Wednesday, September 3, 2014

#BlogElul: Can You Hear Me? We Don't Back Down From Cancer

My sister and I spent a lot of time today listening to medical professionals. 

Here is what we heard:
  1. Amy's small tumor is estrogen-receptor-positive (ER+) and progesterone-receptor positive (PR+), which means that the cells are trying to behave like normal breast tissue cells, but they're not quite hitting the mark. The good news is that this isn't our mother's triple negative breast cancer, and there are very effective chemotherapy drugs to which this type of tumor will respond.  It is totally treatable and curable.
  2. The tumor also is positive for the protein human epidermal growth factor receptor 2 (HER2+), which means it is somewhat more aggressive than other types of breast cancer, but again, there are very effective drugs (Herceptin and Perjeta, among others) to which the tumor will respond.
Based on what we heard and the constraints of the business she runs singlehandedly, this is the strategy she and the doctors have mapped out for the next few months:
  1. She's scheduled to have a lumpectomy (a same-day procedure) on Thursday, September 25, which is the first day of Rosh Hashana, and, I believe, a good omen.  Even as the world is being born, so, too, will she have an opportunity to begin again...healthy, strong, and whole.
  2. In mid to late October, she'll begin chemotherapy, the specific "cocktail" to be determined based on information gleaned from the lumpectomy.  Its frequency likely will be once a week either every other week or every third week, depending on the specific drugs selected for her.  At the same time she'll also be treated with Herceptin or Perjeta.  The chemotherapy will last for about four months, the other drugs for 12 months.  She may lose her hair, but again, that depends on the specific mix of drugs that are selected for her.
  3. Once she's finished with chemotherapy (probably sometime in February), she'll have a window of opportunity of about three weeks to decide about next steps after which she'll either have radiation or a mastectomy.  Not wanting a repeat of the last few weeks, she's leaning toward the latter and I can't say I blame her.  But we'll cross that bridge when we come to it.
  4. In the meantime, she'll also schedule additional genetic counseling and testing (beyond what she and I both had in 2010) to rule out the possibility that this tumor was caused by hereditary factors.  Based on the information available at this point, neither the surgeon nor the medical oncologist believes that it was, but the testing will confirm their hunch (or not...).
We heard a lot today, and it was exhausting.  However, we're good listeners and we've got a pretty good handle on things.  Most of all, we're strong, we're a family, we're in this together, and we're buckling up for the ride.  

Can you hear me?  We don't back down from cancer.

Inspired by Ima on (and off) the Bima, this #BlogElul post is one in a series marking the days of the Hebrew month of Elul, which precedes the Jewish High Holidays and traditionally serves as a time of reflection and spiritual preparation for the new year.