Dana Farber - Consultation # 1

After checking and registering with Isaiah as well as other various check in points within Dana Farber, Leslie and I were in the waiting room waiting to be called.  Leslie had made a banana bread using ma's recipe.  While we waited we noshed and chatted.  We found humor in one of the forms I needed to complete and apparently there were people there who had similar sounding names as us.  There were a number of time I thought I was called only to find out it wasn't for me.  Of course when the did call me I didn't hear it until they spelled out my last name.  How did we not hear it the first time?

Leslie came in with me and we spoke with a woman who explained a voluntary program where my information could be used for the greater good.  I'm all for that.  Sign me up.

Not too long after, Dr. Inglehart arrived and we chatted for some time just to validate what he read and understood so far.  He did examine me.  Leslie decided it was a good time to visit the ladies room.

Les just got back when he started talking about options.  He did say that it was small a bit more than a centimeter.  He thought barring some remote findings that this could be 'cured' with one surgery.  There was a chance that the sentinel node might have cancer, but that couldn't be determined until a test can be run immediately before the surgery.  I suppose there will always be some unknown in the mix.  Initially it sounded like I had two options:
1. Mastectomy - remove the nipple, aureola, tumor, test sentinel node and determine if a subsequent surgery is needed after first is healed.
2. Lumpectomy and radiation - the position of the tumor is very close to the nipple. He thought that removing the tumor will necessitate cutting through the nipple/aureola area.  If not removed it would be discolored and misshapen.  The radiation would happen daily for six weeks.

The downside to #1 is vanity. 
Not that I take off my shirt in public, but in the summer at a pool this might become difficult to deal with.

• The uptick - this is the easiest treatment and easiest to recover from.  Other than a drain for a week or so, the healing is relatively fast - and we are done. (almost)

The downside to #2 is the affects of radiation. 
Long term exposure is like a bad sunburn. The skin gets leathery and radiation is draining.  The doctor says after six weeks of everyday dosage - your pretty much done with that.  He said the other symptoms are permanent hair loss in the at area (not that I have much there) and high risk of aortic cancer because it's on the left side and the heart is so close.  Given the history of heart disease in the family that risk scares me.  In addition, to remove the tumor so close to the nipple, the nipple won't look much like a normal nipple anymore.  (Another reason to keep the shirt on). 

• I can't see the uptick to this (at this writing)

Dr. Inglehart said that my cancer is stage 1 and completely curable.  I just need to know which options to take for treatment.  He did discuss some of the other 'things' that could come into play. How the sentinel lymph node (test) could be good (meaning there's no cancer) or bad (meaning more surgery is needed to remove more nodes after the first surgery is healed.  He did go on to say that both surgeries are fairly common and could be dome closer to home if I chose.

He gave me the number to his assistant who would schedule the surgery if I decided to have this done at Dana Farber.