Mom's Diagnosis

**This is SO long... sorry for the novel!

The month started out well.  It's always fun when there's a holiday, and we lightly celebrated with neighbors and the pool, etc for the 4th of July.  Then July 5th happened.  My mom got a phone call from the surgeon that biopsied a lump she found before her most recent mammogram.  We were hoping it was something along the lines of scar tissue, a cyst, a lost butterbean that somehow escaped her esophagus on the way to her stomach... basically ANYTHING but the word cancer.  But, people get cancer every day.  It's not something you can choose, and mom certainly didn't choose to spend her retirement this way.  So, we fight and we keep going. 

She texted my brother and me the next morning, as we knew she was waiting to hear from the doctor.  One of the [many] things that upset me was/is thinking about her sitting on that diagnosis ALL night long, not telling anyone.  How scary!  So anyway, she texted us... and when the text starts out telling us not to call her yet, you know it's not good.  She relayed what the surgeon told her and immediately I cry, then begin to google.  Millie was at camp that morning, and Craig headed off to the pool to get an early swim in before work (aka - he was away from his phone).  So it was just me and Chase and I was desperately googling everything I could regarding Triple Negative Invasive Breast Cancer.  Chase obviously had no idea why I was crying, although, you could tell he was confused about the crying role reversal.  The first thing I read about this cancer was that it was aggressive and prone to recurrence.  So, I knew I needed to go to the gym and put him in the nursery there so I could [try to] get a handle on this.  Doing anything else was not an option.  I also knew I would have to tell Craig.  Telling him at the gym was not high on my list, but I knew I couldn't sit on it for 2 hours, while trying to distract Chase and research.

I get to the gym and unload Chase in the nursery and continue researching.  I get a slight grasp on it and begin to get upset again.  So I go into the pool area to find Craig and he knew I was waiting on mom's results.  I stood at the end of his lane and he looked up after finishing his lap, and I just completely lost it.  There in front of countless other people in the pool, I just sobbed.  I told him what I knew and once I settled down, we begin to TRY to formulate some sort of plan.  I was a wreck for the rest of the day, but after a couple days and finally speaking to mom on the phone, we started to get better and begin to focus on getting through it instead of all the "what ifs" that seemed to be staring us in the face.  

The 2nd Opinion: 
I was so worried that mom was going to just stick to whatever her doctors in Wilmington told her and suggested, without consulting outside the area.  The oncologist that she was referred to in Wilmington was so overbooked, that they took 6 business days to call her after she had her diagnosis, and THEN they told her they couldn't get her in until August unless she wanted to drive to Leland to a different office.  It just didn't seem like they cared or that this was a priority, to put it plainly.  That's not the kind of care that I (or my brother) wanted for her.  Not to mention that the surgeon and oncologist that would be leading all of this was a general surgeon and general oncologist -- no real focus on breast cancer, much less this form of cancer.  And I knew without a doubt that if the roles were reversed, she would not want me to settle for that either.  And don't get me wrong, there's nothing wrong with using a general surgeon or oncologist, but I personally like knowing that they specialize in what is wrong with me.  When it could be life and death, I would want the best.  Especially considering the treatment centers that weren't that far away, either by car or plane.  

My step-mother's sister is currently being treated at the Cancer Treatment Center of America (CTCA), and has had nothing but glowing reviews of the center, so I mentioned it to mom and eventually, she said she was ready to hear a 2nd opinion.  So, I began making calls for her.  It has been great so far and they have been beyond accommodating.  They made a terrible situation a lot easier to deal with by taking the burden of the back and forth between insurance companies and several doctors offices for medical records.  Obviously, we felt comfortable with their facility and their treatment plan and agreed to begin right away.  We couldn't think of a reason not to, so we felt like that was a good sign.  And honestly, who wants to wait to treat under these circumstances?


Triple Negative Invasive Breast Cancer:
I won't go into all the details of everything I researched and learned from the 2 oncologists, 2 surgeons, radiation oncologist, and plastic surgeon (and then some) that we saw because the number of tabs I had open on my computer alone, for about a week, likely is not recommended for a smooth operating system...  but what I can tell you in a broad sense is that this form of breast cancer essentially means that the three most common types of receptors known to fuel most breast cancer growth (estrogen, progesterone, and HER-2) are not present in the tumor.  So you are pretty limited in treatment options, which basically consists of chemo, surgery, and radiation in some variation.  

The good: triple negative breast cancer may respond even better to chemotherapy in the earlier stages than many other forms of cancer.  But much of it depends on the stage and grade of the tumor.

Before mom's biopsy on July 3rd, she was a late stage 1, with the tumor size just under 2 cm.  Also consider that the biopsy removes a portion of the tumor when extracted to test after that measurement.  However, when we visited the CTCA outside of ATL (for a 2nd opinion) on July 19th, the breast cancer surgeon performed another ultrasound, and it had grown to 2.7 cm in about 2 weeks time.  Which also meant that she was in a solid stage 2 rather quickly.  So, it grew from less than about 1.9cm (since they took some of it to biopsy) and it grew to 2.7cm in a little over 2 weeks.  Again, aggressive.  We met with the oncologist in ATL, same treatment center, 2 days later and he suggested chemo first for 6 months (8 cycles), then surgery (either "generous" lumpectomy or unilateral mastectomy 2-3 weeks after chemo is done), then most likely radiation 2-3 weeks after that.  So she will get chemo tomorrow, and then every 3 weeks after that for 6 months.  8 total chemo visits.  She will not be remaining here and will fly back and forth from Wilmington to Atlanta for each visit.  Because of mom's insurance (thank goodness she still has BCBS), they pay for mom (and sometimes a caregiver) to fly back and forth for appointments, and they have really cheap rates at nearby hotels for accommodations when needed.

The bad: the tumor is grade 3(poorly differentiated) – the cancer cells look most changed and are usually fast-growing.  People with grade 3 invasive breast cancers are more likely to be offered chemotherapy to help destroy any cancer cells that may have spread as a result of the cancer being faster growing, hence the treatment plan presented by the oncologist.  They have a scale when returning results to determine the grade.  They usually like to see it in the 20s... well, Mom's was in the 70s.  It wasn't what we wanted to hear.

Another thing to consider is the BRCA-1 gene.  My mom's maternal family has a history of testing positive for the BRCA-1 gene when diagnosed with breast cancer.  Two of her 1st cousins and her Aunt all have had breast cancer.  The 2 first cousins tested positive for the gene, but my Aunt was never tested (she had it around 40 years ago and is now 96).  We are waiting to hear back from the genetic testing, but obviously, we wouldn't be surprised if she has it.  If she does, I will likely go get tested myself.  I have no idea what I will do if I test positive, but at least I would know (I guess?).  At any rate, if she turns up positive it might effect the type of surgery post-chemo.  Her choices seem to be a "generous" lumpectomy (+ reconstruction), or a unilateral mastectomy (removing 1 breast + reconstruction).  That is all to be decided later.

All of this has led us to where we are now.  We try to stay away from the dark places that this can easily take us.  We focus on the 80% 5 year survival rate (which I feel is good!) and just do the best we can.  We will trust the doctors, but try not to blindly follow them, and ask plenty of questions if we aren't completely sold on something.  We've had an amazing outpouring of support (especially since the Facebook post) and honestly, it's overwhelming but in the best way possible.  So thank all of you that have prayed, offered kind or uplifting thoughts, offered to chat about your own experiences or experiences of loved ones, offering to help watch Millie and Chase so that I can be here, helping with or checking in on Grandmama, and it goes on and on.  This diagnosis has turned our world upside down, but the support has made the outlook a lot less grim.  Don't hesitate to send mom your favorite wig styles and most bizarre scarf creation.  We sure have had some laughs trying to design mom's "new look." 😉😉😉