My updated treatment plan

We just returned from my visit with my wonderful oncologist, Dr. Hellerstedt. She truly is a God-send and a breath of fresh air.   She is always so positive and optimistic about me and defeating this cancer.  Her opinion of the pathology report was actually very favorable.  She pointed out that most of the cancer remaining in my breast was DCIS (ductal carcinoma in situ).  She said that the chemo would not have done anything about that regardless, since it was not invasive.  That type of cancer is considered stage 0 cancer and is simply removed with surgery, which is what we just did.  The concerning cancer is the invasive carcinoma.  This type of cancer is what the chemo was supposed to attack.  This was still found in the small vessels of the lymph nodes and some small sporadic amounts were found in the breast.  However, she said the chemo definitely worked.  The largest focus of cancer in the lymph nodes was .6 cm.  She reminded us that prior to chemo, the largest lymph nodes were around 4cm.  She said that was approximately an 86% reduction.  This is remarkable improvement and something to celebrate!

She communicated with my MD Anderson oncologist, Dr. Litton, and they developed a new plan.  I will begin taking an oral chemotherapy drug, called Xeloda, while I am undergoing radiation.  Dr. Litton indicated that they have found research has not shown more chemo to be beneficial in patients like me who have completed neoadjuvent chemo and surgery and still have cancer remaining but are also so estrogen positive.  So, MD Anderson usually prescribes the Xeloda to take during radiation (in a smaller than normal dose since it is radiation sensitive).  I believe the goal is to prevent recurrence of cancer while I am undergoing radiation.  Then, after radiation, I can start Tamoxifen, which will really help to eliminate the remaining cancer and prevent recurrence on an ongoing basis.  The side effects of the Xeloda are not too bad, and the main risk is that my skin may burn more during radiation.  So, we will need to watch for that.  But, I shouldn't feel nauseous due to the drug, and my hair will continue to grow, so that is great news!  I wish I would have had my port removed during my mastectomy surgery, but there was no way to know that I could have had it removed before-hand.  The plan would be to remove it during my final reconstruction surgery, which will be in about 8 months at the earliest.  Therefore, I will need to have it flushed every 3-4 weeks between now and then.   I am just thankful that we won't have to use it for more infusion chemo though!  :-)

I should be able to have my other two drains removed tomorrow.  My tight bra elastic currently sits directly on top of the drain tubes, so removing the tubes should help me feel significantly better.

Thank you for your continued thoughts and prayers.  I am feeling great (better with each new day) and I know that a big part of this is due to all of the people praying for me.