Today I went for a visit to my Oncologist Dr. H. to go over the final pathology and set my chemo schedule. I brought along my friend (and also my next door neighbor K's twin sister) Lauren to my appointment. She is a Nurse Practitioner in Oncology at U of Penn Hospital and is very passionate about her job and very willing to help me out! Awesome!
When the appointment starts out, Dr. H expresses how relieved he is about my pathology results. Apparently he was *very* concerned about my cancer after our last meeting. But he feels good now. I am finding with cancer, there is a best-worst case scenario and worst-worst case scenario. There's not going to be any "good" news until we're 100% done with it. Every positive has a negative and every diagnosis/treatment comes with some bad side effects.
My chemo schedule will be a "dose dense" treatment, administered every 2 weeks for 8 cycles. I will get 4 cycles of AC (Adriamycin and Cytoxan) and then 4 cycles of Taxol . My first chemo will be Oct 22. If the 2 week schedule is too much for me, we'll back off to the 3 week schedule. Basically he said the day of chemo- I'll be doing pretty good. The next 2 days are when the nausea set in. And 7-10 days later the fatigue. 24 Hours after each chemo treatment I'll get an injection of Neulasta to help with my white blood cells.
After the 8 doses of chemo I will start my hormone treatment for my ER/PR positive receptors. I will take Tamoxifen for 5 years and then we'll see how everything is going. Basically the biggest concern with hormone treatment for young (pre-menopausal) women is ovarian failure...so all you people giving me grief about another baby- NO MORE KIDS! Not my decision...my surgeon and oncologist both say no!
There was also a little monkey-wrench thrown into things today. When testing the cancer cells, my HER-2 level came back negative at 2.2, but a positive HER2 level is 2.3. HER2/neu stands for "Human Epidermal growth factor Receptor 2" and is a protein giving higher aggressiveness in breast cancers. Because I fall into the grey area, we are opting to treat the HER2 as if it were positive with Herceptin, which is an IV infusion administered every 2 weeks for 1 year.
I have a "chemo counseling" appointment next week and I'll go over "what to expect when you're expecting chemo" with the staff. My Oncologist is not a jokester like my surgeon, so there's no funny things to report...all business today. Don't worry though...I will break him or at least make him laugh once. He did point out that Lauren and I had on the same flip flops (different colors). What man notices matching flip flops but had to ask me if I had a lumpectomy or a mastectomy....