Now the waiting for the lumpectomy begins

For better or worse. That is what we said all those years ago and now, on the eve of our 15th wedding anniversary, we will experience the worse -- at least so far.

My wife met with the surgeon at Memorial Sloan-Kettering yesterday and is scheduled to have her lumpectomy in 2 weeks, at which time they will also check her lymph nodes, with her radioactive seed plantation the day before. Next week, however, she will go in for a bilateral MRI  which, as her initial radiologist predicted, they would resist doing as they feel it leads to over diagnosis but they quickly relented when she pushed the issue, noting her breasts are heterogeneously dense, which sounds like it could be kinky but isn't. The surgeon told her he believes the tumor to be stage 1, but that will be confirmed by the results of the sentinel lymph node biopsy (and she will also be tested for the BRCA gene).

While she already has the time set for the plantation, they will not give us the time for her lumpectomy until the day before, which is hard when you have small children. We can't just go "bye, remember to lock the door when you leave for school" if the surgery is early or have no one home if the surgery is late. While we have people from our temple standing by, a little pre-notice would be nice. For now, there is nothing to do but wait, and hope my wife doesn't make any other detours on her pre-surgical trips to the city by stopping at places like Saks when she is walking between where the NJ Transit bus drops her off at the Port Authority Bus Terminal on the west side of Manhattan and Sloan on the east side (I'm driving her in on the day of surgery but, as former long time NYC residents now exiled in the suburbs, we are vary comfortable taking mass transit -- the bus to the city, which takes a little over an hour depending on time of day, is a short walk from our house).

Of course, when you are waiting, you start doing some research, which can be good and bad. My wife has had a couple of good discussions with a woman from our congregation and one of my mother's cousins, both of whom had lumpectomies in the past and both of whom went to Sloan. I also spoke with another cousin whose mother was diagnosed at 49, did not get the best treatment by her doctors (she went elsewhere and they didn't get all the cancer), and ultimately paid the price. At least I now know why her father was really, really pissed afterwards for a long time. We also have been viewing videos on the Sloan YouTube breast cancer page, a serious of taped lectures by senior department doctors which do a pretty good job of explaining breast cancer procedures for laypeople.

One thing we have discovered, how much more pleasurable it is reading ebooks for this over traditional print media. My wife had found a really good breast cancer book at the library and decided to purchase an electronic version as it is a thick, heavy book. Not only is it easier to carry around and read, but we realized we could download the book to multiple readers (smart phones, tablet computer) as long as we had the right app and signed in to the same account, meaning we can both read the book together or quickly reference it if we are somewhere without the reader or tablet. Nice that we can both easily reference the same material on our own devices in lieu of one reading a passage and then passing the book to the other to read and then comment on.

Other research we did revolved around the pathology report, which we saw for the first time yesterday. Doing medical research before bed can be a dangerous thing. Some doctors say a high Ki-67 marker is bad (my wife is at 30%) others call it a poor man's test or just a prognostic indicator they wouldn't necessarily base a treatment decision on. Her Her-2 ratio was 1.08 and not amplified, some said that was good, others not so much and that again it was just another prognostic indicator. The estimated SBR Grade is 2/3, which seems to imply that her cancer cells are poorly or moderately differentiated and growing faster than we would like it to be, but we don't really know what that means. We ended up finding a lot of medical research papers that were a bit outside our field of expertise but did provide the occasional explanation of a term that we could understand. We've been through the message boards with mixed results. It would really be nice if some of the sites that try to define something would explain why X is bad instead of just stating it. We'd ask questions but, at this point, we just don't know enough about what is going on in my wife's body to ask the right questions without scaring ourselves.

Our children, 11 and 7, still seem to be doing ok, although we've noticed they are a bit more clingy and both do not really like it if one of us is not in the bedroom end of the house (we have a "L" shaped ranch) when they go to sleep. I noticed our 11 year old took significant interest when my wife was reading a mommy is sick type of book to our daughter before bed the other night. We are trying to keep things as close to normal as possible, letting our 7 year old have a sleep over Friday (that reminds me, need to buy booze for myself) a family fun day with our congregation on Sunday. We were to go away the week of the 17th (school ends the 15th, camp begins the 25th) but that is cancelled, though we may slip away for a night or two down the Shore instead if my wife is up to it. It really hit home when my wife got her FMLA paper work filled out (fortunately I have a flexible work schedule and can work remotely, or even go into my company's main office which is a short cab ride from the hospital, so at least my paycheck will still be coming in if my wife is forced to take unpaid leave for an extended period).

It will take 10 days post-surgery for the lymph node results to come in, at which point we find out if my wife gets chemo or radiation (tamoxifen is a given). Also, we find out if the margins are clear or she has to go back. Then finally there is the chance she will still need a mastectomy. Left unsaid, for now, are our fears that the cancer has spread, there will be a recurrence and that she may be a part of the small percentage who don't even make it 5 years. I suspect we will be living with that white elephant in the room for a long, long time.

Hopefully, we will get the good news that the tumor can be taken out with the lumpectomy, radiation will eliminate the cancer cells and we can go about our lives and continue to raise our family with just a checkup for my wife every 6 months. Funny what is considered good news these days.