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Filling in the gaps – Part two January 29, 2014

Posted by Judy in Musings.

I realized that I had left several things hanging from previous blog posts, so I thought I’d fill in some more gaps.

Remember that awful drug the surgeon’s NP wanted me to take and I refused? I ended up not taking it, but the surprising thing was the reaction of the surgeon. When I met him for the first time he said, “Oh, and the bromocryptine, you don’t have to take that, you should be fine.” Uh, what? Was he playing good cop to the NP’s bad cop or something? I told him about the study done with using Sudafed to suppress lactation hoping to show that I really was making an effort and wasn’t just being a stubborn patient. He thought that was interesting and great, but seemed totally unconcerned about the weaning. Weird!

Two cancers
I also wanted to clarify the whole “I have two types of cancer” thing. At the beginning, I was told that the two tumors were different types of cancer. Both the medical oncologist and my FIL said that in a practical sense, that didn’t really matter since treatment was the same. It took me quite a while to be satisfied in my head that it didn’t really matter. I don’t think I ever really explained that here, though, and it seems that some of you are much more stressed about the two types of cancer thing than you should be. I’ll try to be brief, just remember that I can talk the hind leg off of a horse!

Breast cancer comes in many different forms. The main ones are:
*in situ – this means that the cancer cells haven’t left the place where they started and haven’t infiltrated to the surrounding tissue.
*invasive – this means that the cancer cells have infiltrated to the surrounding tissue and could possibly have reached the lymph nodes.
*inflammatory – this is actually a type of invasive cancer that blocks the lymphatic vessels in the skin, causing inflammation and redness

The first two have further subsets:
*lobular – cancer develops in the lobules of the breast
*ductal – cancer develops in the milk ducts of the breast

So you could have:
ductal carcinoma in situ (DCIS)
lobular carcinoma in situ (LCIS)
invasive ductal carcinoma (most breast cancers are this type)
invasive lobular carcinoma

My tumors are invasive lobular and invasive with ductal and lobular features. So technically, yes, they are two types of cancer (lobular and ductal). But, they are both subsets of the same type of cancer, invasive, meaning that the treatment plan is pretty much the same for both. Once I got that sorted out in my head, I quit thinking about it as two cancers, which makes it sound much, much worse. Of course, once the full pathology report is in after the surgery, we may have different information. But for now, I’m sticking with plain, old invasive cancer.

Bone/CT scans
I don’t think I ever shared the results from these scans, at least I couldn’t find anything after a quick search. The bone scan came back normal . . hooray. I got a call from the medical oncologist’s nurse regarding the CT scan results. The conversation went something like this (my thoughts are italicized):

Nurse: Dr. R wanted me to give you the results of the CT scan.
Me: Okay
Nurse: They found a uterine
Me: (Great! Now I have uterine cancer too!!)
Nurse: fibroid
Me: (Oh, yeah, that’s not news. I knew that.)
Nurse: and he’d like for you to do a uterine ultrasound.
Me: Wait, an ultrasound? Well, I already knew about the fibroid. They discovered that with an ultrasound during my last pregnancy. So why do I need to do another ultrasound?

Anyway, I guess doctors don’t go reading a patient’s chart from cover to cover. Had he done that, he, too would have known about the fibroid. I went ahead and passed on the ultrasound. I really saw no reason to confirm something that I already knew, and it has nothing to do with the breast cancer. For a minute there, though, I was freaking out that there was going to be something wrong with my uterus. Happily, fibroids are really no biggie!

So there you have it, most of the loose ends are now tied up. Now it’s time to just sit back and wait for the surgery to come and more importantly, to get the final pathology report and the results from the sentinel node biopsy. Have you noticed a pattern here? There are lots of tests, then lots and lots of waiting. Patience is not really one of my strong suits!!


1. Marian - January 29, 2014

I love keeping up with your blog. It makes me feel like I can read how my prayers are being answered. You are a strong woman with an army of us on your team! I will continue to pray for patience and strength! Love you!!! P.S. Tell Rick I’ve not left the house without his scarf and hat for days!!!!

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