After meeting with the doctors at the CU Breast Center in Aurora last Tuesday, the next stop was a meeting with the medical oncologist in Boulder on Friday. He, along with the first surgeon I talked with, were among the doctors at the Rocky Mountain Cancer Center’s tumor board meeting on Tuesday (at the same time I was down at CU).
You’ll recall the first surgeon proposed chemo before a lumpectomy, with the idea of shrinking the tumor prior to its removal. The oncologist explained that this would mean starting with a baseline PET scan. After chemo/hormonal treatment began, the efficacy of the drugs and changes in the tumor would be tracked with successive PET scans. If it appeared a particular drug wasn’t working, this would provide an opportunity to change to a different drug or combination of drugs. I could see the advantage to being able track the effect of the drugs on the tumor. The doctor estimated the chemo would continue for some 18 weeks or so before the tumor was removed. That struck me as a long time to sit around playing footsie with a malignant tumor.
He said the tumor board had been in general agreement, although not unanimous, that this was the way to proceed. He also said that historically, statistically, there is no significant difference in outcome between cases where chemo is used before surgery and those where it is used after.
When I asked, he said the chemo and radiation would be done in that building. The surgery, however, might be done either there or at the Louisville hospital where the surgeon is based. So theirs is a team in the sense that they do consult together, but they are not all based in the same place seeing each other every day.
After taking all that in, I sought out the navigator who had called me and she did indeed have chocolate. Dark chocolate with caramel centers, in little foil wrappers with uplifting phrases printed on the inside. I had several before we set out on a quick tour of the facility.
It was a much smaller, cozier environment than at the university. A real wood fire burned in the fireplace in the main lobby, and the mountains could be seen just to the west (or would have been seen if it weren’t raining).
Perhaps it was just the reality of the situation but I was somewhat put off by the infusion center and the rows of chaise lounges, occupied here and there by little old ladies with their IV bags hanging above them. Forget the mountain view. I’m not yet a little old lady — not that old, anyway — and the last thing I want is to get stuck sitting next to one and having to make polite chit chat for a number of hours. (I’m an extreme introvert; I don’t do chit chat.) I don’t know what the arrangement is in Aurora; I didn’t take a tour. But I will, if necessary, employ my son’s suggestion of donning headphones to signal “Leave me alone”
Anyway, before leaving Boulder, I cancelled the Monday (yesterday) appointment with their radiation oncologist. As before, I didn’t think meeting the radiologist was relevant to my decision.
Worthy of note: The drive to and from Boulder was much easier than the one to the university. Much of it, in fact, was on rural roads. And the parking in Boulder is much better — ample free parking on three sides of the building.
Also worthy of note: Just to hedge my bet, I’d already gone ahead and scheduled surgery in Aurora on May 20, thinking I could always cancel it if the Boulder group made a more compelling case.
After the Boulder trip, I slept on the whole thing for a day or two, as did my son, and we both came to the same conclusion by Sunday night: The university seemed more organized, more close-knit as a team, more dedicated specifically to breast cancer, and in general inspired more confidence. And it is nationally ranked as one of the top cancer centers in the country and Number One in Colorado. A pretty easy decision, actually.
So now you’re up to date on everything. The appointments, the testing, the scrambling, the pressure, etc. are over for now. Surgery will be on May 20th. I have a week to kick back and pretend everything is just as is it was a month ago.
Any bets on how that goes?