Surgeon Dreams

After you talk to a surgeon, you go to sleep and you dream of cancer and surgery. I mean what little I do sleep, I do anyway. Those people close to me know I don't sleep much. I used to sleep from 10-4 a.m. and when I got up, I thought about work. I would review reports, think about the people and think about how to grow my business. Now I am lucky if I can stay awake until 10, but then I fall asleep and every day I wake up at 2, or 2:09, one day 2:39 and then I think about cancer. I lay in bed and toss and turn for a while but then I get up and come into our study and I read, or search the internet trying to understand breast cancer. One morning, at 3 a.m. I called my college roommate in South Africa.

The nurse today in the office asked a bunch of pre-surgical questions and one of them was do you have a sleep disorder? A disorder, no. But I looked at her and said, "Who sleeps?"

If I'm laying in bed, I pray that I will be lucky and my cancer will fit the right profiles and I will not have to have chemotherapy.

I heard today about Tamoxofin and radiation. I heard today about genetic testing. My mother (a survivor) got tested years ago for BRCA (the cancer genetic test) and the test was negative. But the doctor I saw today is suggesting that I get tested and see the genetics people anyway. He would bet, given my family history, that my cancer is genetic. But that it might be a genetic kind that they don't know about yet. He said we will probably never know.

All of this discussion, (I almost wrote, "of course", like duh, everyone knows this), revolves around what kind of surgery to get and the "odds". The chances of reoccurance. If I am a candidate for a lumpectomy (which I would have to go get another biopsy to confirm), I have to get radiation, take Tamoxifin and if there is something genetic (known or unknown) my risk of reoccurance is 30%. If I get a mastectomy of my breast with cancer, he thinks no radiation, I get to take Tamoxifin, and my risk of reoccurance is 30%. If I get a double mastectomy, no radiation, yes Tamoxifin, my risk of reoccurance is 2-3%. No one knows until they fully evaluate the cancer and whether I have any lymph node involvement whether I will need chemotherapy (but they are hopeful I won't).

Tamoxifin will put me into menopause. Welcome hot flashes, and hysteria. Five years. The doctor today thinks I will get that no matter what I do. It is up to the general oncologist but he said, "I don't want you to walk out of here with hope that you won't have to take Tamoxifin."

I know there is big news on TV and in the papers today about mammograms. And I just kept thinking after the conversation with the surgeon and reading the front page of the paper this morning, does everybody really understand what they are saying? What they are saying is that the odds don't get better finding it earlier. Even simpler, it doesn't change the odds of how many women are going to die or the likelihood that you will live or die from breast cancer. Your cancer decides that.

That is why I sit and pray about the profile of my cancer. That is why the surgeon today said I should be happy my cancer is Hormone receptor positive. It is good news because it shows I have a curable kind of cancer. I will live.