At Dr. Fisher’s office, his nurse, Paula, weighs me and takes a blood pressure reading. It’s so alarming, she takes it again. Still high. Normally, it’s in the healthy range. Normally, I don’t worry quite so much.
Maybe the discussion on surgery will calm me down.
Dr. Fisher is no longer talking about cysts. He starts with mastectomies, but when he gets into the details, Bob, seated to my right in the exam room, nudges me and I interrupt.
“I’d like to go with a lumpectomy unless you see a reason not to.”
“You’re a good candidate,” Dr. Fisher assures me. “The tumor is small and doesn’t look to have spread.”
He goes on to say that he has room in his schedule to operate on Monday. Six days away. This is moving quickly which feels startling, but also reassuring. I want this nasty, fast-dividing thing out of me.
Dr. Fisher explains that the surgery will remove the lump along with a margin of healthy cells. He will also biopsy the sentinel lymph nodes (these are the lymph nodes with a direct path to the tumor) to see if the cancer has migrated into the lymphatic system. He expects that I’ll need drains in my breast (I don’t like the sound of that) and an overnight stay in the hospital to monitor the drains.
Do I have questions? Yes. I pull out my pathology report.
To my relief, it’s good news that my tumor is estrogen and progesterone positive. “Hormone triggered tumors are easier to treat.” Even that word, “triggered,” helps my understanding. The trigger can be suppressed to greatly reduce the chances of recurrence. If you know your enemy, you have a better chance against him.
Okay, so far so good. But what about HER2? This was where I’d focused most of my angst in the few waking hours I’d had between getting my report and this morning’s appointment.
Dr. Fisher says that HER2 causes much worry in newly diagnosed breast cancer patients, but with the advent of HER2 blockers, the prognosis is “excellent for most.” As for the “equivocal” on my pathology report, “that just means they’re doing more testing.” The testing has already been initiated, and I should know the result soon. I shouldn’t worry about my 2+.
This is good—Dr. Fisher has dispensed with my greatest worries. I have a serious cancer, but it looks to be very treatable.
Dr. Fisher glances at his watch. “There’s a 90% chance your cancer won’t come back after treatment,” he says, “Here’s how to make it better.”
He launches into lifestyle factors, diet, healthy weight, perhaps mindfulness therapy and yoga. “Exercise is huge.” Bob and I exchange looks. Bob says, “She’s got that covered.” (We hike together as many as five days a week, and I take to my treadmill on the other days.)
As we’re shaking hands, Dr. Fisher says, “Don’t worry. You caught it early and we’ll get it taken care of. I’ll see you Monday.”
There’s no post-appointment blood pressure check, but now that I’m better informed, I feel calmer.