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Tuesday, April 19, 2016

2% - A Wonderful Number

Just got the results of the test we were waiting for. And the number 2% means that I've decided not to have chemo. Big sigh of relief and lots of joy!

A numerical recap, if you want more details. Among the many test results we received about the biopsy, one was the fact that the tumor was 100% estrogen-receptor positive; in other words, it feeds on estrogen. Just one week after the biopsy, Dr. J (the surgeon who is out of our network) saw that result and said, "Let's start you on anti-estrogen meds now." That's not the norm, but it made a lot of sense and my medical oncologist said, "Sure. Go for it."

Another result was the the Oncotype DX test which is a fairly recent test that oncologists now use to help determine whether or not to do chemo. This is the test where I fell in the hazy middle ground. 17 and below is "no chemo for you!" and 31 and above is, "Yep, you gotta do it!" My number was 21 - just enough to say, "Well, it could be helpful - we don't know for sure." Stats are "13% chance of recurrence if you don't do chemo; 9% chance if you do." Your choice.

As we talked about those numbers with Dr. A, the medical oncologist, I confessed my indecision, and my preference for no chemo. Then I asked a "what if?" question. One other test was the "proliferation rate" (division rate) of the tumor cells. From the biopsy, 24% of the cells were dividing, which is a high rate. It was the worst number of all my results. But the cells were 100% receptive to estrogen, which I was cutting out of their diet, so what if that rate went down between the biopsy report and the pathology report after surgery? Would that be helpful information with which to make my decision? Dr. A agreed.

For the rate to change from 24% to 2% is more change than I even dreamed of. I'm realizing now that I hadn't ever put a number on it, but I think I was vaguely feeling that if it moved down into the teens, that would seem pretty positive. So a low single digit is amazing!!

Now the organizing part of my brain wants to kick into gear and get radiation scheduled so I can get other things planned. I've got Wild Canyon Games coming up in about a month, Memorial Day Weekend, a job in Boise on June 11, my brother's wedding on June 18 and of course Kenya in August. From our previous conversation with the radiologist, I think we'll be able to work that all out.

You can still keep praying. I do have an MRI coming up and then my surgeon is going to take all my records to a tumor board to see what they think about those "probably-benign-but-we-don't-know-for-sure spots." Hopefully those will be fading away too without their precious estrogen...

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