Just when you think you are out of the woods, there stands another thicket. Machete at the ready, we just keep swinging away because the alternative... well, there is none. The pathology report came back on Jinni's breast tumor today.
Cancerous tumors usually are pretty well defined, however, it is what happens on the "margins" of a tumor that defines if surgery has successfully removed all of the cancerous cells. The margin of a tumor can best be thought of as a corona around the sun... or... an emanation from the main body. Even after the surgeon removed the chemotherapy-shrunken tumor in her breast, pathology testing revealed that the cancer cells leaked out to some surrounding tissues... aka... the "margins". So they have to go back in and remove more tissue, namely her left nipple, this coming Tuesday.
In addition we will have to endure another round of chemotherapy and that is really pissing us off.
When the Stage II diagnosis was first made, a course of treatment was laid out for us: neo-adjuvant chemo to shrink the tumors in her breast and lymph nodes, then surgery to remove what was left of the tumors, then back to chemo, followed by radiation. However, she responded so well to the nine chemo treatments that we started hearing that a second round of chemo might not be necessary. Wishful thinking it turns out.
Come to find out, two lymph nodes were cancerous instead of the one we knew about, however the "margins" of those tumors were clean. But 'best practices' says that when you couple multiple lymph node engagement with the cancer found in the "margins" in her breast it all adds up to the fact that instead of being completely done with chemo, she is only part way through. Did I mention that this a real pisser? Even though Jinni has tolerated it very well so far, the truth is chemotherapy sucks.
We have a meeting with the oncology (chemo and radiology) folks on Monday in advance of Tuesday's surgery so we will get a better idea of what kind of additional poisons they will be pouring into my girlfriend and how long it will all take. Removing a nipple is apparently considered minor surgery so it will be performed on an outpatient basis, meaning she will not require another overnight stay.
For those of you wondering, I asked this question of our surgeon: "Is is time to go ahead and perform a mastectomy instead of cutting away a little at a time?" His answer was, "No. According to what I have seen of the pathology report (there is still a portion that will not be available until Monday), mastectomy is not necessaryand I would not hesitate if it was, we just need to make sure we get all the marginally affected tissue." Those who have been following along know we have absolutely no qualms about breast removal but there is no reason to cut off one's breast simply to spite one's disease.
Needless to say, next week will be a little different than planned. But, with your continued prayers and support, we persevere.
Dust off those meatloaf recipes, we've still got work to do.
8:02:18 PM 
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