To Mayo We Go

We get a flurry of appointments at Mayo. We meet with an oncologist who says we might consider 4 cycles of Docetaxel instead of 4 of Adriamycin and 4 of Taxol. Shorter sure sounds better to us, and maybe Docetaxel is a better drug with less side effects.

Next we meet with a radiation oncologist who says we don't have much use for radiation. Followed by another radiation oncologist who can't seem to decide if we need radiation or not. We ask if there are any gray areas where we might receive some radiation but not the whole 36 treatments but no. The radiation oncologist who can't decide (we call her the hand-wringer) defers judgment to the whole team.

Finally we meet a surgeon. She wants to re-excise the area and try to get better margins. We decide we'll do it if we can avoid radiation. It also means another month before the chemo can start though and it's awful knowing that is coming. Two days later we schedule the surgery.

Oncologist Visit

Today we went to the oncologist to review our bad path report. He says we'll need chemotherapy. He wants us to do 4 cycles of Adriamycin+Cytoxan and then 4 cycles of Taxol. This is the worst news so far. All the chemo horror stories are coming back to us now. Hair loss. Vomiting. He wants to start next week.

We decide to abandon the standard doctors-near-a-hospital method of care. We have a Mayo clinic here in Jacksonville and we hear great things about them. We set up some appointments there.

Bad Path report

Yesterday the surgeon's office called and said that although he was out of town they had the path report back and we had clear margins. Today though Dr. Hartigan called with much worse news. The margins were indeed clear but less than a quarter millimeter thick. To most oncologists this is nearly a positive margin.

Worse still they found 7mm of tumor and it had "angio-lymphatic invasion", also called "lymphovascular invasion" or LVI (see definition here). It isn't clear just what that will mean but we're scared that our node-negative status is in jeopardy and chemo might be in our future.

We have no idea how the tiny 7mm (pea sized) remaining tumor would show LVI while the large 23mm tumor we took out at lumpectomy had no LVI in it.

And yet more bad news they said our cancer was "multi-focal" so had many small areas of invasive cancer instead of a clearly defined lump.

None of this sounds good to us.