Tuesday, March 17, 2009

FIRST VISIT TO ONCLOGIST - DEVAN MOODLEY

I went to see the oncologist (Devan Moodley +27 11 356 6520/04, Wits Oncology Donald Gordon Medical Centre, 17 Eton Road, Parktown, Johannesburg, Gauteng, SA) yesterday who works with my breast surgeon and plastic surgeon.

Although we are still waiting for breast tissue analysis results, he was able to give me 2 senario's:
  • We know from previous biopsies that the DCIS was estrogen positive - meaning the cell growth was stimulated by estrogen.
  • We don't yet know if the tissue was progesterone positive or not.
  • And we don't know whether the cells were Her2 positive or negative.
He put my info:
  • my age = 35yrs - young to get breast cancer
  • that my DCIS was grade 3 - meaning it was quite aggressive and fast growing
  • that there was a 0.3cm bit of invasive cancer (they normally only suggest chemo from 1cm - dependant on other variables) that had invaded micro blood and lymph vessels.
into a computer program and it gave the following info:
  • If the cancer was progesterone negative and Her2 negative => treatment would include chemo for 3 months and Tamoxifen for 5 yrs
  • If the cancer was progesterone positive and Her2 positive => treatment would include chemo for 6 months + Herceptin for 1yrs + Tamoxifen
The program showed I have a 94% chance of the cancer not returning in the next 10 yrs without treatment. Which I was quite pleased with!

Breast cancer is not like some cancers where, once you have gone beyond a certain time period, will not return. It can return at any point.

So, without treatment in the next 10yrs without treatment, I have a 6% chance of the breast cancer returning.

If i have the oncology treatment, I will only increase my chance of no recurrence in the next 10 yrs by 4%.

So I will then have a 98% chance of the breast cancer not returning in the next 10 yrs after the treatment.

94% chance no recurrence with no oncology treatment
98% chance of no recurrence with oncology treatment


The conversation yesterday was very academic therefore quite easy, and I walked out with a stat report and a prescription that looked like:
  • T + C + TAMOXIFEN (if results are negative)
OR
  • T + C + H + TAMOXIFEN (if results are positive)
(T = Taxotere. C = Cyclophosphamide. H = Herceptin)

All quite easy to deal with until the physical reality of actually living through the process hits.

I am between a rock and a hard place trying to decide what to do next. I need to get my breast tissue results before I can think about it further.

Strange, but now the double mastectomy seems like light work compared to the next step.

I think the thing I am most nervous about most are the side effects of the suggested treatment.

Read on this site for more info on the T and C:
www.taxotere.com
http://www.drugs.com/sfx/cyclophosphamide-side-effects.html

I feel quite calm though and am getting better at living in the moment and holding my centre. That said, this decision is not easy.


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