Update 11/22 radiation oncology consultations..

Hi all,
I went yesterday to a few appointments in LA and then had one here today in the desert. As I mentioned in my last post, I was really thrown for a loop when my oncologist Dr. Dreisbach suggested that I consult a radiation oncologist, becuase I wasn't expecting to do that since Dr. Silverstein basically said I wouldn't need it. However, at the same time Dr. Luke suggested that I look into radiation he also stated that it would be controversial since the data for someone like me isn’t conclusive. At that point I mentally had kind of a jolted out of a mindset of “rehab” and recovery back into marathon treatment mode. Actually, it was like he was talking to me but I was processing the nonverbal informaiton and just the impact of him telling me I might need radiation when I had already mentally switched to recovery mode. However, after the appointment, and wrestling with it, I finally got to the place where I just said okay, God, whatever you have planned for me, that’s what I want to do and then it was easier to hear what I might have to hear. It was either that day or the next (probably the 20th) I was reading in Proverbs 20 and both verses 12 and 18 just seemed to leap right off the page of my bible and speak to me about the situation, which is so awesome because I had asked friends to pray for wisdom, and both of these proverbs just seemed to speak right to it.
Pr 20:18 "make plans by seeking advise if you wage war, obtain guidance."
Pr 20:12 "ears that hear and eyes that see--the Lord has made them both" These two verses are exactly what I'm doing is waging war on the cancer and it spoke of getting guidance and advice so that I could make plans. It was just what I needed to hear to confirm my pathway of seeing the doctors and listening to what they had to say and then listening to God about it all. It was great becuase it reminded me that God really is in control of this whole thing.
Anyway, so I went to LA yesterday and saw Dr. Sherman for my third fill of the expanders and then went to see the radiation oncologist at USC, Dr. Streeter, and it was a great meeting. What a great guy very personable and knowledgeable. The whole team there is just great. He was very informative and thorough and his opinion is that I do NOT need radiation, but that I would need to make sure that my follow up is good (i.e. some regular MRIs to check to make sure everything is fine). It was HUGE to me that he was firmly in this camp. I mean, we talked about the data and he gave me a copy of the most recent study on the matter and talked about some of the prior research and I had none of the indications that would make radiation seem to be a benefit. The costs (personal, physical) of doing it would outweigh whatever benefit I might receive from it. Namely, the greater chance of lymphedema considering that I had 50 nodes removed, in addition to complications with the reconstruction, etc. as well as other things.
Okay, so on to seeing Dr. Khanna this morning here in the desert. At last I spoke to her, she was leaning toward doing radiation, but when she looked at the final pathology from my surgery, she agreed with Dr. Streeter and said that, while there is some controversy, I’m NOT a candidate for radiation. I was surprised becuae I really thought that she would suggest it. So, as it stands now, I don’t need it. After I got dressed I did a little jig in the exam room becuase I was so happy! There is still one more doctor in the valley that I’m going to consult just to bring a final confirmation to the other two doctors, and even if the third were to present a convincing case for it, I probably won’t do it, since the risks outweigh the benefit. I just want to be able to really put the matter to rest and be able to go back to Dr. Luke on the 8th of Dec and share the concurring opinions with him.
However, regarding follow up, Dr. Khanna did suggest that I follow up with a PET scan (a PEt scan picks up actual cancer in the body whereas MRI is very sensistive and picks up both cancerous and benign tissues so it can lead to undue biopsies at times) rather than MRI because the risk of distant metastases might be greater than it recurring locally. So, I’ll bring these ideas back to Dr. Dreisbach, my medical oncologist, when I see him on December 8th for another infusion of herceptin. I’ll also be starting Tamoxifen shortly thereafter I would assume.
So, in the meantime, I’m working on my own little rehab world of exercises, scar massage, naps doctor appointments, reading research, trying to keep up with communicating, participating in worship etc. It’s been great to be able to spend time with family too as I go back and forth to LA. My brother is in town and will be here in the desert this weekend and my dad and his wife will also be down for the weekend so I'll get to see them since they are r&r - ing in Palm Springs until Monday.

I just thank God that He does hold all things together (1chrn 29:11)
Happy Thanksgiving!
Julie


Happy Thanksgiving!!
Julie