Monday, August 4, 2014

Sue the badass, Perjeta and cureable

We meet first with Sue, Dr. Silver's PA, who reminds me of my pal friend Diane, who died from lung cancer.  Short, feisty and badass.  She has a gravely voice like Diane too. She is a force. When she hugs me, she means it.  

Sue studies my chart, explains characteristics of my particular cancer, and answers questions. She examines my swollen, tumor filled right breast and lumpy armpit. She tells me, "We're gonna kick this pig. Don't worry."  

The first thing my new Oncologist does is really hug me. No fake shit either, she wraps me up and gently strokes my back and head as I break down again. No other doctor has ever hugged me and it's a bit astonishing, even given the circumstances. She is dressed beautifully and does not seem to care about my tears staining her outfit. Maybe she keeps a closet full of nice clothes, I think. She must, because this shit must happen 10 times every day to her. 

My cancer is Stage 2, perhaps slightly Stage 3. The technical name is Invasive Ductal Carcinoma, and it accounts for 80% of all breast cancers. It's just as Dr. Prakash said, invasive and aggressive. Very fast growing and already in one axillary lymph node. However, there are actually a few things in my favor. IDC is the most studied form of breast cancer. Mine is highly HER2 positive and should be very responsive to chemotherapy and Herceptin. Also, I qualify for Perjeta, which has just been rush approved by the FDA for some early stage breast cancers. Prior, it had only been available to women in Stage 4. She tells us that Perjeta "melts tumors like magic" and I begin to hope for the first time. 

She then examines my bloated breast, lymph nodes and armpit tumor. Her touch is cool, efficient and kind. She recommends chemotherapy with Herceptin and Perjeta shooters, a lumpectomy or mastectomy, and radiation. She gives all the warnings that she is supposed to - in short,  treatment may fuck me up, or worse, kill me. But the cancer will definitely kill me if I do nothing. 

Finally, she writes it down for us, in her neat hand, the year of hell to come, in a clear step by step flow chart. This is a piece of paper I will come to worship like a relic. 

Because among all the unfamiliar words and frightening interventions is one word I do understand - CURABLE.