Part IV: The Plan

Today was the big first meeting with the oncologist.  We walked out with a December to January calendar including 13(!) appointments.  And that's only because they don't schedule more than two months out.  Here is the update (hopefully answering the various questions that some of you have sent me):

Big Picture: 4 months of chemo + 4 week break + 6 weeks radiation + 6 month break + final reconstruction surgery* + 10 years of endocrine therapy

Before Chemo:  I am scheduled for a Chemo Class, a PET scan, a meeting with a genetic counselor, an echocardiogram, and a mediport placement.  I still need to schedule some related appointments with my regular docs, most importantly one to remove my Mirena IUD.  Why am I doing all of these?  Chemo class seems self-explanatory and the genetic counselor is to discuss the genetic tests (see below). The PET scan is to look for any signs that the cancer has spread, although we are hopeful that it has not. The echocardiogram, as I understand it, is a baseline so they can monitor any effect of the chemo on my heart.  The mediport placement is an outpatient procedure where they put a port under my skin in the chest area that they will use to administer the chemo drugs more directly to a major vein.  Finally, I have to give up my much beloved Mirena IUD because, as previously mentioned, my cancer likes estrogen and progesterone.  I have to go with a hormone-free IUD in the future.

Chemo Plan:  The chemo happens in two parts - each part is 4 treatments (8 weeks).  My treatment is called AC (doxorubicin + cyclophosphamide) followed by paclitaxel.  Beginning on December 14, I will have a chemo treatment every two weeks for 8 weeks that will consist of the two drugs doxorubicin and cyclophsphamide.  These treatments will be about 2 1/2 hours.  Immediately after that is complete, I will have a treatment every two weeks for 8 weeks that will consist of paclitaxel.  These will take about 4 hours each.  I have all kinds of additional info, like other drugs they'll give me before, during and after to counter the side effects, etc.  But I suspect only 1% of you are interested in that level of detail, so I'll forgo trying to understand it and put it into plain language.

We timed the first two treatments around Christmas so that on Christmas, I should be feeling okay.  Also, hair loss typically happens between the second and third treatment.  Which means, by New Years Eve, I should be ready to shave my head!  

Radiation and Beyond:  I can't tell you much about this part since I haven't met with my new radiation oncologist yet.  From what I do know, it will likely be 5 days / week for 6 weeks.  Stay tuned for more exciting details!

Genetic Testing:  I tested NEGATIVE for the BRCA gene.  But they did find a variant in the ATM gene of "unknown significance". Therefore, I will meet with the genetic counselor to hopefully understand this better.  I will likely also enroll in a hereditary cancer research program.  Again, if I understand correctly, this is so they can track my outcomes and collect data connected to my genetic profile. 

How Can You Help?  TBD.  It's tough to say at this point.  Again, the husband's brain can't process all of the help we have had already and doesn't want to accept any help, but knows it's going to be a long tough year or more.  It will largely depend on how I respond to chemo.  Re Food - we have more than enough help through December but will think about what we can use, if anything, in January and beyond.  Re Childcare - I suspect that once the effects of chemo hit, we will benefit from some help with after-school pick-up and play dates to occupy and distract the kids when I feel like crap.  When I know better what we need, I might ask someone to coordinate that for us.  A couple people have already offered wigs!  I'm not sure I'll be crazy about wearing a wig and have a feeling I'll prefer the hat/scarf approach.  But I'm willing to try.  If you have one you want to pass along and need my address, message me.  Most likely, I'll just want one or two funky colored wigs for the kids' amusement.

Blog Name:  I removed my full name from the top of the page because I decided I would prefer to leave the page public and more anonymous, in case someone else happens upon it in the future and finds it useful.  

*There was some possibility of reconstruction in between chemo and radiation.  It sounds more likely to be at the end, but I neglected to confirm that today.