The Best of all Possible News

Barbie got a call this afternoon from Dr. Gadd, the doctor who performed her lumpectomy 8 days ago.  The pathology report came back early, and all the news is good.  The cancer measured 1.6 centimeters, and all the margins around it tested negative; hopefully, they got the whole cancer.  Plus the sentinel lymph node was also negative.  This was the best possible result.  Yes, the growth was beyond the margins of the duct, but small enough to be classified as a stage 1 cancer.

Repeat: all the cancer is gone, and it has not spread to the lymph nodes.  Hooray!!!

The relief is palpable.  Barbie can now concentrate on preparations for her concert without having nagging doubts about what the pathologist’s report will say.  There will be a conference of several experts on 3/27, the Wednesday after the concert to determine what the course of treatment should be.

• Last week when Barbie was getting operated on, I went to Beth Israel to have a 4-week checkup and to get an infusion of Zometa, the medicine that promotes increased bone density.  The nurse I normally get, Mary Jane (MJ), has gotten to know Barbie and me quite well.  She was devastated to hear that Barbie had cancer too.  She immediately went somewhere, and came back with the book I Flunked My Mammogram, and gave it to me to give to Barbie.  It has lots of information about Breast Cancer, in understandable layman’s terms.  It was a perfect gift.  Thank you MJ!  I read it while waiting for Barbie to come out of the operating room.  One of the diagrams it contains presents information about the size and growth of breast cancer tumors.

We took 4 things away from studying this diagram.    

1. Barbie’s tumor, at 1.6 centimeters was around 32 doublings. 
2. At 90 days a doubling, and since the tumor only becomes detectable at 30 doublings, her tumor has only been detectable for 180 days.  180 days before her surgery was September 6^, 2012.
3. If Barbie’s mammogram was every year in June, it could have easily been a 2 centimeter tumor and likely a higher stage cancer.
4. The tumor has been growing for 8 years.  How many other tumors are growing in our bodies that are undetectable?

The next step is to deal with the concert.  Now that worries about the disease are somewhat diminished, Barbie can concentrate even more fiercely on the music.  She is very enamored of this piece.  I expect to be won over by the performance.

What happens next on the medical front will be determined by a conference with MGH experts, hopefully on March 27.  Oncologists with specialties in radiology and chemotherapy will be there, as will Dr. Gadd.  Barbie has asked if they can do an Oncotest before that time.  This test categorizes the DNA of the cancer, and determines on a scale of 1 to 10 how likely it is to return.  That group will determine her course of treatment, whether it be radiation, chemotherapy, estrogen suppressing pills, or some combination of these and other options.   But for now, it is just a huge relief to know that it is out and gone, and has not progressed to other systems.

Thank you all so much for your encouraging notes and thoughts.  We are both going to gain weight on all the delicious meals and special treats!  The best aspect of all this is learning about all the good friends we have.  It truly helps.