Enough with the lemons

Just when you’ve finally developed a positive outlook on your diagnosis and prognosis, a pathology report comes in and kicks you back to Square One.

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Damn, enough with the lemons. I’m fresh out of sugar for lemonade.

My breast cancer surgeon just called with my post-op pathology report.  Seems she didn’t get a clean margin on the tumor after all because it was into the chest muscle and she couldn’t take any more tissue on that side.

A real gut punch, since both my son and I interpreted her remarks after surgery as meaning she was about 98% sure she got a clean margin. Perhaps we only heard what we wanted to hear. Hard to say now. I guess, against my better judgment, I forgot the “cautious optimism” I was going to maintain and allowed myself to slide into full-blown optimism.  My mistake.

She said the sentinel nodes were clean, so I’m okay there, and that no more surgery will be necessary. From here on it’s chemo and radiation. Whee. Not. As before, the HER-2 report is still outstanding and I really, really want that to come back negative, not “equivocal” like the first time. If it’s positive, cardiotoxic drugs will probably be used and I really don’t want to deal with that.

The tumor was larger than expected — 5 cm at its widest/tallest point. Their second opinion path report had said it was 2.6 × 2.7 × 2.3 cm. Yes, I heard wrong on the first report (and my copy of it was blurred) but I was still really rattled at the time. I don’t understand how they measure these things — 3 dimensions, single longest dimension, etc. How do you compare those? All I know is 5 cm is just about 2″ and that’s a big chunk of bad juju. You sure can’t tell that from the incision, but I suppose that could change a lot over time. At the moment it looks almost like nothing was removed.

So here I am, feeling like the Mack truck that hit me last month just circled back and hit me again. I’ve been thinking the tumor was out and all we had to do was ensure with chemo and radiation that it didn’t come back. Now I’m in limbo again until I talk to the medical oncologist on June 9 and find out if this is going to mean a lot more chemo and radiation than before. (It was already bad enough that the heart lies directly under the left breast and thus potentially in the line of fire for radiation.) I don’t know how “unclean” the margin was, whether it was just a few stray cells or a significant mass of them. She may have said something about it but I’m sure I didn’t fully grasp everything she was telling me. She will be talking to the CU tumor board before I see her and the oncologist again on the 9th. By then I’ll have regained my composure (I hope) and come up with a long list of questions.

 

11 thoughts on “Enough with the lemons”

  1. Never did like Mack trucks . . . sorry to hear. I like that you’re analytical enough to ponder if you inferred something that was not so, but I would still put some of the blame on the doctor; you have to be clear AND ensure the patient understood everything you said.

    I have relatives who go to the doctor, come back with some news, I ask a question, and they don’t know the answer. Sure, some of that is on the patient. On the other hand, the doctor should make sure the patient hears and understands everything relevant and pertinent to their condition. Especially, not give any news until they are sure.

    Anyway; neither here or there. Hope the news is a bit better on the 9th.

    . . . the waiting does not make it anything easier . . .

    1. Yeah, I’m not happy at all about the misunderstanding, or whatever it was. Admittedly I was just coming out of anesthesia, but my son was perfectly lucid and we both got the same impression. Four ears are better than two, but apparently not always good enough. You can bet we’ll both be armed and ready on the 9th.

      You’re right, the waiting is the pits. I’m already back on the Ativan. It will take me at least day or two to come to grips with the new reality.

  2. Well, rats! Still, I’ll keep up the cautious optimism for you. My mom is four years out from her renal cancer diagnosis and is doing very well, so I have every reason to hope the same for you. Sending every positive thought I can your way …
    It’s always frustrating to not be sure that you heard what you thought at the doctor’s office … perhaps they already told me what caused my stroke and I was still too gobsmacked to understand it. The doctors who go over everything with you until you understand are true gems, and far too rare.
    (Yep, I reflexively hit “Like” too, so removed it … shit storms are not in the least likable.)

    1. When I’ve been in their offices, the doctors have talked until I had no more questions and everyone understood everything. It’s that initial revelation on the phone that scrambles my brain. Like you I was gobsmacked when I got my diagnosis and had to wait for the details, and this feels a lot like that. She might well have answered my questions this afternoon and I was just too busy trying to process the previous answer and formulate the next question. I get it on the second go around, in their offices, after I’ve had time to calm down and think more clearly.

"You don’t have to say everything to say something." ~Beth Moore

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