The “infusion room.” That’s what they call the area where they administer the chemotherapy drugs. At Cedars-Sinai, where I was this afternoon, it’s a surprisingly welcoming space with deep geometric aquariums full of colorful fish, big palm trees stretching towards a ceiling dotted with bright, open skylights and comfy recliners equipped with their own televisions and workstations. If it weren’t all the poles and bags labeled “BIOHAZARD – FATAL IF ADMINISTERED INCORRECTLY” full of blood-red doxorubicin, you might think it’d be a pretty nice place to have a Super Bowl party.
Fortunately, I wasn’t at the Cedars-Sinai Infusion Center to actually receive an infusion today. Instead, I was meeting with the first of three surgeons who will help determine the course of treatment for my cancer. He was frank, but what he had to say was mostly positive. And perhaps most importantly for my peace of mind, he helped us fill in some more pieces of the puzzle so we can figure out how to get this monster out of my body forever.
So, we learned a few new things, mostly good things:
First, my cancer is estrogen-receptor positive. This means that it feeds on estrogen to grow, and unfortunately for me, being all young and fertile, my body makes an awful lot of estrogen. But being ER+ is actually good news, because there is a special drug that I can take starve my cancer cells to death, drastically reducing my odds of a recurrence. The drug, called Tamoxifen, will put me into premature menopause – hot flashes, osteoporosis and all – for five years. But it’ll kill the f–k out of cancer cells, and that’s the name of the game here.
Second, preliminary tests indicate that my cancer is very slow-growing – slower, even, than many other breast cancers, with only 5 percent of its cell population actively dividing at any time. This is great news because it means that there is a very good chance my cancer has not spread. The surgeon estimated that there was an 80 percent chance I am still in stage 1 – which sends my odds of disease-free five-year survival well above 90 percent. Nothing is for certain, however, and we will have no way of knowing until my lymph nodes are surgically biopsied. Even if the lymph nodes are cancerous, it doesn’t automatically make me terminal. The surgeon was extremely optimistic that I was at an early stage and my treatment, while unpleasant, will be straightforward and effective.
Finally, there’s the matter of the surgery itself. I have two options – a lumpectomy plus radiation, or a bilateral mastectomy. Since I’m still enjoying the sexiest years of my life, I’m not especially keen to surgically amputate both of my breasts. (I’m a good candidate for reconstruction, however – and what better way to tell breast cancer to shove it than by getting massive fake DDs just for fun? IN YO FACE, KILLER BOOBIES.) On the other hand, the lumpectomy isn’t a perfect option either. Since my tumor is directly above my heart, there is a (very remote) chance that some errant x-rays could damage my cardiac muscles. And while it’s only a few percentage points, a lumpectomy does increase my odds of a local recurrence compared to a radical mastectomy that’ll just rip all of that booby biz right off.
Decisions, decisions. Considering that up until this whole cancer shenanigan, the hardest decision I found myself making on a regular basis was whether or not I wanted Jimmy John’s to deliver when I could easily walk the two blocks to pick it up myself, it’s kind of hard to believe that anybody is putting me in charge of these things. To keep my breasts or not to keep my breasts? That, I suppose, is the question.