Thursday, May 28, 2009
Yesterday I had my followup appointment with my surgeon. It's been two weeks since my surgical biopsy. I was told the mass removed was not malignant ... however, there were "other findings" my doctor wanted to discuss with me. I get a crash course on how normal cells progress to cancer cells. Normal cells are uniform. Some of these uniform cells start to multiply (hyperplasia) --> cells begin to lose uniformity and take on different shapes and sizes as well as multiply and form along the lining of the duct (ayptical hyperplasia) --> they continue to multiply/progress but remain with the membrane (ductal carcinoma in situ ... this is considered cancer) --> abnormal/cancer cells break through the membrane (invasive cancer).
Yesterday I learned my cells had progressed to atypical hyperplasia. And of the grade of atypical hyperplasia it was the most severe. Essentially, I am in that very gray area. Not quite cancer but I guess bordering it. Atypical hyperplasia is considered a precancerous condition - not cancer, but a forerunner to cancer. My doctor read something on the pathology report to me (of course, it was like speaking another language to me!) ... it was concerning to her especially on top of the fact I was already high risk. The pathologists found atypical cells in one duct but was not convinced it was localized to one duct based on the way my cells appeared. I believe that's the gray area i'm in ...
So the options given to me were: a) "surveillance" -- essentially closely monitor and come back in 6 months for an MRI. At that point I would probably have additional tests and probably an additional biopsy. She said "if we're lucky, you're MRI comes out squeaky clean. I would plan for more tests though," b) hormone/drug treatment - take tamoxifen for 5 years. Side effects include blood clots, other types of cancer, plus many other non-desirable effects, c) double mastectomy!
With a smile on my face, I tell my doctor, "I'm not so sure i'm liking all my options. Don't you have something somewhere between option A and option B??" Given my choices, I pick "surveillance." She assures me that the rate of growth is slow and that 6 months is a safe time period. She tells me that the results of the MRI will tell them so much more.
My doctor tells me "You've known you were high risk for breast cancer with my mom having had both breast and colon cancer. These results confirm you are high risk." She also tells me that ayptical hyperplasia does not always progress to cancer. She also tells me if it does progress to cancer and we catch it early the prognosis is very good.
Over the course of the afternoon I realize I have a choice on how to approach the next 6 months. My doctor will contact me in 5 months to schedule the MRI. Until then, I will do everything I can to take care of myself. I can choose not to let this consume me with worry. There's something scary about knowing that there are cells inside of me that have started going haywire. The knee jerk reaction is to fight and resist all that I have no control over. The buddhist teachings I have come to embrace, tell me to welcome and accept all parts of myself, even the cells breaking out of the norm. They are doing it for a reason. This is my "wake up call" ... it's time for me to notice, slow down, pause and listen.