A new study looked at survival of moderate or advanced breast cancer patients between the 1980s and 2000s. During those two decades new treatments and advancements, greatly decreased the recurrence rates.
I read the attached and two areas were of great interest. During that time Herceptin was made available and Her2 positive cancers became much easier to treat. Also, estrogen driven cancers used to have a consistentlyhigh recurrence rate but now it is much lower.
While the rate changes vary, overall the recurrence rate has fallen by 50% in those twenty years. This makes me wonder what can happen in the next twenty years in terms of cancer treatment progress.
While breast cancer is the most common cancer among women, we must not forget about other cancers and their recurrence rates.
But in the meantime, I will call this progress.
Showing posts with label recurrence. Show all posts
Showing posts with label recurrence. Show all posts
Sunday, November 29, 2015
Sunday, July 19, 2015
Why do I bother to ask these questions anyway?
This week I saw my oncologist for my annual check up. I am happy to only see her once a year... Except when I nominated her for an award last winter or when I ran into her in the hallway at the hospital. So, I, who am never afraid of the direct question, asked her "so what are my chances of more cancer?". Why not ask? I would prefer to know what can be known. This little question of what could be coming in the future has been irking me for years.
The answers I got were:
Does it mean I have a 6% chance of recurrence? Or that my chance is 6% greater than the rest of the population of getting another breast cancer? I just have to accept there is a 94% chance I will not have a recurrence.
Why do I even bother to ask these questions? Did it get me anywhere? No. I guess I am asking questions that have no answer. Damn.
The answers I got were:
- Even with my medical history of two cancer diagnosis and family diagnosis of a parent with cancer, there is no way of knowing if I am likely to get another cancer. If there was some genetic predisposition that would be different but there is no way of knowing. People who get cancer once, are more likely to get another cancer. People who get cancer twice, are more likely to get a third cancer. Et cetera. Not very helpful.
- The chances of having a thyroid cancer recurrence are still out there but not known. It has been known to recur decades later.
- The chances of having a breast cancer recurrence since I am still on Femara (Letrozole) are somewhere around 6%. She ran my data through a computer model and got the magic number.
Does it mean I have a 6% chance of recurrence? Or that my chance is 6% greater than the rest of the population of getting another breast cancer? I just have to accept there is a 94% chance I will not have a recurrence.
Why do I even bother to ask these questions? Did it get me anywhere? No. I guess I am asking questions that have no answer. Damn.
Saturday, May 30, 2015
Predicting breast cancer recurrence five to fifteen years out
When I was diagnosed with breast cancer seven years ago, I heard about the Oncotype Dx test, for which I was not eligible (for some stupid reason I can't remember) that would help decide whether chemotherapy was necessary. It has now been available for ten years and has been shown that it can help predict late recurrence of breast cancer - which is defined as five to fifteen years out from the initial diagnosis.
I think this is real progress in reining in cancer. [I wasn't going to use the word battle or war or anything like that. I had to think and settled on reining in.] This ties in with extending the use of tamoxifen for ten years to obtain better results.
"As recognized by ASCO's guideline update, recent studies have shown that extending tamoxifen treatment for 10 years is associated with better outcomes, however, we still need better tools to identify who those patients are," said Norman Wolmark, M.D., chairman of the National Surgical Adjuvant Breast and Bowel Project (NSABP). "This study confirms that Oncotype DX can help better define who is at greatest risk for late recurrences and the potential to benefit from extended tamoxifen, as well as those who are at lower risk and will likely have less absolute benefit from extended tamoxifen and, thus, could be spared prolonged exposure and risk of long-term side effects."
Now of course, I am still do not have the criteria to belong to that group that was in the study but it is nice to know that there is progress in knowing about who is more likely to have recurrence. This in turns allow them to be better followed to catch any recurrence early.
I think this is real progress in reining in cancer. [I wasn't going to use the word battle or war or anything like that. I had to think and settled on reining in.] This ties in with extending the use of tamoxifen for ten years to obtain better results.
"As recognized by ASCO's guideline update, recent studies have shown that extending tamoxifen treatment for 10 years is associated with better outcomes, however, we still need better tools to identify who those patients are," said Norman Wolmark, M.D., chairman of the National Surgical Adjuvant Breast and Bowel Project (NSABP). "This study confirms that Oncotype DX can help better define who is at greatest risk for late recurrences and the potential to benefit from extended tamoxifen, as well as those who are at lower risk and will likely have less absolute benefit from extended tamoxifen and, thus, could be spared prolonged exposure and risk of long-term side effects."
Now of course, I am still do not have the criteria to belong to that group that was in the study but it is nice to know that there is progress in knowing about who is more likely to have recurrence. This in turns allow them to be better followed to catch any recurrence early.
Tuesday, April 28, 2015
Sued for not disclosing cancer had returned?
Now I assume she was under some kind of contract with all sorts of weird clauses that you usually do not see outside the entertainment world. But it is stated in law that medical issues are no business of the employer. But they are mad so they are suing her.
And where is their compassion? You may remember in January she disclosed that she had three months to live as result of her brain cancer. She is now cautiously optimistic.
Let me just say a few things about this as I am seriously ticked off:
- You are morons and being childlike. She was sick and couldn't perform.
- She has cancer and doesn't know how long she will life.
- Its none of your business that she had cancer before and she had no way of knowing that it would recur.
- Finally, don't you have any sense of compassion?
Friday, January 30, 2015
Predicting breast cancer recurrence five to fifteen years out
When I was diagnosed with breast cancer seven years ago, I heard about the Oncotype Dx test, for which I was not eligible (for some stupid reason I can't remember) that would help decide whether chemotherapy was necessary. It has now been available for ten years and has been shown that it can help predict late recurrence of breast cancer - which is defined as five to fifteen years out from the initial diagnosis.
I think this is real progress in reining in cancer. [I wasn't going to use the word battle or war or anything like that. I had to think and settled on reining in.] This ties in with extending the use of tamoxifen for ten years to obtain better results.
"As recognized by ASCO's guideline update, recent studies have shown that extending tamoxifen treatment for 10 years is associated with better outcomes, however, we still need better tools to identify who those patients are," said Norman Wolmark, M.D., chairman of the National Surgical Adjuvant Breast and Bowel Project (NSABP). "This study confirms that Oncotype DX can help better define who is at greatest risk for late recurrences and the potential to benefit from extended tamoxifen, as well as those who are at lower risk and will likely have less absolute benefit from extended tamoxifen and, thus, could be spared prolonged exposure and risk of long-term side effects."
Now of course, I am still do not have the criteria to belong to that group that was in the study but it is nice to know that there is progress in knowing about who is more likely to have recurrence. This in turns allow them to be better followed to catch any recurrence early.
I think this is real progress in reining in cancer. [I wasn't going to use the word battle or war or anything like that. I had to think and settled on reining in.] This ties in with extending the use of tamoxifen for ten years to obtain better results.
"As recognized by ASCO's guideline update, recent studies have shown that extending tamoxifen treatment for 10 years is associated with better outcomes, however, we still need better tools to identify who those patients are," said Norman Wolmark, M.D., chairman of the National Surgical Adjuvant Breast and Bowel Project (NSABP). "This study confirms that Oncotype DX can help better define who is at greatest risk for late recurrences and the potential to benefit from extended tamoxifen, as well as those who are at lower risk and will likely have less absolute benefit from extended tamoxifen and, thus, could be spared prolonged exposure and risk of long-term side effects."
Now of course, I am still do not have the criteria to belong to that group that was in the study but it is nice to know that there is progress in knowing about who is more likely to have recurrence. This in turns allow them to be better followed to catch any recurrence early.
Friday, January 23, 2015
Its all about the language
Who calls it a relapse when cancer recurs? I didn't know anyone did. It has a different connotation. But maybe in Australia its common.
There is a new bit of medical research (because we have to keep those researchers working) in Australia where they found a gene that half of women with estrogen positive breast cancer have. If women have the gene, they could alter the timing of chemotherapy.
Basically a basic blood test could determine if patients have the gene.
"The test would be used to determine when cancer cells are most vulnerable to chemotherapy, which would be used to kill them off and prevent a relapse.
At present patients with this type of cancer typically receive anti-oestrogen therapy and generally respond well. Within 15 years, however, half develop drug resistance, followed by relapse and death."
How's that for putting it morbidly? Nice - huh?
"Scientists believe the anti-oestrogen therapy weakens the BCL-2 gene, which protects the cancer.
The idea would be to test all patients and correctly time the use of chemotherapy to kill off the cancer and prevent a relapse when the gene is sufficiently weak."
So its much more specific.
But its a theory now and has to go through testing and trials and don't go holding your breath because it will be quite a while.
I just wish that they could be a little nicer in their phrasing and skip the damn word 'relapse'.
There is a new bit of medical research (because we have to keep those researchers working) in Australia where they found a gene that half of women with estrogen positive breast cancer have. If women have the gene, they could alter the timing of chemotherapy.
Basically a basic blood test could determine if patients have the gene.
"The test would be used to determine when cancer cells are most vulnerable to chemotherapy, which would be used to kill them off and prevent a relapse.
At present patients with this type of cancer typically receive anti-oestrogen therapy and generally respond well. Within 15 years, however, half develop drug resistance, followed by relapse and death."
How's that for putting it morbidly? Nice - huh?
"Scientists believe the anti-oestrogen therapy weakens the BCL-2 gene, which protects the cancer.
The idea would be to test all patients and correctly time the use of chemotherapy to kill off the cancer and prevent a relapse when the gene is sufficiently weak."
So its much more specific.
But its a theory now and has to go through testing and trials and don't go holding your breath because it will be quite a while.
I just wish that they could be a little nicer in their phrasing and skip the damn word 'relapse'.
Monday, January 19, 2015
Why do I bother to ask these questions anyway?
This week I saw my oncologist for my annual check up. I am happy to only see her once a year... Except when I nominated her for an award last winter or when I ran into her in the hallway at the hospital. So, I, who am never afraid of the direct question, asked her "so what are my chances of more cancer?". Why not ask? I would prefer to know what can be known. This little question of what could be coming in the future has been irking me for years.
The answers I got were:
Does it mean I have a 6% chance of recurrence? Or that my chance is 6% greater than the rest of the population of getting another breast cancer? I just have to accept there is a 94% chance I will not have a recurrence.
Why do I even bother to ask these questions? Did it get me anywhere? No. I guess I am asking questions that have no answer. Damn.
The answers I got were:
- Even with my medical history of two cancer diagnosis and family diagnosis of a parent with cancer, there is no way of knowing if I am likely to get another cancer. If there was some genetic predisposition that would be different but there is no way of knowing. People who get cancer once, are more likely to get another cancer. People who get cancer twice, are more likely to get a third cancer. Et cetera. Not very helpful.
- The chances of having a thyroid cancer recurrence are still out there but not known. It has been known to recur decades later.
- The chances of having a breast cancer recurrence since I am still on Femara (Letrozole) are somewhere around 6%. She ran my data through a computer model and got the magic number.
Does it mean I have a 6% chance of recurrence? Or that my chance is 6% greater than the rest of the population of getting another breast cancer? I just have to accept there is a 94% chance I will not have a recurrence.
Why do I even bother to ask these questions? Did it get me anywhere? No. I guess I am asking questions that have no answer. Damn.
Sunday, January 18, 2015
Progress in Breast Cancer Treatment Shows in Recurrence Rates
A new study looked at survival of moderate or advanced breast cancer patients between the 1980s and 2000s. During those two decades new treatments and advancements, greatly decreased the recurrence rates.
I read the attached and two areas were of great interest. During that time Herceptin was made available and Her2 positive cancers became much easier to treat. Also, estrogen driven cancers used to have a consistentlyhigh recurrence rate but now it is much lower.
While the rate changes vary, overall the recurrence rate has fallen by 50% in those twenty years. This makes me wonder what can happen in the next twenty years in terms of cancer treatment progress.
While breast cancer is the most common cancer among women, we must not forget about other cancers and their recurrence rates.
But in the meantime, I will call this progress.
I read the attached and two areas were of great interest. During that time Herceptin was made available and Her2 positive cancers became much easier to treat. Also, estrogen driven cancers used to have a consistentlyhigh recurrence rate but now it is much lower.
While the rate changes vary, overall the recurrence rate has fallen by 50% in those twenty years. This makes me wonder what can happen in the next twenty years in terms of cancer treatment progress.
While breast cancer is the most common cancer among women, we must not forget about other cancers and their recurrence rates.
But in the meantime, I will call this progress.
Saturday, January 17, 2015
A peek at life with cancer
It took a new study to confirm what all of us living with cancer know - its still scary years and decades later. The study said that for the first few years after a cancer diagnosis patients cope with depression but then it turns to a much longer bout with anxiety. Why you ask? Because there is no guarantee it won't come back.
This study also looked at anxiety in both patients and their caregivers. The caregivers also tend to cope with anxiety.
If you have some sort of other chronic illness such as rheumatoid arthritis or fibromyalgia or many others, patients tend to deal with it as a chronic illness. Cancer patients also deal with it as a chronic illness but its also a chronic threat because there is no way to control or prevent it from coming back or showing up with a new cancer some place else.
How pleasant.
It took this fancy research study to tell me something I know well, 32 years later, that it still looms over me. In 2005, 24 years after my first diagnosis, I had millions of uterine fibroids that resulted in a hysterectomy. I expressed my concerns to the surgeon that I had had cancer before and was concerned about more cancer. Her reply 'fibroids usually are benign but to be sure we slice and dice them to make sure' left me feeling better about it. But I had been concerned enough to ask.
In 2007 with my breast cancer diagnosis, I started the roller coaster again. But full of little tips and reminders, that because it was my second cancer at such a young age (never say that to patients please), I got extra tests and exams as a special perk.
Years of going to doctors who say things like 'with your medical history, we need to be sure', while reassuring it does reinforce the possibility of cancer looming.
So now I shouldn't worry about depression but only the anxiety and wait for a guarantee.
This study also looked at anxiety in both patients and their caregivers. The caregivers also tend to cope with anxiety.
If you have some sort of other chronic illness such as rheumatoid arthritis or fibromyalgia or many others, patients tend to deal with it as a chronic illness. Cancer patients also deal with it as a chronic illness but its also a chronic threat because there is no way to control or prevent it from coming back or showing up with a new cancer some place else.
How pleasant.
It took this fancy research study to tell me something I know well, 32 years later, that it still looms over me. In 2005, 24 years after my first diagnosis, I had millions of uterine fibroids that resulted in a hysterectomy. I expressed my concerns to the surgeon that I had had cancer before and was concerned about more cancer. Her reply 'fibroids usually are benign but to be sure we slice and dice them to make sure' left me feeling better about it. But I had been concerned enough to ask.
In 2007 with my breast cancer diagnosis, I started the roller coaster again. But full of little tips and reminders, that because it was my second cancer at such a young age (never say that to patients please), I got extra tests and exams as a special perk.
Years of going to doctors who say things like 'with your medical history, we need to be sure', while reassuring it does reinforce the possibility of cancer looming.
So now I shouldn't worry about depression but only the anxiety and wait for a guarantee.
Friday, January 16, 2015
Recurrence prediction 10 years out
The Oncotype DX test came around a while back which could help predict whether women were likely to have recurrence of their breast cancer. This score is also used to suggest different treatment options.
Now there is another option using the ICH4 gene which helps predict recurrence during the first ten years after diagnosis. Most breast cancers recur during the first three to five years so having a test which can extend well past that time frame is a wonderful option.
I will need to have a conversation with my oncologist about this when I next see her. I am sure I will get the same answer I always get - my criteria don't meet the requirements for the test. Often its because I had another cancer prior. Or because it has been so long since my diagnosis.
Crap, they don't know, I don't know either. I'm still here and that's what is important.
This lovely little video gives about 20 seconds on this test after you learn about exercise and migraines first.
I believe my cynical side is showing today. I'm going to the gym.
Now there is another option using the ICH4 gene which helps predict recurrence during the first ten years after diagnosis. Most breast cancers recur during the first three to five years so having a test which can extend well past that time frame is a wonderful option.
I will need to have a conversation with my oncologist about this when I next see her. I am sure I will get the same answer I always get - my criteria don't meet the requirements for the test. Often its because I had another cancer prior. Or because it has been so long since my diagnosis.
Crap, they don't know, I don't know either. I'm still here and that's what is important.
This lovely little video gives about 20 seconds on this test after you learn about exercise and migraines first.
I believe my cynical side is showing today. I'm going to the gym.
Thursday, January 15, 2015
Sued for not disclosing cancer had returned?
Now I assume she was under some kind of contract with all sorts of weird clauses that you usually do not see outside the entertainment world. But it is stated in law that medical issues are no business of the employer. But they are mad so they are suing her.
And where is their compassion? You may remember in January she disclosed that she had three months to live as result of her brain cancer. She is now cautiously optimistic.
Let me just say a few things about this as I am seriously ticked off:
- You are morons and being childlike. She was sick and couldn't perform.
- She has cancer and doesn't know how long she will life.
- Its none of your business that she had cancer before and she had no way of knowing that it would recur.
- Finally, don't you have any sense of compassion?
Tuesday, January 13, 2015
A (Short but) Very Stressful Trip on the Cancer Rollercoaster
Yesterday I went to have my annual check up with endocrinologist. When I first saw her about five years ago, I was sent for a baseline thyroid ultrasound because I hadn't had either an ultrasound ever or an endocrinologist in a very long time (decades?). Big surprise there when they found a 'something' in the thyroid bed where the thyroid used to be but wasn't supposed to be anything.
We started following it with ultrasounds to see what it was. It was clearly in the evil category of 'big enough to see but too small to do anything about'. So six month and then, as its stability became established, annual ultrasounds were the result.
I ran into friends entering the hospital and then was a little late for the ultrasound but still had to wait a few minutes. I didn't have any great expectations of issues with the ultrasound. They finally called me and I went in for my turn. It met my expectations of no problems. I went on to my endocrinologist appointment to get the results and talk about my thyroid or lack of.
While in the waiting room, I ran into another friend (see what happens when you are a frequent patient - your social life happens at the hospital?) and we were chatting away. Then a doctor showed up in scrubs and asked the front desk attendant for me because of the innocuous reason that 'the doctor needed more pictures'.
My stress level grew. Immensely. No cancer patients ever want to hear that. They sent me back to the ultrasound waiting room for a few minutes and my stress level continued to grow. I was the only one in the waiting room - me and my mind which quickly goes down that evil little road to hell.
After a few minutes they called me in again. Another tech started another ultrasound and would only tell me that 'the doctor had requested more pictures'. After a few minutes of clicking away on her screen and squishing the side of my neck with the stupid wand thing, she left to check with the doctor to make sure they had enough pictures.
My stress level grew some more. I was in tears.
The attendant came back with the supervisor/instructor. They resumed the ultrasound and whispered away while clicking and and pointing at the screen. I was more stressed.
Finally they decided they had enough pictures and sent me and my kleenex back to endocrinology where I was greeted with 'there you are - we called you and you weren't here even though you had checked in'. I was told to take a seat, no they would take me, not sit, no go in. Eventually they said go in. The nurse said she had forgotten I was sent back over to ultrasound....
She stuck me in an exam room and attempted to take my blood pressure. I have no idea what it was but I bet it was a bit high. I stressed.
Then the doctor came in and apologized and said everything is fine. She told me to take a few deep breaths. My stress level started to go down. She told me she could not imagine what I went through as even she was very surprised to learn that I was sent back to ultrasound. She wasn't the doctor who wanted more images, it was the radiologist so she was surprised as well. My stress level went down so more.
What happened is that the evil little something they were following was not found in the first ultrasound. The tech measured something different which was a completely different size. They had to go back and find what the first tech had measured and then to decide that the evil something was no longer there. Great big sigh of relief. That was about 45 minutes of sheer hell on my part. Then I went to the gym to finish destressing.
I do not blame the techs as they were doing their job and I do not expect them to tell me what they see as the doctor needs to put it in context. I'm just glad I had the results of the ultrasound about 10 minutes after it ended.
This is a day in the life of a cancer patient. Every test no matter the expectations can quickly go to hell in a hand basket. If you haven't walked the walk, you have no idea what its like.
We started following it with ultrasounds to see what it was. It was clearly in the evil category of 'big enough to see but too small to do anything about'. So six month and then, as its stability became established, annual ultrasounds were the result.
I ran into friends entering the hospital and then was a little late for the ultrasound but still had to wait a few minutes. I didn't have any great expectations of issues with the ultrasound. They finally called me and I went in for my turn. It met my expectations of no problems. I went on to my endocrinologist appointment to get the results and talk about my thyroid or lack of.
While in the waiting room, I ran into another friend (see what happens when you are a frequent patient - your social life happens at the hospital?) and we were chatting away. Then a doctor showed up in scrubs and asked the front desk attendant for me because of the innocuous reason that 'the doctor needed more pictures'.
My stress level grew. Immensely. No cancer patients ever want to hear that. They sent me back to the ultrasound waiting room for a few minutes and my stress level continued to grow. I was the only one in the waiting room - me and my mind which quickly goes down that evil little road to hell.
After a few minutes they called me in again. Another tech started another ultrasound and would only tell me that 'the doctor had requested more pictures'. After a few minutes of clicking away on her screen and squishing the side of my neck with the stupid wand thing, she left to check with the doctor to make sure they had enough pictures.
My stress level grew some more. I was in tears.
The attendant came back with the supervisor/instructor. They resumed the ultrasound and whispered away while clicking and and pointing at the screen. I was more stressed.
Finally they decided they had enough pictures and sent me and my kleenex back to endocrinology where I was greeted with 'there you are - we called you and you weren't here even though you had checked in'. I was told to take a seat, no they would take me, not sit, no go in. Eventually they said go in. The nurse said she had forgotten I was sent back over to ultrasound....
She stuck me in an exam room and attempted to take my blood pressure. I have no idea what it was but I bet it was a bit high. I stressed.
Then the doctor came in and apologized and said everything is fine. She told me to take a few deep breaths. My stress level started to go down. She told me she could not imagine what I went through as even she was very surprised to learn that I was sent back to ultrasound. She wasn't the doctor who wanted more images, it was the radiologist so she was surprised as well. My stress level went down so more.
What happened is that the evil little something they were following was not found in the first ultrasound. The tech measured something different which was a completely different size. They had to go back and find what the first tech had measured and then to decide that the evil something was no longer there. Great big sigh of relief. That was about 45 minutes of sheer hell on my part. Then I went to the gym to finish destressing.
I do not blame the techs as they were doing their job and I do not expect them to tell me what they see as the doctor needs to put it in context. I'm just glad I had the results of the ultrasound about 10 minutes after it ended.
This is a day in the life of a cancer patient. Every test no matter the expectations can quickly go to hell in a hand basket. If you haven't walked the walk, you have no idea what its like.
Thursday, January 8, 2015
A very unsettling conversation
Yesterday, as part of my day to myself, I dragged my sorry a$$ to the gym. As part of my getting ready ritual, I pulled on my lymphedema sleeve. An older woman entered the previously empty locker room and asked me if it was a lymphedema sleeve. Often I just say it is a compression sleeve so as not to enter the 'what is lymphedema' conversation and get into my medical history with a virtual stranger.
She looked somewhat on edge. I told her it was a lymphedema sleeve. She said she had been diagnosed with breast cancer 28 years ago when she had a lumpectomy and radiation. Then she had a recurrence 7 years ago (I am pretty sure it was 7, it might have been 4) when she had a mastectomy and more treatment.
Three weeks ago she started to get swelling around her implant and around to her back. She had had an MRI and a CT scan to make sure it was not more cancer. It was lymphedema. I believe she said her doctor called it 'sectional lymphedema'.
She wondered how she could have gotten lymphedema at such a late date for no reason. I did remind her you can get it from a little cut or injury. She replied but it wasn't on her arm and just her torso on that side. I did suggest she call and get some treatment asap as it is important to get lymphedema under control as soon as possible. She said she was going to call her doctor back later in the day.
Then we both went our separate ways.
Later I started thinking.
First of all a recurrence over 20 years after the first diagnosis. Crap.
Second of all, lymphedema 28 years after the first diagnosis and 7 years after the second surgery. Double crap.
You start to get comfortable with a cancer diagnosis. And then whammy. You find out about late recurrences and it all becomes a little too close to home. Triple Crap.
That brief conversation gave me a lot of food for thought and was very unsettling.
She looked somewhat on edge. I told her it was a lymphedema sleeve. She said she had been diagnosed with breast cancer 28 years ago when she had a lumpectomy and radiation. Then she had a recurrence 7 years ago (I am pretty sure it was 7, it might have been 4) when she had a mastectomy and more treatment.
Three weeks ago she started to get swelling around her implant and around to her back. She had had an MRI and a CT scan to make sure it was not more cancer. It was lymphedema. I believe she said her doctor called it 'sectional lymphedema'.
She wondered how she could have gotten lymphedema at such a late date for no reason. I did remind her you can get it from a little cut or injury. She replied but it wasn't on her arm and just her torso on that side. I did suggest she call and get some treatment asap as it is important to get lymphedema under control as soon as possible. She said she was going to call her doctor back later in the day.
Then we both went our separate ways.
Later I started thinking.
First of all a recurrence over 20 years after the first diagnosis. Crap.
Second of all, lymphedema 28 years after the first diagnosis and 7 years after the second surgery. Double crap.
You start to get comfortable with a cancer diagnosis. And then whammy. You find out about late recurrences and it all becomes a little too close to home. Triple Crap.
That brief conversation gave me a lot of food for thought and was very unsettling.
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