Not so fast, there...

And here I thought I wouldn't find anything else to write about.

I do love roller coasters, especially with lots of twists and turns, but the roller coaster of my health is just not fun anymore.

Yesterday my doctor in Boston called me. Even though they still hadn't received the slides from my first surgery or my radiation records, they talked about me at the tumor board, so he was calling to tell me what they had said. Present in this discussion was one doctor who specializes in Hodgkin's survivors who have developed breast cancer, and one who specializes in young women with cancer. (You can see why I opted for Boston! It's like they KNOW me!) Taking what data they have on cases like mine, and my particular age and life goals, they had a conversation about my next steps.

Turns out my risk for breast cancer reappearing in the next 5 years is considerably higher than we were led to believe. Because both sides were equally exposed to radiation, I'm like a ticking breast cancer time bomb; whatever it was that turned some breast tissue into carcinoma on the left side is still working on the right, and could potentially rear its ugly head at any moment. The risk of something appearing in the next 5 years in the affected breast is about 15%, and about 18-20% in the opposite breast. For average DCIS patients, risk starts small and increases, but for patients like me, the risk of recurrence in the short term is much greater.

Now, if they could be sure it would recur as DCIS, that would be simple because it is very treatable. Just snip snip, sew sew, and it's out. But they can't be sure of that; it could come back as something invasive. Or it could not come back at all. There's just no way to tell.

So what do they recommend? At the end of the day, they are urging me to seriously consider a bilateral mastectomy, either all right now, or one right now and one after I breast-feed. (By now, I've let my dream of breast-feeding go. Would be great if I could, but if I'm going to do this all eventually, let's just get 'er done all at once. As my dad pointed out, he wasn't breast-fed, and he turned out pretty well.) One doctor, the one specializing in young woman, said a bilateral mastectomy in the near future might even be better for facilitating my goals (child-bearing) because I could just take away the risk entirely and be able to be there for my children without either having to do this surgery while they are young, or turning up with invasive breast cancer and having to deal with that with a couple of rug rats under toe.

They have a group of 18 women like me - Hodgkin's survivors with breast cancer. Of those 18, 14 opted for the bilateral mastectomy. Of the four who didn't, two of them developed breast cancer again in three years. Now granted, that is a small sample. But pretty sobering.

So what's a girl (who is planning her wedding and would sort of like to fill out a dress, not to mention a swimming suit on her honeymoon) to do? I feel awful. I had decided not to even start processing this possibility until well down the line. All the weight I felt had been lifted from my shoulders now feels like it has been dropped back on from several feet up. It might as well be July again. It would almost be easier if they'd just said to me, "It's invasive. They've got to come off." Great, tell me what to do. But to have this, "Well, your risk is higher than most, about a 20% chance you could get something else that may or may not be life threatening..." What do I do with that?? I mean, 20% risk - driving my car on any given day is as life-threatening as that!

Really all that's keeping me from hacking these trouble-makers off at this point is my vanity. I'm kind of fond of them, to be honest, despite the mischief they've caused. Also, it feels like over-treatment, a bit. Pretty drastic move for 20% risk. Reconstruction is of course an option, but the recovery is so long, and the possibility of taking tissue from elsewhere in my body to fill up the new boobs is tricky when I don't really have a lot to spare. (Doggone my healthy physique.)

And where does planning a wedding fit into all of this? If I had this done, say, in the spring, am I really gonna be ready for a wedding in July? Plus, I have learned that two VIPs won't be able to be at the wedding on July 20, like deal-breaker important. God, are you trying to tell me that July is not the time? Earlier, then, so I could have a live-in husband to take care of me as I recover? Or later, so I have time to heal and be healthy and ready to start a new life with someone? July was going to work so beautiful for so many reasons... Dang it!

My next appointment with my medical oncologist is on Monday, so I'll talk with her about all this. My next appointment with my surgeon is January 9. Maybe I should move that sooner and ask her what she thinks? Maybe I should keep it in January, and just enjoy Advent and Christmas, my favorite time of year? I don't know. :(

Just when I thought my life was back on track. Cancer is such a jerk.

(By the way, as I was processing all this yesterday, Klaus decided it was a good time to poop and pee on the floor again. Bad dog. That's not the pet therapy I had in mind. At least his cute doggie antics had made me giggle uncontrollably a mere couple hours before.)