Rise of the Fall

 

I had my 2nd opinion yesterday. The oncologist was nice, and seemed very knowledgeable, but unfortunately he did not give me the news I was hoping for.

He believes that Dr. Joyce essentially ordered the mammaprint test to placate me. He said he would not have ordered it, and that his recommendation would be for me to have chemo. 

He also disagrees with Dr. Joyce’s plan of starting with tamoxifen for hormone blocking therapy, and instead recommended lupron injections to shut down my ovaries (force menopause) and giving me aromatase inhibitors instead of tamoxifen (Dr. Joyce’s plan would swap aromatase inhibitors for the tamoxifen later down the road). I will have to discuss this with Dr. Joyce, because I’m already close to menopause at my age, and chemo causes many people to go into “chemopause”, anyway. He assured me that his plan is the “better option”, but I need more information.

It is most likely that I will be having port placement surgery, and I will be having chemo. The “gold standard” plan of AC/T is the same plan he recommended. He also mentioned, however, that his “second choice” which is still “very good” would be T/C, and if I choose that route I would only have to do 4 sessions over 9 weeks. Dr. Joyce did not mention this alternative, so I’ll have to discuss it with her. I’m not sure if it’s less effective than the “gold standard”, and if so, if that difference is significant. I do know that 4 sessions sounds a lot more doable than 8, and it’s also the version they try when people can’t tolerate the AC/T. 

There is an option to use a cooling cap to try and keep my hair. Either chemo option *will* cause hair loss. I’m not necessarily hung up on the going bald part, but I am struggling with the subsequent years of trying to grow it back out to something I don’t hate. I also don’t love the idea of having to deal with the discomfort that cancer causes other people. If I’m bald, people will know, and some of them will ask. I’m not a fan… We get enough staring, “pity”, questions, and awkwardness as it is, and my patience is very thin. Unfortunately, the cooling cap rental is EXTREMELY expensive, so we’re still deciding if that’s really a worthwhile “investment”.

I will still wait to see what Dr. Joyce has to say after the mammaprint results come back, but it looks like it’s almost certain that I will be having chemo. After that, I will still have to do radiation, and then endocrine therapy for at least several years. It is a long and daunting road.

In other news, I got my Covid booster today! I will still be considered immuno-compromised throughout chemo and radiation, but it will at least give me a little extra protection. It’s pretty frustrating that we have tickets for IU men’s and women’s basketball, but many fans aren’t following the city mask mandate, the IU mask mandate, or the venue mask  rules, so I can’t attend. I will be much more compromised when I have chemo and radiation, but I am also considered compromised as a post-surgical patient, a pre-surgical patient, and a cancer patient. There are so many people who are at much higher risk than me. Nobody thinks it’s fun to wear a mask, but it’s such a small thing to ask to help keep other people safe. Please consider doing your part.