"Don't spend time worrying about how you are going to die. Worry about how you are going to live today"

Tuesday, January 18, 2011

Now what do I do? More difficult decisions

So I did meet with the medical oncologist today to really discuss the Oncotype DX test results and chemotherapy.  My medical oncologist told me that based on my score of 17 that I was at an 11% risk of distant recurrence in the next 10 years based on my tumor.  Being that this it technically the "low risk" group, she did not recommend chemo because she did not believe the benefits outweigh the risks.  She indicated the additional risk reduction that potentially could be obtained was only an additional 1-3% and because I have a less aggressive tumor (Grade 2, HER2- and strongly ER/PR+) that chemo typically doesn't work as well on these types of tumors.  Chemo is looking for rapidly dividing cells to kill and my tumor is not that aggressive.  The other thing she showed me from the test results are that the confidence interval is 95% meaning that the range of my recurrence rate is 8-14% and they take the average (11%) and that is my recurrence rate.  They really don't know if I am 11% - that is just the average...so this is a 7 point difference from 8% to 14%.  At 14%, the potential 3% may sound appealing.  At 8% the risk reduction is a potential additional 1 1/2%. 

I had a few things to question her on.  First of all on my pathology report from the lumpectomy it indicated that I have "angiolymphatic invasion", meaning the cancer cells have a pathway to vessels and lymph nodes.  It doesn't necessarily mean the cells have moved, but they could have (that sounds bad hu?).  So I asked if this puts me at a higher risk and she said it does a little bit but there are other higher risk things that would be more concerning like HER2+, ER/PR negative, Grade 3, etc...  Still, it make me feel like I have cancer cells swimming all over my body right now and I am freaking out!  So if this is my one chance to try to blast these swimming cancer cells, why wouldn't I want to do it?  She said she would give me chemo if I wanted it (Cytoxen and Taxotere for 4 cycles over 3 months) for peace of mind, but there are risks of having chemo and you may not see any result in the end anyway.  UGH! 

My thought is, how do I live with my decision on this either way?  If I have no chemo, will I constantly worry that I didn't do the right thing?  If I don't do chemo and it does come back, can I live with that?  If I do chemo, it can still come back - there are no guarantees either way.  I feel like I am making decisions based on rolling the dice or something else by chance.  Nothing seems clear.  Nothing seems compelling to help me know what is the right thing to do.  In the end, I want to be here to raise my young son and I want to do whatever I can to have the best odds of that happening.  I also have to live with the decision for the rest of my life.  Will I be OK with it either way or always have regret?  I just don't know how to work through this right now.

I guess I will seek a second opinion and see if another medical oncologist tells me something different or something compelling that makes the decision easier.  My medical oncologist also referred me to a oncology psychiatrist that can help me sort through the decision (not medically) by helping me address my own issues and feelings on all of this.  I must really be a "basket case" if I need a psych to help me and my doctor recommended it!  I actually think it is a good idea as I am just freaked out on this one. 

I am so emotionally drained and physically tired.  I am SO SICK of breast cancer and all the crap it dishes out.  I want my life back.  I am sick of asking questions that no one can answer.  I am sick of searching for something NO ONE can provide (guarantees).  I am sick of trying to make life saving decisions based on vague information.  I am sick of being obsessed and consumed by breast cancer.  I am sick of going to the doctor and having people check out my boobs.  I am so sick of crying and being scared.  I am sick of looking at my son and wondering if I will be here for him. 

I keep looking for meaning in all of this and I just can't see it yet.  I am so tired, so very tired.  I just want to sleep peacefully and wake up in the morning not thinking about this.  I need a vacation from cancer, but I know that's just not possible.  It is part of me now.  It will always be a part of me and my life.  I just have to find a way to make it a smaller part of me - somehow. 


  1. I just want you to know I'm praying. For you. For me.

    I was diagnosed on January 13th. I hate it.

    I'm scared.

  2. I am sorry you are going through this too. It is a long, scary and uncertain journey. Prayers to you too!