Today we went to the Greenville Hospital System for a second opinion on Lucia’s cancer. This meeting was probably not necessary. Our primary aim was peace of mind. The LORD has been good to keep our hearts sufficiently guarded and we don’t expect any surprises at this point.
In the carpentry field there is a phrase “measure twice, cut once.” The meeting today was our “measure twice” moment before they cut once.
The doctor was Brian McKinley. He had gray in his hair too. Yay for that. He went through the battery of questions about how we got here, history of cancer in her family, and the things we’ve done thus far.
The McKinley highlights
Here’s a list of some of the things we talked about, in no particular order.
Two parts of the body need surgery: surgery for breast and surgery for lymph nodes.
There is no test short of surgical biopsy that will reveal what needs to be known, hence the lymph node surgery. The lymph nodes in play are around the upfront armpits. That is what they will go after. These are the sentinel lymph notes, in that they “stand guard” for all the others.
The breast surgery can be a mastectomy and lumpectomy. Dr. McKinley said it did not seem wise to have a lumpectomy. The surgical procedure does not determine the success rate. The main things are getting all cancer out and making sure the lymph nodes are clear.
The harder part for us is the psychological aspect about a mastectomy.
The risk of the tumors coming back with a mastectomy is lower than with a lumpectomy, which is why radiation is almost always necessary for a lumpectomy.
The Oncotype DX test is used to estimate a woman’s risk of recurrence of early-stage, hormone-receptor-positive breast cancer, as well as how likely she is to benefit from chemotherapy after breast cancer surgery. This test assesses the tumor cells themselves.
The process, loosely outlined
- Remove the cancer
- Measure the largest one
- Remove lymph node
- Get the Oncotype test
- Determine radiation, chemo, and/or estrogen blocker
One of the things, maybe the main thing, we appreciate about all the doctors, navigators, and nurses that we’ve met is how releasing they are about the processes we choose. They are not pushy or impatient. We are in charge, as though the medical team is working for us. That is comforting.
This may be the last doctor visit until the week of the surgery. Lucia is tired each day. I ask her about this. She does not seem to know why she’s tired, other than the weight of it all and the constant conversation. (I’m talking about our private talks. We seem to be talking all the time. There’s no way around this, though it is taxing.) We do pace ourselves well. We say “no” often.
As they say, “It is what it is.” …and there is grace for that.