The Treatment Plan...

After several appointments this week, I now know the general plan for the treatment of my breast cancer.  The oncologist and surgeon worked together to come up with the best course of action for my specific situation.  That situation is this... I still have DCIS (cancer in the milk duct) but it is not contained to the milk duct.  It is outside, which means it's more "invasive" than I was originally told.  This is not extremely alarming to the doctors, they still feel very confident that is a treatable, curable, and survivable diagnosis.  It is also important to note that it is more likely that it could have spread to my lymph nodes since it is not contained to the duct, although the surgeon does not feel any indication, nor does the ultrasound show any indication the it has.  There is also a small chance it could have spread to my blood.  This is not likely.  So my first prayer request that this cancer has/does not spread my blood, lymph nodes, nor any other part of my body.  I also could have Paget's disease, which renders my nipple unsalvageable for the future.  The cancer I have is fed by all 3 hormones that can feed breast cancer, progesterone, estrogen, and HER2.  In the recent past, groundbreaking researchers have found methods to drastically decrease the reoccurrence of HER2 cancers.  This is a big deal for me because prior to that research, breast cancer fed by HER2 was more likely to reoccur.  I'm so grateful that God has revealed these new methods so that I can benefit from them.

In the next few weeks, I will begin chemotherapy to hopefully kill the cancer and possibly shrink it.  This means I'll have a port installed sometime soon through which they will administer my chemo.  I'll have 6 infusions, around 5 hours each.  It will take 18 weeks to complete the chemo (barring any setbacks) because I'll have 3 weeks between each treatment.They will monitor the progress of the chemo halfway through, probably through an MRI since my "lump" is not able to be felt.  I'll have my first MRI next Thursday so they have something to compare it to.  I'll likely finish up chemo sometime in October.  I've asked the oncologist if I can work through chemo and she says we'll have to wait and see.  Since my immune system is compromised, a school is not the best place for me.  But since I teach 4th graders, we might be able to make it work.  I'm just going to play that by ear.  I'll know more as the treatment progresses.

Because the affected area is 8-9 cm and the nipple is unable to be reattached, my surgeon has recommended a mastectomy for that breast about a month after I finish chemo.  Because of my age, there is a possibility that I could qualify for a double mastectomy.  I do not have to make that decision now, so I plan to let everything sink in before I start figuring that out.  Whichever I end up having, a single or a double, my surgeon says it's a 4-6 week recovery with at least 4 weeks off work. This surgery will likely be sometime in November or December, so I'm going to have to figure out what work will look like for me at that time, as well.  As for reconstruction, I'm really on the fence about whether or not I want to go down that road.  Again, I don't have to make a decision just yet, so I'm not going to worry about it.  If I choose to reconstruct, it's a 12-18 month process.  There are so many other factors that are involved in that decision, so I'm going to do some praying, thinking, and research before I decide.

After surgery, they will send my breast tissue to pathology.  At that time, they will determine if I need radiation.  If it has gone to the lymph nodes, I will need radiation.  If the area outside the duct is over 5 cm, I will need radiation.  My prayer is that neither of those situations arise and that I will not have to endure radiation. Because my dad developed a second cancer because of his radiation, I worry that could happen to me, as well.

I also had some genetic testing done this week.  The results for the breast cancer genes (there are around 15) will come in within 6-10 days.  The results for all other genes will be back in a month.  I opted for the full test since I was paying for it anyway.  And at this point, knowledge is power.  I could have future scans if I have genetic abnormalities that make other cancers more likely.  I know that it is what it is.  I can't change my genetic makeup, but I am currently praying that these test results don't completely scare the heck out of me and that I don't have any genetic abnormalities!  Feel free to pray with me!

I've got multiple appointments lined up for the next few weeks and into the summer.  I'll see the dietician to get some guidance about foods to have during chemo.  Unfortunately, I will not be losing weight during the process.  They'll pump me full of steroids.  I will lose my hair, so get ready for bald and beautiful Kristy!  Currently I'm having some anxiety about everything, so I setup an appointment with the oncologist psychologist, as well.  I know myself pretty well and I'm guessing that most of these feelings are because I'm extremely overwhelmed right now. I'm guessing they will pass as the ball gets moving and as my faith gets even stronger.  But I have an appointment in early July, just in case!  Please say prayers that my nervousness subsides in the days ahead.  I also have an appointment with a lymphatic specialist person-thing (I can't remember what they're called) because of some things that can happen to my arm after they take lymph nodes during surgery.  I have no clue about all that right now.  I'll figure it out later, too!

As you can see, I've got a lot of "figuring it out later" to do.  That's okay.  One thing I'm learning through this experience is that God wants me to find security in Him.  I'm such a planner and it brings me comfort and security to always know what is coming next.  Well... I'm living in a curveball right now and I must find a way to feel secure in His plan.  His word.  His love.  Clearly, I'm a work in progress.  But I know I'll make progress to be more like Him.  There are several verses that have brought me much comfort, Philippians chapter 4 is so helpful and calming.  2 Timothy 1 vs. 7 is also powerful for me.  I've had a few friends send me words and verses of comfort.  It helps immensely to read these words and know I'm being thought of.  I cannot express my humbled gratitude enough.

So if you would please do me a favor and keep praying for me, Ryan, and for our girls, I'd really appreciate it.  We shared the news with them last night and it went better than I had expected.  Thanks be to God.  Gracie had a bunch of questions, the first of which was, "Can it kill you?"  I told her that it will not kill me.  We discussed that it's not contagious and how smart all my doctors are.  We talked about how no one caused this to happen and how Momma is gonna try out being bald!  She has some experience with this from a show she watches and from a few friends who've gone through this.  She asked if I was excited to be bald and told her I might like it?!  We discussed how I need a team of people to help me through this.  We talked about everyone who's on my team.  All of our little family, all of our bigger family, and our friends, and church family, and work family, and on and on.  She quickly moved on and asked if we could play the cupcake game.  I said, "Let's do it!"  And that was about it.  A few more questions later in the evening, but mostly we're gonna take it as it comes.  She knows I want her to talk to me about it, but I also told her it was okay to talk anyone she wants about it.  This is not a secret.  So if Gracie seeks you out, please stay positive and encouraging.  That's what we need!

Specific prayer requests...
1.  Pray that the cancer has/does not spread to my lymph nodes, blood, or other body parts.
2.  Pray that I do not require radiation.
3.  Pray that my anxiety leaves and my faith is strengthened.
4.  Pray that I don't have a meltdown during the MRI... I'm kinda claustrophobic!
5.  Pray that Ryan feels peace and support during this time
6.  Pray that my girls remain peaceful, happy, and healthy in the days ahead.

I could go on and on, but we'll start with that!