We have completed Day 1 of MD Anderson. We started with registration, then met with Dr. Moulder, the oncologist. She was very nice and spent a lot of time explaining things to us.
We started by telling her what Mercy had told us. Surgery, chemo, radiation, reconstruction. She threw us some possible alternatives: 1) Chemo first. 2) No chemo (followed quickly by a “you will probably need it though” statement).
First, we will be going to get a mammogram and another ultrasound. The mammogram will be to make sure she agrees that my left side is clean. The ultrasound will be looking for any trace of cancer in my lymph nodes. They will be prepared to do a biopsy of the lymph nodes if they see something.
Reminder: If they cancer has hit the lymph nodes, we know that it is potentially elsewhere in my body. That means chemo for sure.
So, if she KNOWS I will have to have chemo (because the biopsy shows it has hit the lymph nodes), she might start me out with chemo before surgery. While the outcome of doing the chemo FIRST is no different than doing surgery first, the benefit of doing it first is that they can watch the tumor to see if it is responding to the chemotherapy. If they remove it first, they can’t. So, we would know if the drugs (with not-so-great side effects) they are injecting in me are actually working.
If the ultrasound does not show cancer in the lymph nodes, that doesn’t mean it isn’t there. This type of cancer, she says, tends to not cause tumors in the lymph nodes, but instead more of a web of cancer cells that grow. This makes it harder to see on an ultrasound. So, if my ultrasound shows nothing, they will still be doing the sentinel node biopsy during surgery.
We are scheduled to see the surgeon tomorrow morning after my mammogram. They are hoping to get me in for an ultrasound in the afternoon or Monday morning. We are banking on a cancellation to happen so I can get in because right now, there isn’t an opening until Tuesday morning. Assuming they get me in, I believe that my visit would then end with a 4 pm appointment with Chloe (aka Dr. Moulder) on Monday. So, cross your fingers that they fit me in for the ultrasound. This means we can head home on Tuesday!
Oh, and I almost forgot! Dr. Moulder (though stressing that she is not the surgeon so her word isn’t THE word on this) talked about options of inserting expanders during the mastectomy. If we do that, it will allow them to save skin during the mastectomy in anticipation of reconstruction. Throughout chemo, the plastic surgeon would slowly add fluid in to stretch the skin out (accommodating for the skin they had to remove during the mastectomy). I’m not sure of the details on how this is not a problem with radiation. I’ll ask tomorrow! But, I was excited to hear how they will prepare me for reconstruction. No one mentioned any of that at Mercy.
Long medical post, I know. Tomorrow’s will probably be more of the same. I hope, at some point, to give you a glimpse of the fancy (**shaking my head**) hotel we are staying at. Top notch, I tell ya.