Miri’s Choice

After sticking my head in the sand regarding the treatment for my breast cancer, the time has come for me to make a decision and get started. First of all, let me say that yes, thank G-d that the cancer was caught early so that I do, indeed, have choices. Let me follow that by saying the choices are really trying to decide the lesser of all evils:

#1. I’ve already had a lumpectomy, so really, I could do absolutely nothing. Benefit would be great– continue with my life like nothing happened. Drawbacks, like 85% chance of a recurrence within five years leads me far away from this option. I don’t want to go through this again.

#2. Second option: Seven weeks of radiation followed by six months of recovery, plus five years of the drug Tamoxifen, a hormone-like drug that “turns off” the estrogen-producers. This is currently the standard of care for DCIS patients. Of course, that means DCIS patients without mitigating factors like angioedema. People with angioedema cannot take Tamoxifen, and radiation can exacerbate angioedema. Radiation angioedema can last for months or even years. Not the best option with my history of puffy face.

#3. Third option: More surgery. Mastectomy provides a 99% chance of no recurrence. I am a candidate for immediate reconstruction, so I could go to sleep with 46 year old “old lady” lumps and awaken with 20 year old “young lady” lumps. They use stomach tissue for the reconstruction, so, in reality, I could wake up with a flat belly and nice, perky girls up top. “But wait,” you might ask,”Both? Why both if only one tried to kill you?” That is the subject of a whole ‘nother blog, but remember what I said, I don’t want to go through this again! Since radiation and Tamoxifen are bad for me, I need to think about reducing my future risk. Both will give me the greatest margin of safety. That, and the doctors say I will not be happy with the cosmetic results of just one. I’m JUST vain enough that I want a matching set! I could also choose NOT to reconstruct, but for me, this doesn’t sound like my type of choice. My clothes just wouldn’t fit right!

Added to the mix is the oopherectomy and hysterectomy I still need to have since I can’t take tamoxifen. The plastic surgeon says the upstairs has to come before the downstairs, so the surgery scheduled for July 8 would have to wait for at least six weeks if that is the way I choose to go.

Like I said when I began, thank G-d I have choices, but, quite frankly, they all suck. Kind of like Sophie’s Choice, although, thank G-d, not as severe.

So what should I do? To keep me from having to come back to CancerLand in the future, with all my mitigating factors, I feel I have to be aggressive. So, on July 8, instead of having the baby oven deleted, I have an appointment with the plastic surgeon to discuss the options I have for reconstruction. Will it be like going into the hair dresser’s and showing a picture of Jennifer Aniston’s latest haircut and asking for something like that? Do I say just take a little off the top and leave the length? Bring a Dolly Parton doll for giggles and grins? Maybe, if it helps me get through the day. But when it comes down to it at the end of the day, I’m looking for the option that will keep me sane and keep me alive to see my son get married, please G-d.

Surgery will be some time in mid-July, not certain yet. It is an eight hour operation and the doctors have to coordinate their schedules. However, whenever it is, I will approach it with trepidation but not with fear. I know the choice I make is right for me–maybe not for everyone, but given my situation, the one that will keep me around the longest and back to school in the fall. And when I do go back, it will be with the confidence that I will not have to go through this again (B”H, tfu tfu tfu).

So, when I go back, some students or co-workers might whisper amongst themselves, “are they real???” I can proudly answer, “NO! They’re not real, and they’re FABULOUS! The old ones tried to kill me!”

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2 Responses to Miri’s Choice

  1. Sabina, developer of the Department of Defense Breast Cancer Decision Guide (1998-2001) says:

    It’s really a shame about the radiation and tamoxifen not mixing with angioedema, since the choices that you are forced to make are such overkill for DCIS. I do agree that lumpectomy without radiation is an unacceptable option though.

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