The Second Opinion

As you all know if you've been paying attention (there will not be a test, no worries), on Thursday I went to KU Breast Center to visit Dr. Priyanka Sharma. I also know that many of you have been waiting on an update. Um, yeah, so...I'm sorry. I needed some time to cool off a bit before I posted for your viewing pleasure. Why, you may ask? Well, honestly, I was a little ANGRY!

I have a right to be MAD!!

I've been working very hard on accepting my 'plan' for treatment, but I guess I've always had this gut feeling that things aren't moving fast enough and something is not quite right. Well, it turns out that I was right.  

On Thursday, Kelly met me at KU and as usual, was my rock as we waited patiently (for TWO HOURS!) to see Dr. Sharma. It was frustrating, but as soon as we (I) had her undivided attention, I immediately understood why she was worth the two hour wait. First of all, on the KU webpage, this is what she has listed as her specialties:

• Hematology and Oncology
• Second Opinions in Cancer

• Medical Oncology

• Oncology

What better place to go than someone who specializes in second opinions?! AND she was referred to me by my old (time reference only) boss and dear friend, Kristy, who works in Oncology now for Amgen. I trust her with my life. Obviously :) So anyway, we waited, were visited by the NP and a student and welcomed by everyone who was around. The overall atmosphere was very calming, reassuring...almost like a...spa?? But few guests were smiling. I guess I will always be the exception there :) Dr. Sharma did a quick exam because the majority of the examination and questions asked came from the NP. She consulted with Dr. Sharma before she met with me and we quickly proceeded to a consultation room. In the room Dr. Sharma explained to me a few things:

-She had 'concern' for me and the fact that it had been 3 weeks since excision (removal of the tumor) and almost 8 months since the tumor was 'found' and we were still 3 weeks from doing anything about it! (when she said it, it started to freak me out too!!) (For the record, it's been a week since my appt with Dr. Belt and I still have not heard a peep from him or his staff)

-There is a marker on the pathology report called the Ki-67 which no one has mentioned to me yet. I'm no doctor, but this seems *kinda* important when dealing with triple negative breast cancer such as mine, which is known to be more aggressive...

Ki-67 is a cancer antigen that is found in growing, dividing cells but is absent in the resting phase of cell growth. This characteristic makes Ki-67 a good tumor marker.

A breast tumor that scores high for Ki-67 is made of cells that are rapidly dividing and growing. Chemotherapy drugs target cells that are growing beyond the normal rate, and so these drugs can be effective on aggressive cancers. Knowing your Ki-67 score helps you and your doctor decide what treatment will work best for you.

In my research, I found that there are some women with a Ki-67 of 3-4% with growing cancer...my score? 81%!!!

-10 weeks (my previous plan) from excision is WAY too long to wait to start chemo

-The excision of the tumor takes away the opportunity for me to have Platinum Chemo because they need to have a tumor to track. Her opinion is that my lump should have been biopsied before removal so we would have had more options.

-Although the BRCA tests were negative, she needs to see the report (which was faxed today) to pick it apart and see if there were other abnormalities, mutations that could represent a genetic link. She's a smart cookie.

-Finally, (and I've been uncomfortable about this from the start) no one has tested my lymph nodes yet and I have an aggressive cancer with a propensity to travel. Breast cancer typically travels to the nodes in the underarm first. Hmmm... 

So I was quickly escorted down the hall to have an ultrasound on the lymph nodes. I know what you're thinking... didn't the PET scan cover that? I thought so too. No, the PET wouldn't necessarily have noticed a lymph node if it was small. Within a few minutes, the Wizard of Oz (or the nameless/faceless person who read the ultrasound) let Dr. Sharma know that there were nodes that showed up and he wanted to biopsy in the morning. Please keep in mind that most of the staff had gone home and we were well into after hours time at this point. I went in at 7:30am this morning for the biopsy (which was quick and uneventful except my armpit now hurts like hell!) and went straight to work for the day. The results should be back by Monday afternoon, Tuesday morning at the latest.

What does all this mean? Oh, did I fail to say that my plan has now changed DRAMATICALLY and I am now planning on starting chemo next Thursday? Yes, less than a week away. Trust me, no one can be as shocked as I was. As soon as those results come back, we will know exactly where we stand moving into it. I haven't cancelled all the surgery appointments over the next couple weeks yet because honestly, I was busy working today and thought that they could hold their horses. I certainly have! 

I think I forgot to mention that I have mixed feelings about the lymph nodes... No way do I want them to come back positive because it means it's traveling. Yeah, bags packed, looking for a beach and I'd hate for them to end up in the tropical paradise of my brain or lungs. However... there can be a positive to a positive node. If there is a tumor for Dr. Sharma to follow, I could possibly be a candidate for Platinum Chemotherapy. I really don't know exactly what that means yet, but since they don't offer Palladium Chemo, I figure it must be the best. So, we'll see on Monday! 

I promise I'm done being angry. I actually smiled a whole lot today :) :) :) :) 

Happy Weekend!

xoxo 

Shelley