Taxol #7 - counting down to the end

I'm in the chemo chair again receiving Taxol #7. I pray that my fingers and toes remain as minimally effected by the neurotoxin as they have so far, but I have sworn that I will discontinue treatment if they worsen, and I will. So far, it is tolerable and minimal. I'd like to get the treatment in, but will opt for quality of life over an unknown longevity benefit.

I had a wonderful weekend of picking and grinning with Dave and then just plain screwing around, going to thrift shops and used book/record stores as is our wont. We were on the side of town where my favorite, rarely visited Vietnamese restaurant is located, and had a cheap and terrific meal there. The way I have gained weight since starting Taxol, one would hardly  believe that I'm a chemo patient. I kind of wish my appetite weren't so good. But I would not trade for the nausea that I experienced early in treatment. I'll find a way to pare down again, as I always have, when this adventure is over. I'm not exactly two ton Tessie, but I did enjoy my extra-lean-ness for the few months that I experienced it.

I met with Dr. Kelley yesterday to discuss the thinking behind his plan to wait until next year to do another MRI. He tells me that some breast abnormalities show better on mammogram, and that it is also easy to get false positive reads so soon after surgery with the MRIs. The point may be moot anyway as I also discussed with him changing plans and going for the bilateral mastectomy. Won't need no MRIs if I shed these babies! Dr. K says that the stats for reduced rate of local recurrence and of secondary breast cancers or a primary in the contralateral breast are actually better than those with lumpectomy followed by radiation (which only addresses the effected breast anyway), and in my book, significantly so, and in the Doc's opinion, a bilateral mastectomy is a very reasonable plan to avoid radiation and minimize my future risk. I'm not making a decision yet, but right now, I feel that I am strongly leaning in that direction. I'm such a no-cut kinda girl that contemplating cosmetic surgery is odd for me-thinking about the pain of getting there being worth the good boobs for life and no more bra wearing.  But one must focus on the up side when faced with the horrific realities of life, and definitely up for me is the option to reduce down to a C cup, to go braless, to stop the biannual anxiety fest that accompanies visits to the breast center. I'd still be monitored, but with less trepidation.

So the numbers I have so far are:
the risk of local recurrence with lumpectomy/radiation-10-15%
the risk of local recurrence with mastectomy: 3-5%.

I didn't write the following stats down, but per my memory, my lifetime risk of another breast cancer was something like 30% which goes down to about 1-3% on the right with the preventative mastectomy. As I've already had a diagnosis of atypical lobular hyperplasia in the right breast (the ductal carcinoma for which I'm being treated was in the left), my chances of a cancer there are higher and would be 97-99% eliminated by the mastectomy. The choice at this moment is looking pretty clear; I hate to think of altering my body like that, and to look ahead at the dangers of surgery in general, the pain and challenge of rehabilitation and the altered body image, lack of nipples (not so much for looks but for sensation), etc, but I am also starting to experience anxiety regarding follow up to my diagnosed tumor; that anticipatory stress would be lessened by the additional surgery.

No amount of surgery can totally prevent another cancer experience, however. My best safeguard against that is prevention of the nutritional/exercise/spiritual peace nature, and I must practice that either way, with or without additional surgery. And as radiation carries risks of its own, such as minor heart and lung scarring, tissue loss of elasticity, small potential of secondary cancers such as leukemia, the surgery offers a way to avoid dealing with these detractors.

Still, the prospect of having a permanently numb chest freaks me out considerably, and I am not taking this decision lightly. It is monumental, and I believe I'm giving it the respect it commands. But the choice is mine to make, and doing the research myself to make it as an informed person helps me feel "empowered", and therefore better about the experience. I may choose poorly, or I may fail in my attempts to implement lifestyle changes that will keep me safe from future grave illness, but I will have taken the reins in my own hands, and that feels more right to me than simply following a doctor's lead down a path with which he/she is familiar.

So 5 more infusions to go, assuming I can tolerate them. I hope so. And I hope that I'll reach a decision soon and be at peace with it. I felt this gut-wrenched when deciding about the ooferectomy, and then eventually reached a choice that felt right and with which I was comfortable. I assume I'll be able to get there again with this new choice.