Tuesday 22 October 2013

Day 43 (Wednesday, 23 October): My treatment plan

It's 1p and I just got home from my 10.40a appointment with my medical oncologist. She was running late because the breast cancer multi-disciplinary team meeting was a bit heated and ran late.  As I said before, I love the idea of having all those specialists (surgeons, medical oncologists, pathologists, radiation oncologists, Breastcare nurses, etc.) applying their expertise and brains to my "case" (amongst others, of course).  I did forget to ask whether it was my "case" that caused the heated discussion but I suspect that's best left unasked...

The great news is that I really gelled with Dr. Fran.  She, like Dr. Andrew, is pretty straight forward yet compassionate.  She started by asking about my journey and my family, interests, etc.  Then she queried my knowledge of chemotherapy in the big picture and asked what Dr. Andrew and I had discussed.  After getting this picture, she moved on to treatment specifics.
Again, the good news is that I expected what she had to tell me.  The top-level is that, starting on Tuesday, 26th November, I'll have 6 cycles of chemo at 3 week intervals, followed by 3 weeks of recovery, then into 5 weeks of daily radiotherapy (M-F because, as Dr. Fran said, "radiation oncologists have worked out that cancer cells don't grow on the weekends"), followed by hormone blocking drugs (Tamoxifen) for 5 years.

The specifics of my chemo are as follows:- the first 3 cycles will consist of a cocktail of Epirubicin3, cyclophosphamide and 5-fluorouracil (5FU) 
- this will be followed by 3 cycles of docetaxel (Taxotere®) alone.

The side effects can be:
- hair loss
- decreased white blood cell count (I'll need to inject Neulasta, a booster drug, the day after my treatment and be very aware if I have a fever about 38 degrees C)
- nausea (I'll be taking anti-nausea meds)
- interference with the heart muscle's strength (!)

Dr. Fran suggested that I try the "scalp-cooling" to see if I can retain some of my hair for the first few cycles and then I could start the school year next February with a new hair style.  I like her reasoning, if nothing else than for Remie's peace of mind.

And for all to whom it matters, my cancer is a Stage III (T3, N1, M0 - with the latter to be hopefully confirmed after my full body scans).

I have to get the full body scans and blood tests before I start.  Thankfully I have another 5 weeks to do so and get my strength back and prepare.  For all of you who are local, I'll be in touch soon with requests for help (apparently the week following treatment is going to be the toughest).  The plan is to expect the worst and hope for the best!

At least now I know that my days will number over 250 as of 6th May 2014 when this treatment plan will be behind me and I have to set my sights on ticking away at that.  One day at a time.





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