Center) 30 minutes before my appointment, as directed. I submitted all my paperwork and paid my co-pay. About 30 minutes later I was called back. My posse (Scott, Greta and Jennifer) were asked to sit in the hallway in chairs they had lined up while I was swept away to the lab. That place was BUSY! They had 4 stations in a room roughly 9 x 9, each with a chair, a nurse, a computer and a shelf full of tubes, needles, blood pressure machines and thermometers. I was weighed and my height was measured (5' 1" in case you're wondering.....and no, I'm not telling you my weight).

My temperature and blood pressure were taken and then she got out the needle. Rats! She drew about 5 tubes of blood. I commented, "Wow. This place is busy." The nurse replied, "Yes, it is. And sometimes it's busier than this."

I was then asked to sit with everyone else in the hall. They didn't have a room available for me. After a few more minutes of waiting, we were all ushered back to a room. A very small room. And it was stuffy in there. And we could hear the conversation next door. We cracked the door a little bit to get some air and Dr. Yardley finally appeared about an hour later. I was getting antsy at this point.

She started using really big words and it was tad hard to understand her (she mumbled a little) but once she got going, I was able to understand what she was saying and started to relax a little.

Dr. Yardley stated that I had a few things in my favor and a few things working against me. The positive things were that the cancer was caught very early and the lymph nodes were negative. She said the tumor was small in comparison to others. Her exact words were, "It's amazing that you actually found this because it was so small." God and I did a mental hi five (because He's cool like that) and I said to myself, "GOD is the amazing one." She went on to explain the negative pieces: I have a 30% chance of never getting this again if I don't do any chemo and those odds weren't good with her. Also, the type of cancer in my case is very aggressive and very fast growing. She said the tumor hadn't been there long.

Along with the aggressiveness of the cancer, she also said the cancer is estrogen positive but HER-2 negative. Basically a HER-2 negative diagnosis means that the the HER-2 gene is not over-producing protein, causing cancer cells to grow. The estrogen positive factor means that I will have hormone therapy for 5 years after chemo is over.

She is recommending 6 chemo treatments to be administered once every 3 weeks. If I start in the next couple of weeks, I'll be done somewhere around Thanksgiving. I can add that to my list of things to be thankful for.

She went on the explain a drug trial that is available to me. It's a drug called Bevacizumab that blocks a protein that is required to form new blood vessels. Without new blood vessels, the growth of the tumor is slowed. If I choose to participate in the trial, there is only a 33% chance that I will receive the trial drug. Do you know how they decide? It's basically a crap shoot. Seriously. It's completely random. The paperwork even says so: "Research participants will be randomized (similar to flipping a coin or the roll of dice)". There are 3 groups and only Group 3 gets the trial drug. The other 2 receive a regular chemo regimen. In group 3 the trial drug is administered along with a regular chemo regimen. I have to decide if I want to participate in the next few days.

Dr. Yardley also stated that there would be lots of support drugs. She said the chemo would be the easy part. But they give you lots of prescriptions to keep with you for immune support, nausea (about 3 different ones for that) plus drugs to keep infections at bay, etc. I will have to be on several drugs prior to starting chemo and continue a lot of them throughout the 18 weeks. Some will only be taken as needed. She said they want to provide me with everything they can, so that I won't have to suffer through any additional medical problems. They stay on top of it because the chemo can really weaken the immune system. She said not to go to the emergency room for anything, but to let them know ANY other symptoms I'm showing, even if it's just sore throat.

Several tests need to be run before I can begin chemo. Next week is going to be busy. Monday morning I have to be at Imaging Alliance on White Bridge Road at 6:50 to drink the contrast fluid (a powder mixed with Crystal Light). Then the test will begin at 7:50. It should take about an hour. Then Wednesday morning I'm scheduled for an echocardiogram at 8am, then it's off to Dr. Cooper for a surgical consult about placing the port. If he says my incision is healed up enough (it's still open in one tiny spot and still draining) and he has a spot open on the surgery schedule on Friday, I will then have the port placed.

The port: It's about the size of a nickel and it's placed under the skin. It had a long tube on the end of it that will be placed inside a vein. It will look like a knot on my skin. It's placed just under the collar bone on the opposite side of the tumor (mine will be on the left).

If Dr. Cooper can put the port in on Friday the 6th, I will begin chemo on Wednesday, August 11th. I will see Dr. Yardley before each chemo treatment and they will do lab work (draw blood, take my blood pressure, etc). Each treatment (including the labs and doctor visit) will take approximately 4 hours.

After chemo, I can return to my normal activities, as long as I'm feeling ok.

She said around day 10 after chemo I would start to feel tired and my immune system would start to fade. Around day 14 I would begin to lose my hair. I want to thank my new friend Shelly Hackney for giving me all her hats and headscarves. She just finished her chemo back in February and is doing really well. Momma, Angie and I are going shopping this weekend to see what else I can find. There is also a web site (http://www.headcovers.com) that has a boat load of hats, headscarves and other things for women (and men) going through chemo hair loss. Dr. Yardley stated the hair would begin growing back after the last treatment.

Speaking of hair loss, I would like to also mention my brother Ted and his wife, Greta. Greta has really short hair and is going to let it grow out as long as I'm going through treatments. Ted has shaved his whole head completely bald so I don't have to go it alone. And Scott says he's going to do the same thing when I start losing my hair. How sweet is this family?

I think I covered everything for now. I will post another update once I get through all my tests next week.

Everyone have a great weekend! I'm headed to Fall Creek Falls to pick up my niece from church camp tomorrow. I love church camp and plan on going for the whole week next year.

It's good to be alive! -