Kris, Dave and the Lumps: Tests, tests and more tests

Monday, 8-Sep-2008 to Wednesday, 10-Sep-2008
Busy week. Kris went to a Pet scan and an MRI one of which had to be rescheduled at the last minute. As a reminder, the scans are to see how well the Chemo Therapy did and to see if it's feasible to go through radiation treatment as a followup. We're actually hoping that we don't have to do radiation. Partially because it's an uncomfortable treatment, partially because it implies that things haven't gone as well as they can, and in no small part because it means delaying the reconstructive surgery which means delaying putting all of this behind us.

Thursday, 11-Sep-2008
Met with Dr. Antel who is our Radiologist. He revealed that a lymph node was caught up in this mess which is not truly in the area considered to be the left breast. It's still in the left chest wall area, just not directly in what's considered to be the set of lymph nodes associated with that breast. The implications I don't like are that this means the cancer moved beyond the left breast. Dr. Antel was not actually prepared with an answer. He'd consulted with two of his colleagues he has a lot of respect for and they gave him split answers. One, with a lot of experience, stating that he'd simply not do the radiation treatment at all. The other saying that it looked to be a good idea.

He went on to explain that treating patients in whom cancer had reoccurred with a second bout of radiation was new. There is apparently a study out with about 8 years behind it wherein patients were treated to a second round of radiation and studied for one year following the treatment and the results were quite good. The Numbers are that for a first round treatment they give about 5000 rads and this reduces the chance of recurrence from 20% to 30% down to 10% to 15%... about half. With a second round treatment, they would reduce the area they would radiate so that rather than hitting the whole upper left chest area, they would hit only the breast area and go up high enough to catch the one lymph node and they would also reduce the radiation to about 4500 rads. Further, they would use an electron stream as opposed to the normal X-ray radiation. Electrons have a more shallow penetration. While he can not guarantee that Kris lungs will not be affected this time, the chances of them being affected are greatly reduced, if not eliminated. Basically Legalese for there really is no chance but, it's radiation, we can't give guarantees. The downside is that there is about a 5% chance of complications due to the radiation. Specifically, there could be tissue killed other than the cancer. This means that tests will have to be performed after the radiation and if there is dead tissue, another surgery to remove it will be required. It also means that they can't perform the reconstructive surgery since radiation treatment would effectively kill the tissue used to reconstruct the breast.

We've not yet decided what to do. In fact, Dr. Antel isn't looking for a decision yet. He's going to contact folks from the study he quoted, among others, with specific questions related to our case. He's also waiting for the local cancer board to meet and discuss our case Tuesday. Kris and I meet with Dr. Moran Tuesday to discuss what comes out of the cancer board meeting later Tuesday.

More after Tuesday...