FIRST FOLLOW-UP

posted Thursday, 13 April 2006

Today was my first quarterly follow-up visit with my oncologist... How odd it felt to be back in that office that I frequented so often last fall.

It was like deja vu as I headed back to the lab for my blood work. It appears that my veins are beginning to heal, making this a rather uneventful experience. In addition to standard blood tests, I had an additional test called a CA-125 test (this is a protein that can be made by abnormal ovary cells and is used to help screen for ovarian cancer). Because of my BRCA 1+ status, I am also at high risk for ovarian cancer. Unfortunately, there really is no good way to screen for this (even the CA-125 is often inaccurate)... but I suppose this is the best we can do.

Next I saw the nurse for my blood pressure and weight. I think she was surprised to see that I had put back on all the weight I lost during chemo (and then some!)... I guess I hide it fairly well!

Finally I go in to see Dr Cairoli. He examines me and we discuss the ongoing screening. I had heard from some others that even with a mastectomy, they sometimes offer/recommend radiation (typically, you get radiation after a lumpectomy). Over the past few months, I had been thinking a lot about this... should I ask for radiation? (Am I crazy to want more treatment?) It feels so good to be done, but I do not ever want to look back on this and wonder "if only I had done the radiation..."

What I had heard was that with mastectomy, the recommendation is based on the # of + lymph nodes:


3+ radiation of the node field & chest wall

1-3 optional radiation (not necessarily recommended)

0 no radiation (risks outweigh the benefit)


I fall into the 1-3 range, where it is not really recommended, but sometimes offered. Dr Cairoli clarified the guidelines for me. He said that with 1-3 lymph nodes, radiation is only recommended if the tumor was very large (>5 cm). He really felt that the risks of the radiation would outweigh the benefits that I would receive, therefore he would not recommend it. After discussing it, I was comfortable with this recommendation and could put the issue to rest. I've done everything I can to fight this with the information that is available at this time and I can not/will not question that further.

We wrap up the appointment and schedule my next visit. On my way out, I stop by the treatment room to say hello to the nurses and show off my curls. It's like a big reunion party. It's kind of strange, as I look into the treatment rooms, knowing that that was once me sitting in those chairs... and in all honesty, it could be once again.

I now have to wait a few days for my bloodwork to come back. This is fairly excrutiating. Why is it taking so long? Finally, Dr C calls and lets me know that all of my tests came back normal. It is really a huge relief. I can't believe that I will be going through this every 4 months. The waiting game is frustrating, nerve racking and emotionally exhausting. It is hard to keep from thinking about "what if", but for now, I will try to focus on "what is".