Finally, somewhat of a plan

This morning was results day, so Tanai and I arrived at St Bart's somewhat bleary-eyed after a late night (at a great Sampha gig) and broken sleep. I felt very calm and eager to find out what's what. So, here we go.

There's a lot of good news and I'm generally feeling very positive. I have a tough few months ahead but my inner project manager is kicking in, and soon I'll have a proper plan (complete with spreadsheets and gant charts, ha ha).

Thankfully, my left breast is fine, and the small lump in my right breast is benign, so the only cancer is the large lump in my right breast. It's a ductal carcinoma grade 3 (which means that it's a cancer in my milk ducts, looks different to normal breast cells and is fast-growing, or 'aggressive'). It's oestrogen receptive 7 and they're still waiting for the HER2 receptor results. This is relevant to deciding which drugs will be most effective to nuke the cancer.

I was expecting to have surgery first and then additional treatment, but my surgeon is advising me to have a course of chemotherapy first and then surgery. This is primarily because this cancer is likely to be receptive to chemo and hormone treatment, so it could be significantly reduced in size and may even be nuked completely by the drugs (although unlikely) so this is the best way round. They are making me an appointment with an oncologist for next week where I will discuss my chemo schedule, but it's likely that this will begin in a couple of weeks. They are also going to give me Pertuzumab which is a new drug only recently licenced, which is pretty cool. (I'm not used to being an 'early adopter' but why not start now!)

The general schedule for chemo is once every 3 weeks, for 6 rounds, which will pretty much take me through the summer (fun times!) and then some more tests and likely surgery in the autumn (September-ish). Hopefully the chemo will have shrunk the tumour to a teeny size so the surgery won't be too bad. When they remove the lump they will do more tests on it, and check my lymph nodes at the same time. Depending on the results of those tests (which will determine if it has spread) I may have to have a) more surgery, b) radiotherapy or c) nothing at all.

So, first things first. On the way home from the hospital Tanai and I stopped by St John's Bakery and got a couple of lemon cream-filled donuts to have with coffee as we digested the news. When life gives you lemons, eat delicious lemon cream-filled donuts!

My initial thoughts are very positive. It feels containable and treatable. It's also highly likely that I can continue to go to work while having chemo treatment, and with a combination of strategic allocation of my one day off a week, and timing of treatment, I could end up having minimum time off. It's likely that I would need to take a chunk of time off after surgery (eg 6 weeks) in the autumn but the doctors don't know for sure yet. And of course I don't know how my body will respond to the chemo so a degree of flexibility will have to be involved.

My surgeon, Miss L___, followed up her news about my results today with, "So of course, we will have to talk about fertility treatment..." I'd barely let her get the words out before I said "No we're not, we don't want kids!". She was a little taken aback. I suppose most childless women my age who are diagnosed have an initial response of "Will I still be able to have kids?", and they have various strategies to increase the possibility of future conception, such as egg harvesting. It's probably rare that someone is as blunt as I am, and blurts out that my only worry is that the hormone treatment interferes with my birth control and I accidentally end up pregnant! Poor Miss L___, my style is far too direct for her. I wonder if she will mellow a little over time.

Anyway, the news is still fresh, so I'm going to digest it today and have a low-key weekend working out what the practical next steps are. Buying wigs, etc. My style is to keep going, be honest about things but be positive and encourage people around me to be positive too, but I also need to develop a good way of assessing whether or not some days I'm better off staying at home and just letting myself have a Shit Day.

I'm not underestimating how huge this is, I know that chemo is a bastard and I've got a tough few months ahead, but I'd like to try to keep going as much as possible and I know that I have an amazingly supportive network of friends, family and colleagues around me. And of course Tanai is being awesome as ever. Now that we've eaten our yummy donuts he's gone off to work and I am going to enjoy the rest of my day off doing some Life Admin and trying to catch up on emails. I've had some lovely messages from people far and wide with really supportive and encouraging words. I will try to respond to everyone, but know that your positive thoughts are reaching me and giving me strength.

Cx