Here we are . . . at a point in the journey that I didn't know would come. I am scheduled for an outpatient lumpectomy surgery! The tumor has shrunk close to 96% and had a total area of 1.275 sq cm at the last measurement. (Originally, it was over 27 sq cm!) It may be even smaller now, but no more measurements will be taken.
On Wednesday morning, I will go through the admissions process and then have a "guide wire" placed to the tumor. This procedure is done by a radiologist and is pretty simple. Very similar to having tumor markers put in, something that's been done twice now. I will then receive a mildly radioactive ttracer dye injected into the tumor to find out which lymph nodes are "connected" to the tumor. All of this will most likely be completed by noon.
I will then go into waiting mode for surgery. Art will be with me during this time. Surgery will begin with the surgeon using the equivalent of a Geiger counter (it's called a gamma detector) to determine which nodes responded to the dye. She will remove those nodes (up to six) and send them to the laboratory for a freeze section pathology study. The lab will be waiting for the specimens and will work on them right away. While they are at work, the surgeon will remove the tumor and some surrounding tissue. By the time she is finished with that, the lab should have the results from the lymph nodes. (This procedure is called a sentinel node biopsy.)
If all the removed lymph nodes are clear of cancer, then she will close me up and send me to recovery. If any of the removed nodes show signs of cancer, she will then do what's called an "axillary node dissection" and remove more of the lymph nodes under my arm. The extent of how many to be removed would be based on how many of the initial nodes were cancerous. If I have to have additional nodes removed, then I will need to stay in the hospital overnight.
No one suspects node involvement. Everything looks clear, but of course, we know that all cancer is not visible to the naked eye. That's why biopsies are needed.
The pathology report on the tumor itself won't be ready for a week. My post-op appointment is Friday, September 14. Those eleven days will be very hard to wait through! Patience, while easier for me now than it was six months ago, is still not one of my strongest virtues. If the pathology report on the tumor shows that there is clean tissue surrounding the tumor, then typically means that all cancer has been removed. Six weeks of radiation will be recommended to help reduce the chance of local recurrence. If the surgeon is unable to get clean margins (if cancer is in the tissue outside the of tumor), then I will have to have a mastecomy mid/late-September. No radiation with a mastectomy.
Rachel and Michael will be spending the night with friends on Wednesday night. Even if I get to come home after surgery, it would be somewhat late and it's better for them to be in bed on time.
Things to pray for us:
- I had an ECG today (electrocardiogram) to check my heart. I've been having edema in my calves and feet and while it's most likely chemo related, they need to check to make sure it's not heart related. Asking that all is well and that there are no alarms. (UPDATE: I got a call from the surgeon's office and my heart is fine. Also, I had a ECHOcardiogram, not an electro . . . . I was way too tired when I wrote this last night.)
- That the kids be at peace. Rachel has already had one nightmare in which I didn't make it through surgery. This reflects her deepest fear.
- That there is no cancer in the lymph nodes.
- That the tumor is able to be removed with clean margins.
- That I don't get too cranky with the lack of food before surgery and that Art has patience with me leading up to the surgery. I will encourage him to go out and eat for himself so that we both aren't cranky!
- That I respond well to the anesthesia and that there be no complications of any kind.
- That recovery from the surgery is as quick and easy as everyone expects it to be.
- For patience as we wait eleven days for pathology results.
Thank you for your continued part in our journey.