Thursday, September 6, 2012

The Plan

So I met with the doctor this afternoon about my next steps in treating my ductal carcinoma in-situ (DCIS). The appointment went well - my surgeon was very clear, very positive, very calm. We have laid out a plan with several steps and if/thens. Here's what it looks like:

I will go forward with the procedure ("site select" for those who know what that is) I had scheduled on Sept. 17th to see if there is cancer in that (different) quadrant. If there IS, then two areas are affected, and a mastectomy (plus reconstruction) is the best way to go. If there is NOT (here's hoping), then I will have a lumpectomy the following week, Sept. 25. If, once they check out the tissue, they have determined that they got it all out, then I will continue with 6 weeks (5 days a week) of radiation treatments. The drug Tamoxifen may or may not be useful to me; they'll know after the lumpectomy. If they look at the tissue extracted and find that the cancer is more extensive than they thought, they'll have to do another surgery, or maybe just a mastectomy. (I'm picturing a flow chart for this - anyone up to it?)

The doctor said pretty confidently that, given my age, and the fact that I'm getting married (!) and will want to have kids, I should do a "breast preserving" surgery (aka lumpectomy), because the two options (lumpectomy or mastectomy) are equally effective as treatments. At some point I may decide to do a mastectomy, even a double mastectomy, because I'm a very high risk patient now. There's a very good chance I will face this again in the next 20 years sometime. But I agree - I want to hang onto my "girls" until they've done their main job, at least.

I apologize for the emotionless report. Just trying to process all of this. But I feel okay. It's about the best case scenario that I could have expected. As long as I only look at the one next thing, it's very easy to be fine with all of this. So next stop: site select procedure on Sept. 17!

Thank you all for your continued prayers and support.

4 comments:

  1. Johanna,
    I just wanted to express to you my pride in knowing you. I know we didn't share a lot together while I was in seminary (just one class I think!) but I grew to respect you. In reading about your life over the past year I am truly inspired by your physical, mental and spiritual strength, and faith in God during this journey.
    I will pray to God for your continued healing and strength, and praise God for your continuing gifts in ministry and in life.
    Congratulations on your engagement as well!!
    Blessings,
    Stephanie Zinn

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  2. Johanna,
    My mother was diagnosed with breast cancer before I was born. She did exactly the course you're setting off on. Lumpectomy + radiation and Tamoxifen. It was very successful. She did eventually have a mastectomy, then another and reconstruction later when she got cancer two more times. She kicked cancer's butt each time and I'm sure you will too!!

    God Bless!

    Carol

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    1. Really! Interesting. Good to hear it worked so well for someone. It is sort of unnerving knowing the great likelihood that this could come back, but I am interested enough in breast feeding my children that I'm willing to take that risk. I've beat cancer once, I plan to again, and who's to say I can't "kick its butt" as many times as necessary! (That said, I'd prefer this be the last time!) Thanks for sharing.

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