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| This is Dr Webster posted by another patient, Heather. |
So my lovely oncologist Dr. Marc Webster referred me to a surgeon for a consultation this week. Her name is Dr. Daphne Mew (like a cat, awesome) and although the appointment wasn't perfect, it wasn't the worst either. I wanted to go in and have her say "you are a candidate for a mastectomy and I think it will prolong your life. Also, your reconstruction will look amazing!" Instead she said " you are a healthy candidate for a mastectomy and you're ideal scenario is to get radiation afterward. This means that reconstruction options aren't great and that your results will be cosmetically detrimental. Also, I don't think that surgery will prolong your survival." Overall, I liked her but she was honest.
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| Dr. Mew |
It felt bad afterward because I'm a high achiever but it also felt bad because she wasn't telling us the information exactly as it stands. Stage IV cancer patients were ignored by curative research prior to 1995 which is why this stage of cancer is statistically untapped and they just don't know what will happen with certain treatments. I think that Dr. Mew is well informed and that doctors aren't sure how much their patients know or want to know. Luckily, Kill and I are wildly well read. Here's what we know based on medication trials, studies and papers published about
metastatic breast cancer patients:
- Lumpectomies and mastectomies are surgical options that stage IV's can choose and if the tumor breaks through the skin then surgery is better than the risk of infection (that info is straight from Dr. Mew herself.)
- Women who have mastectomies either live the same amount of time as those who didn't or longer.
- The worst part of a mastectomy is actually undergoing the surgery itself and coping with your changed appearance.
- Radiation after surgery may increase the chance of disease-free periods however it also makes your skin less healthy, springy and stretchy for reconstruction.
- Lumpectomies are equivalent to having no surgery at all as far as survival goes for metastatic patients.
- Recent studies have begun to show that surgery is more beneficial for those under 50, who have had a response to chemotherapy, have less tumors in fewer organs, whose organs function even when impaired and have long disease-free intervals (Cheng et Ueno, Vol 19 No 3, 2012.)
- Ultimately, the results are still inconclusive as to survivorship, which means that
doctors have no statistical proof that surgery is better and will make
you live longer. However, it doesn't seem to hurt except for the psychological difficulty of seeing yourself with a new shape, scars and the pain of surgery.
I've got some thinking to do.... mastectomy or no mastectomy?
4 comments:
Mastectomy with radiation and reconstruction is the way to go here. Get a plastic surgeon involved in your treatment plan immediately. There are fantastic reconstruction options available and the more planning that is involved that includes the plastic surgeon, the better the outcome. The combination of implants, fat grafting or the use of autologous tissue (your own stuff)is all very possible. You MUST bring more physicians into the fold than just the breast surgeon and the radiation oncologist.
I had several people asking me today who the anonymous poster was and you know what? If they want to be anonymous that's okay by me, I'm just happy that someone wrote what I felt I wanted to do but didn't know how. It felt good and I think they are very clever. Excellent comment!!
Cail, you and Kill are tremendous researchers and decision makers. I know you'll make the right choice for you.
Anonymous sounds very knowledgeable, experienced or both. You are attracting good input. Love you tons.
Hmmm, c'est toute une decision.
I know it's going to be tough deciding, but I'm confident that with the information you have at hand, all the research you have done and the experts you have consulted, one day you will wake up and know exactly what you want. Don't stress out about it too much.
On pense a toi d'icitte
French farmer
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