Tuesday, May 30, 2023

State of the Schafer: Celebrating good news

Got some very good news last week: the pathology report for the tissue excised in my 2nd surgery came back clean, no evidence of cancerous or abnormal cells. WHEW. It was such a relief, it honestly took a little while to sink in. It wasn't until many hours later that I shed a few happy tears. I think I've been so braced against the possibility of bad news, I had all the emotional walls up high and tight. 

But now I can relax a little. No more surgeries! Chemo officially off the table! That is very good news indeed. I may still need radiation treatment--my surgeon will be discussing my case at a tumor board meeting tomorrow, plus he'll have my cancerous tissue from the first surgery sent off to an overseas lab for a special test that examines the cell characteristics and estimates risk of recurrence with and without radiation. 

Most women who have excision/lumpectomy surgery do go for radiation, but in my case, the cancerous area was deep in my left breast, close to my chest wall, which means an increased risk of heart and lung damage from radiation treatment. So, I will need to weigh the risks: potential damage to heart and lungs vs. risk of cancer recurrence. Having a really good estimate of that recurrence risk will be a big help in deciding, so hooray for modern medicine. (The test my surgeon has ordered is an example of AI used for good, in fact. My personal risk based on my tissue characteristics will be estimated by a model trained for accuracy on medical datasets. Note the part about "trained for accuracy"...as opposed to "trained to sound like a human", like ChatGPT. There's a tremendous difference there.)  

So....still a bit of waiting and uncertainty to go, but with far less worry and stress. That's a win in my book! Especially because now I can start planning to get out in the mountains again. The recovery from the 2nd surgery has been faster and easier than the recovery from the first, so I'm raring to go. Even if I do have radiation, it wouldn't happen until a month or more from now, because they'd want the tissue to be completely healed from surgery. That means I've got 4-6 weeks with nothing medical planned, woo hoo! It's not quite ski season yet, but the mountains are still looking mighty fine. Time to enjoy them.

On the Mt Iron trail overlooking Wanaka

Lake Hawea, with Mt. Maude behind

Saturday, May 13, 2023

State of the Schafer: Back Under the Knife

This Wednesday I'll be having surgery again. Sadly, multiple surgeries aren't unusual for women diagnosed with pre-invasive breast cancer. Something like 25% of women having excision/lumpectomy surgery have to go back for a second time. Some ladies have to go back even more. Pre-invasive cancer is sneaky; it doesn't show up well on imagery, nor does the tissue look different to the naked eye. It takes a pathologist with a microscope to examine tissue at the cellular level and know if the margins are clean or not.  

My surgeon isn't happy with one of my margins. I too would like to minimize my chance of cancerous cells remaining and growing into something far more difficult to treat. So! Back into the operating room I go. I'm not thrilled about the prospect, but at least this time the surgeon only needs to take a little bit more, so it's a faster and less involved surgery. I'm hoping that means the healing will also be a bit faster, but on the other hand, the surgeon will be re-opening the original incision, which means re-injuring the half-healed tissue, so I'm not sure. 

I think the hardest part will be the wait for the new pathology report. It's possible that yet more DCIS (the pre-invasive cancer) could be found in the newly excised tissue, in which case, I might face yet another surgery, or even a mastectomy. I'm obviously hoping for the more happy outcome, in which the tissue is all clean and I'll be free to move on to the next phase of treatment, which involves decisions about radiation therapy. But until I get that pathology report, all the outcomes are still on the table, and that uncertainty is far harder than the actual surgery and recovery, at least for me. 

That said, the recovery is still kinda annoying. I was just starting to be able to hike and everything again! Oh well. I can still look at the pretty mountains, even if I have to wait a while longer to play in them. Some early snows have come to the high peaks, which always makes them extra beautiful (and makes me dream of skiing...fingers crossed I'll get some days in this winter.) 

Took these pics the other day while walking Comet. Winter is coming!

Anyway, once the surgery is done, I'm going to be looking for some great distractions to keep my mind off the waiting while I recover. Maybe I'll re-read Dunnett's Lymond series (my fav books of all time!), although those need a lot of concentration. Maybe I'll re-read some Diana Wynne Jones and Patricia McKillip. If anybody's got really fun absorbing books or shows to recommend, please get in touch.