I had a meeting with my oncologist, Dr. David M. Heyer MD at Medical Oncology and Hematology in his Fairfax office. He is a very nice man, but did not sugar coat what the next year of my life will be. It was hard to hear, but I appreciated him being straight with me. Kwiatek tried to warn me that he wouldn’t make me promises or give me false hope -- he will just be aggressive and fight like hell to save my life. Lord, hear my prayers.
By the time Kwiatek and I left, half of what Dr. Heyer had told me, I had already forgotten or missed completely. I am relying on her notes in order to remind myself what happened since I am having trouble retaining what I am being told.
Here are Kwiatek’s notes:
- They will draw blood in Dr. Heyer's office on Monday morning to do the genetic testing.
- From the information we have right now, it appears the cancer is Stage IIIC
- The cancer isn't hormone receptive
- When you have surgery, they will send the tissue to pathology again and they will test for hormone receptors -- if you happen to have any traces of positive receptors, he might put you on Tamoxifen
- You are HER2 receptor negative, so you will not receive Herceptin
Full Body Scan:
- You need a PETscan to make sure this cancer didn't spread anywhere else. This is JUST a precaution to ensure the cancer is isolated and can be treated with his recommended cocktail of chemotherapy
- If for any reason the PET is inconclusive, he can order a bone or CTscan
- Dr. Heyer is "not suspicious," but he wants to cover all his bases to treat you effectively and efficiently -- this is his standard M.O., to exhaust all possible options to have a clear picture of what he’s working with
- Assessment of your heart prior to chemo -- either a MUGA or eco-cardiogram
- 1 in 500 people on this chemotherapy cocktail -- the heart pumping is effected due to the drugs
- You might want to think about harvesting fertilized eggs to increase your chances of having another child post-cancer
- Pretty good odds (80%) that you won't go into menopause from chemotherapy
- Absolutely chemo first prior to surgery
- You will need to attend a chemo teaching session with Jessica on Monday at 9:00am
- It will be easy to tell if the chemo is working because the lump is so prominent and it will start going down and shrinking
- Having NO active cancer cells post-surgery is 20-30%, so you will absolutely need radiation to kill any remaining cells left over
- You will lose your hair within three weeks
- This type of cancer is very responsive and sensitive to chemotherapy, so Dr. Heyer is optimistic that this course will be effective
- Typically side effects from chemotherapy happen days 1-4 post-treatment (chemo day counts as day #1):
Chemo Cocktail: Option 1 (preferred):
AC = Adriamycin and Cytoxan -- together every 2 weeks for 4 weeks (After the first two treatments, Dr. Heyer will do imaging to ensure the cocktail is shrinking the cancer cells and will make a decision on whether Taxol will be every 2 weeks or weekly for 4 weeks).
Taxol every 2 weeks, or weekly for 4 weeks
Chemo Cocktail: Option 2:
TAC = Taxotere, Adriamycin and Cytoxan
Every 3 weeks for 6 weeks
- Thursday: MUGA Heart Scan (Jessica will call you to give you the time and location)
- Friday: PETscan (Jessica will call you to give you the time and location)
- Monday: Chemo teaching with Jessica at 9:00am, Mediport surgery arrival at noon, surgery at 1:30pm
- Wednesday: First chemo treatment