A few weeks have passed since Mark had his last
operation to
remove a lymph node, in order to define whether his breast cancer has spread.
Since he was
diagnosed with invasive papillary carcinoma, a very rare, but
encapsulated cancer, everyone assumed the lymph node would be clear. When we
received the pathology report, however, 80 scattered cancer cells were found.
Nothing to worry about, so the specialists said, because those cells don’t mean
much (“We count this result as 0” –
Hmm,
we thought zero actually meant zero…) and they might have ended up in the
lymph node system after the first biopsy “poking” in Tahiti. We also found out
that Mark, as assumed, has the BRCA1 mutation, which is now generally believed
as the cause for his breast cancer.
Other than that, Mark is healing well from surgery and we
have come to the point, where we now have all the information we need about his
situation. What we don’t have is results, statistics or accurate prognoses
about his disease, because he falls in a category all by himself. Mark is a
male of 43 years old, with the BRCA1 gene and a very uncommon type of breast
cancer. Usually, when a man is diagnosed with breast cancer, they automatically
do a mastectomy, since, usually, not enough breast tissue is in place to remove
the tumor with clear margins. In Mark’s case, his surgeon from Newburyport did
a great job and succeeded to remove the tumor
with clear margins, meaning all the cancer would theoretically be
removed just by this “lumpectomy”. Hence, the preferred follow up treatment
would be radiation and hormone treatment.
Fast forward to a couple of days ago, when Mark’s case was
brought to the “tumor board” in Dana Farber, one of the top cancer institutes
in the US. Mark and I were meeting with our radiation oncologist (and head of
the radiation department) to set up the radiation plan and to see what the
board had decided. Big – and unpleasant – was our surprise, when we heard that
many people of that meeting felt that a mastectomy would be the best plan of
action. What??? I thought we had passed that point already? Where the heck did
this come from all of a sudden? Here we believed we had a plan and we could
move on, starting with the treatment. Instead, we were offered an alternative
again and, worst of all, after some more thinking and talking, this alternative
(which was actually an old alternative that had always been on the table)
started to make sense!
So, there we went again, thinking, talking, reading and
researching (mostly in vane) our two options: mastectomy (= another operation,
a few weeks recovery, a permanent scar and missing nipple, but that’s it) OR
radiation (for four weeks) in combination with hormone treatment (for five
years) with possible side effects. Both options had the same outcome and chance
of recovery, but which one would be better to prevent any recurrence, which is
now all that matters? It boiled down to a personal preference, and… Mark was
“lucky” he had a choice!
It is June 20
th today and Mark has been in the
States for over a month and a half, about the same time we have known about his
dreadful cancer verdict. As of this day, we finally have a plan and a schedule
and that is good news. Yesterday, radiation technicians “mapped” his body for
the weeks of therapy to follow, and on June 26
th (after a “dry” run
the day before) his 19 radiation treatments will start. Five days a week, he
will have to lay in a machine and get zapped (the actual radioactive beam will
only hit him one minute or so). Once all this is finished and we have met again
with our wonderful, skillful and highly experienced medical team of Dr.
Jeselsohn, Dr. Carter and Dr. Harris (all three are also professors at Harvard
University), Mark will most likely have to take the hormone drug Tamoxifen for
five years. This, with a personal choice of natural remedies and a healthy
lifestyle should minimize bad cancer cells to linger around, multiply or recur.
We sure hope so!
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| The CAT-scan machine for Mark's "mapping" |
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| Mark's view from the CAT-scan machine. Looks familiar? :-) |
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| The radiation technicians left some magic marker spots behind. Five tiny, but permanent tattoos will help line up the machine during treatment. |
Since the moment Mark and I arrived in the US, about two months ago (yes, time flies!), we have moved into the condo of his parents in Newburyport, Massachusetts. They have a room with a separate entrance above their garage, which we call home for the time being. We sleep in a sofa bed, have our own bathroom, porch, desks to work at and some level of privacy. It works out great: we do our own thing during the day (which mostly entails computer work and cancer treatments) and hang out and catch up with them in the evening.
One of the things I have been wanting to do for many weeks, is getting dropped off at a shopping mall out of town to do some needed clothes shopping (and get a haircut) and walking home from there. Recently, on a pleasant, sunny day, this is exactly what happened: I had my exercise walking home on the shaded footpath along High Street, gazing at all the stately, historical buildings along the way. They are a big part of what this area is about, so I figured I’d share some pictures.
