Oncology appointment

So the oncologist basically gave me the results that I already knew. It was kind of funny, though - I'd mentioned that we couldn't be absolutely certain that the lesions are breast cancer, even though it is most likely that they are metastasis as opposed to a new cancer. He sort of hemmed and hawed a bit and said I was absolutely correct. Then he said brightly that if there were any other spots that showed up on the bone scan, then we'd know for sure that it's breast cancer in the bones. He checked the report, and of course there were no other spots on the bone scan. So he thought for a bit more, and then he said that it was very unlikely that a new bone cancer and the breast cancer would show up at the same time. Well, yes, that's true - but I don't find that last argument all that convincing. I mean, it's highly unlikely that a bone lesion would have showed up at all, let alone be larger than the breast tumour :) Also, this entire experience has been one of "well, it's highly unlikely that <blah> is the case, so it's probably not <blah>". And then it turns out to be <blah>. Maybe I'm just a bit spooked by all of that :)

What he recommended is that we go ahead with the hormonal treatments, which is to remove my ovaries and start me on the aromatase inhibitors. If the lesions don't get smaller and/or the pain doesn't lessen, then we would do a biopsy. I think I'm ok with that, provided that we don't have to wait too long to do the follow-up scans and stuff. We'll see what my family doctor says tomorrow and what the medical oncologist says on Tuesday. I see my surgeon on August 21, so if we are removing my ovaries right away, then I hope we can do that August 29 or the day after Labour Day. As an aside - I can hardly wait to see my surgeon. He's not going to want to believe that I have bone mets, because he barely believes that I could have had a recurrence at all :)

I also talked to this oncologist about the pain. I know that the theory is that the pain should go away once we do something that looks like treatment... but that's still 3 or 4 weeks away, and I can't go on with that kind of pain. He's put me on T3s for now. They're ok. They don't make me nearly as fuzzy-headed as the Percocets, and they don't have the other side effects I get from the Percocets like the itching or the nausea or the migrainey stuff. They take almost all of the pain away - I'm hoping that once I've got the drug in my system, all of the pain will be gone. The doctor also said that once I figure out how much of this I need, they can put me on a time-release pure codeine pill. His idea is that I'll have some idea of the required dosage by the time I see the other oncologist on Tuesday.

He also explained a bit why the pain is so bad: it is because of the previous radiation. I guess the cancer kind of eats away at the bone and makes a tumour, and the bone tries to heal itself. Irradiated bone is different than non-irradiated bone in some way that I don't know, which is why it hurts so much. The healing also explains the deep itching I'm getting over the lesion on the irradiated side. As I'm sure you can imagine, scratching at it doesn't help, given that it hurts if I touch the area :)

BTW, in case you are curious, we want the cancer in my sternum to be bone mets (ie a breast cancer metastasis to the bone). They're getting to a point where for some people, bone mets are a chronic disease that is managed. The prognosis is pretty good, comparatively speaking. The prognosis is much less good for a radiation-induced cancer.

Also, thanks for all of your support. I really appreciate it - it's comforting to know that there are people in my corner.