Dana Farber - Consultation # 2

 Les and I were discussing what we heard and looking at her notes when Dr. Overmoyer, an Oncologist at Dana Farber came in accompanied by a visiting professor from Italy.  The doctor asked if the professor could be present, to which I gladly obliged.

Doctor Overmoyer introduced herself to us and we did the same.  She had said that she talked with Dr. Inglehart, the surgeon and she had a good understanding of what we were dealing with.  She repeated facts for validation then began to explain what the interpretations of the images, medical files and initial look at the pathology meant to her.  She took a sheet of paper and as she spoke she illustrated various pieces of information.

From my understanding (which she said I had it), the cells withing the breast (both males and females) have structures (if I were a woman they would be for breast milk).  For men these structures are not needed and as cells divide and are not needed they are supposed to die off.  However they are not and they are 'growing' because the cancer I have is estrogen fed.  Estrogen receptors tell the cells to multiply.  However, there are other receptors that are correctly shut off so the cancer is slow growing.  But until the tumor itself can be sent through pathology she doesn't know if there is a rogue cell or mutate gene that causes those cells to grow faster.  If those cells grow faster they can be (released) from the (structure) cell and get into the blood.  Generally the blood is toxic to these cells and they are eventually excreted.  But if they stick or stick to nodes or organs, they can metastasize.

She said she'd be interested in the BRAC results, but thinks they might be negative (which is a good thing). [Update 3/10 afternoon - Dr Moore's office called and said these tests came back negative.  I have no BRAC gene mutation]

Once the cancer is out she needs to ensure that any other dormant cells can't be fed by estrogen.  So she said that I would need to take Tamoxifen (hormone therapy) daily for 10 years.  She did say that there is a risk for blood clots.  But she also said that that could be mitigated.  I could also elect not to take it if the risks were too great, but she said that the estrogen could cause a tumor in the other breast.  She did not recommend a double mastectomy.

Something she said gave me pause.  She asked how long I was taking spironolactone.  The strange thing is my primary care physician prescribed that a little more than a year ago.  She said that drug has been known to cause increased cell growth in men.  (I did look up the side effects and did see that: Gynecomastia (enlarged breast tissue) in men, and breast pain in women.).  She did say the she was going to reach out to him and swap it off for something else.  [It definitely makes you wonder].