Isn't that a strange thing to say? But everytime we leave his office we feel so much better about what's happening to us. We feel true hope.
Dr. Chemo too was saddened about the cancer in Lefty, and said it really doesn't matter if we do chemo before or after Lefty's mast. He said, however, that we have to wait at least 2 weeks after tomorrow's "re-surgery" on Righty to see whether Venita's good to go. Chemo lowers the body's ability to heal so chemo and surgery do not mix.
Dr. Chemo said that from what he's seeing in the path reports, there's no reason to worry about bone scans, liver scans, any overian treatment, or genetic testing (given Venita has no children). Tests he previously ordered came back fine--chest X-Ray, MUGA scan, hormone level test. (That hormone level test apparently told him that Venita still is premenopausal and thus a candiate for tamoxifin therapy.)
Venita will be on the "standard of care" for chemo and hormone therapy based on Righty's cancer staging of T3N1M0. (Yep, once we understand this staging thing better, we'll write about that.) For chemo, that will be 4 treatments of Adriamycin (chemical name doxorubicin) and Cytoxan (chemical name cyclophosphamide), once every two weeks, followed by 4 treatments of Taxol (chemical name paclitaxel), once every two weeks. If she has problems with the chemo, the interval between treatments may be lengthened to three weeks. Each "infusion" will take 2-3 hours. The days after each infusion, Venita will need to return for a white blood cell count and possibly a shot of Nulasta.
The chemo will be followed by 5 years of Tamoxifin, hormone theraphy that blocks the production of estogen and progesterone, hormones that the path reports show "feed" Venita's cancers.
Dr. Chemo thinks we need to get Dr. Nuke on line in some of the decision making that is going on about timing of treatment, so Jim and Venita now have an appointment with Dr. Nuke in 2 weeks.
Dr. Chemo also explained the downsides of having a portacath to deliver the chemo, and one of his nurses found Venita's extra large veins just fine for direct infusion. So that's two fewer surgeries (inserting and removing the port) for Venita (and two fewer encounters with the ever-congenial Dr. Cutter).
We now have the names of 3 local breast surgeons to consider for 2nd opinions. We feel less pressure on moving quickly in that regard now because Dr. Chemo seemed to have no problem leaving Lefty in place until after the chemo.
Thank you all so much for continuing to suffer through all this with us.