Category Archives: Decisions

The hair thing

Alright, you knew it was coming: I have to talk about my hair.

Objectively, the hair thing just seems so…trivial. I mean, if a genie came up to you and said, “[Your name,] I’m going to let you live a long, healthy life – provided that you go six months completely and utterly hairless. If you refuse, there’s a 30% chance you’ll die.” You’d obviously take the half a year of baldness, right? I mean, I totally would. Wouldn’t I?

Also, what kind of asshole genie would ask that?

But subjectively, when B-Day (that’s Baldness Day) starts to sneak up on you, it becomes this big, distracting deal. I was tired of dealing with the stress of that when I really needed to be focusing on the fact that while yes, chemotherapy will make me look temporarily like an alien, it’ll also be saving my life. So I made a decision that I was going to take charge of the hair situation. And then I hemmed and hawed about it for a while.

As a woman with cancer, there’s just no getting around the hair thing. As a guy, maybe you can pull it off. Maybe you joined the Marines or you’re taking control of your premature balding. But as a woman, owning the baldness thing takes a whole lot of swag – swag, I am sorry to say, I don’t possess. I dress more or less like a 20-something Liz Lemon (blazers and cardigans FOR DAYSSSS), and the most adventuresome hairstyle I ever had was the full, blunt bangs my mom cut me with manicure scissors when I was 4. I’ve spent all of my teen and young adult years with hair cascading in waves down to at least my shoulders, in varying shades of blonde and brown. I barely even ever wore it in a ponytail. And I’m supposed to jump from that to bald?

Nuh uh, my friends. I need a transitional phase. I need something to help me adjust.

See, when you don’t have any hair, all that’s left is your face. You can’t curl your hair nicely and hope it’ll distract from the zit on your chin. You can’t sweep your bangs down over your eyes to hide the fact that you haven’t tweezed your eyebrows in weeks. Without hair, your face is the main attraction. You’re a walking marquee sign proclaiming the latest features: CHECK OUT MY NOSE. DO I HAVE ANY PIMPLES? I MIGHT KINDA HAVE A UNIBROW. I DIDN’T PUT ON EYELINER TODAY!

I happen to be of the opinion that cancer has taken enough from me, especially when it comes to my femininity. It took my breasts (although my plastic surgeon gave me better ones to replace them, if I’m being honest). It may take my fertility (although the fertility doc says we’ll be getting 12-15 eggies in the freezer by Monday). So if it’s going to take my hair, it’s going to do it on my terms.

I’ve been determined to go ahead with this pre-chemo cut since my diagnosis because it’s basically my hair’s way of saying, “You can’t fire me, I quit!” But I have to admit that the whole ordeal was a lot less frightening because my bold, beautiful friend Katie Bo went before me. Without telling me, she cut her own long, dark, voluminous hair into a pixie and donated the rest to a cancer charity. (I’m secretly hoping I’ll get the resulting wig because her hair is far more beautiful than mine ever was.) Anyway, because she looked so chic, stylish and feminine in her pixie, I was excited instead of filled with dread when I walked into the salon.

I told my hairdresser the situation and warned her that I might burst into tears at any moment during the cut. “I promise it’s not because you’re doing a bad job,” I added.

“Don’t worry,” she said. “I’m going to make you adorable.”

How’d she do?

BeforeAfter

Truthfully, the experience was far less traumatic than I was expecting it to be. There were no tears, but plenty of laughter. And because it was a laid-back Friday afternoon in the salon, lots of the hairdressers came over to play with my newly shorn locks, apply product and show me all kinds of styles. I briefly sported a fauxhawk, which actually looked cute, if I do say so myself, and may be recreated on a day when I’m feeling particularly bold.

I thought I’d leave the salon in tears, hating my pixie cut. Instead, I honestly love it. It’s a pity that it’ll all fall out by mid-March.

Thundercats are go

Scene: A virtually empty Southwest Airways 737 begins its descent into San Jose Airport just outside of San Francisco, California. Three sleepy, cranky passengers – myself, my mother and my father – snooze uncomfortably in our seats. A flight attendent comes over the intercom to announce: “We are now beginning our descent into the Bay Area. The time is 8:34 am.”

Fantastic, I half-think, half-dream to myself. My appointment at Stanford Women’s Cancer Center isn’t until 1:30 pm, but here we are in Palo Alto at prime Starbucks hour because my dad insisted on a 7am flight.

I would love to bitch more about my 5:45 in the morning wakeup call for a daytrip to San Francisco to see a doctor we could never realistically choose as my oncologist because it would mean traveling all the way to Stanford twice every three weeks for a year, but the truth is, things converged in one of those kind of magical, coincidental ways that make you think God is looking out for you and cares about you even though He slipped up and dumped this cancer thing on you at 25, which was totally not cool, God.

I started my period in the San Jose airport. I’d spent about 10 days waffling in painful indecision about whether or not to freeze my eggs. Would the hormones pose a risk? Four separate oncologists had assured me they would not, but I couldn’t understand how that was possible. I imagined injecting myself with a hormone that would go straight to a cancer cell, which would then hulk out, latch onto one of my vertebrae and explode it, crippling me for life slash killing me, depending on my mood during said daydream (daymare?).

Was I even going to get my period? My monthly visitor was AWOL, thanks to the stress of surgery, anesthesia and a really unexpected cancer diagnosis. Contrary to what the movies will have you believe, fellas, I don’t have violent mood swings or chocolate cravings that herald the appearance of menses like shining trumpets of bitchiness playing Reveille to my vagina. So I was just as surprised as anyone when I discovered that of course, 350 miles away from the fertility clinic, my uterus finally decided that now was the time to make the most important decision I’d ever been asked to make in my short 25 years of life.

I wouldn’t, however, have to make said decision before speaking to the oncologist at Stanford. In my head, I was already composing the lengthy list of questions I would ask him about whether or not egg freezing was safe. I knew that I needed to pester him with a hundred queries about the biology of my cancer and why, exactly, feeding it with tons of hormones wasn’t going to cause it to grow out of control like a science fair project gone horribly, horribly wrong.

When we finally did get in to see him, after a morning of exploring Palo Alto’s cute downtown and eating omelettes filled with avocados and cheese (which probably explains how I’ve gained two pounds since my last doctor’s appointment on Friday), it was exactly how I expected it would be. And here’s where that silly sometimes-God-gives-me-a-deadly-illness-but-then-sometimes-he-is-kinda-nice-to-me thing comes in, because I swear, this doctor did and said and was everything that I needed someone to do and say and be at that exact moment in my life. He was like my own cancer oracle, come to assuage my final fears and set me on the right path before fading back into the closets full of folded blue scrubs and whirring centrifuges of a research hospital.

The four weeks of elevated hormones that happen during egg retrieval are nothing to a cancer cell, he said. It takes years for a tumor to reach a harmful size, and four weeks is less than the time it takes even one single cancerous cell to split into two cancerous cells. Even if a cell or two did divide during the treatment, chemotherapy would crush it once the cycle was over. I can’t explain why this explanation calmed my fears while others had failed to do so, but it did. Having this decorated, intelligent medical professional look me in the eye and tell me with 100% clarity and certainty that undergoing fertility preservation would pose exactly zero risk to me as a cancer patient, even though (or maybe because) he was the fifth doctor to do it, finally galvanized me to woman-up and get this thing done. Operation Oocytes is a go, and begins tomorrow at 7:15 am.

He also said something important to me, something other doctors have also said but that somehow carried extra weight coming out of his mouth. “We’re aiming to cure you,” he said. “I believe that the odds that we can cure you are greater than 90 percent. Our goal is not to manage this. It’s to cure it.”

Fingers crossed.

While I was in the mood for making big decisions, I also chose my oncologist. Dr. R will be taking care of me during my treatment. We’re working towards a chemo start date of February 26 – a Tuesday instead of a Monday for school reasons. With that date, I’ll complete treatment on June 11, and have my implant exchange surgery by July 30.

Can’t wait for August!

Oncology Tour 2013 continues

Before I was sick, I had virtually never set foot in a hospital. In fact, really only two hospital experiences come to mind:

The first was when I was about 6 or 7. I was walking down a dingy hallway with well-worn gray carpet, a seemingly endless tunnel of taupe doors stretching out before us in a strange visual illusion. Staring ahead at this Mobius strip of a hospital corridor, I accidentally stepped in a puddle of vomit.

The other was when I was about 17, and my dad had his gallbladder removed. I visited him in the hospital afterwards, but he was groggy and nonsensical. Then he vomited. He swears the vomit part of this story didn’t happen, but he was on drugs and I know the truth.

So basically, my hospital experiences had, up until this point, been significantly tainted by barf. Now, however, my hospital resume is rapidly expanding. I’ve seen all different parts of hospitals, like in-patient rooms, clinics, bathrooms, waiting areas, phlebotomy labs, infusion suites, check-in desks, and parking garages. I’m a veritable connoisseur of hospital decor. Note to healthcare interior designers: Less grey, it’s depressing.

I haven’t been updating much this week because Gordie’s in town, and we’ve been attempting to enjoy ourselves like a normal 20-something couple as much as we can. In spite of the whirlwind tour he’s gotten of the weird, secret, hidden world of sick people that you only get to see once you become direly ill yourself (hint: not worth it), we have managed to have a couple of nice dates. Plus, one of the 200 oncologists I’m still speed-dating gave me the A-OK to drink alcohol, so I enjoyed a delicious Shock Top the other night and forgot for about 20 minutes that I’m a cancer patient.

My personal episode of America’s Next Top Oncologist continues. This week, we saw four doctors, and I have two clear frontrunners I’m trying to decide between. One, Dr. A, is a calm, reassuring man who always makes me feel like everything’s going to be alright. The other, Dr. R, is a bold, confident woman who doesn’t sugarcoat anything. I like Dr. A’s demeanor, but I love that Dr. R drives the bus, so I don’t have to worry about deciding everything.

That’s something weird that no one tells you about cancer – there’s an awful lot of deciding to do. Mastectomy or lumpectomy? TCH or ACT? Neulasta’s unbearable bone pain or take your chances with a lowered white blood count? Freeze your eggs or leave your fertility to fate? Some people might enjoy that kind of self-directed care, but I don’t. For God’s sake, I’m 25. I haven’t even decided what I want to wear today, but I’m supposed to decide which treatment plan is the most likely to prevent an early death? I’m not a doctor, that’s why I’m seeing you! Decide for me!

Update on Operation Oocytes: Still waiting on my uterus, so I’ve had plenty of time to think about whether or not the delay in treatment and all the extra needle sticks will be worth it. Things move fast in the IVF world, because menstrual cycles are unpredictable and everything needs to be in place immediately, so I feel like I’m getting a phone call every day from one doctor or another asking for an update on my monthly visitor. Dr. R is confident that deciding to go ahead with fertility preservation won’t alter my prognosis, but she insists that I need to be able to believe her if things go pear-shaped. It’s an awful lot to think about, so the deliberations continue.

Wanting to have things in place just in case, I had blood drawn yesterday for all of the tests that fertility clinic requires. I was handed a piece of paper with virtually every single box checked, and needed about a dozen vials of blood taken. As I was waiting in the lab, another young man was sitting across from me. He was reading a packet I immediately recognized – his pathology report. It looked a lot like mine. His face conveyed that it wasn’t good news. I could see the boxes indicating it was a cancerous tumor they’d removed, although I didn’t know from what organ. When asked by the doctor, he gave his birth year as 1986.

“Hey man,” I said, thinking about how weird it was we were in this boat together.

“Hey,” he replied. “How’s it going?”

I just laughed, because he, of all people, already knew.

Real talk

Dear ABC Programming Executives,

I would like to propose a unique addition to your spring lineup of primetime television shows. It will be called The Oncologist, and, like The Bachelorette, it will follow a young woman – who also happens to be a cancer patient – as she interviews 5,000 different oncologists to choose the one who is right for her. They’ll go on hot dates in the chemo ward, and all those dreamy helicopter scenes will take place in MedEvac choppers. Not only will there be boob shots, there will also be an enormous amount of boob fondling, boob pressing, boob gazing and even boob needle sticking. At the end of each episode she’ll hand the best oncologists a single plastic tube from a bouquet of surgical drains. “Dr. Jones, will you accept this Jackson-Pruitt bulb?” 

If you like that, just wait for my other proposals: Dancing with the Surgeons and Keeping Up with the Kancer Ward.

Warm regards,

Michelle

Today I had yet another meeting with yet another oncologist, but this time it had a different tone. Now that my pathology report is in from the surgery, we can stop talking in hypotheticals and start talking about what’s actually going to happen to me. We’re shooting for a chemo start date of Monday, February 25. I chose Monday because Mondays suck anyway, so what’s little poisonous vein detergent here and there? The oncologists are recommending six cycles of TCH, a standard chemotherapy regimen for my type of cancer, follow by an additional 12-14 cycles of Herceptin (the H in TCH) on its own. The infusions take around three to four hours each, during which they give you a happy cocktail of anti-anxiety, anti-nausea, anti-allergy meds that make you sleepy and silly, so most people just nap in the chair. Additionally, every single one of those treatments will be preceded by a blood draw and followed by a shot of Neulasta, a drug designed to boost white blood cell counts. Neulasta can cause debilitating pain, so I’ll be getting yet another painkiller to deal with that pleasant little side effect. Otherwise, the main things I can expect to experience are fatigue and baldness. Fortunately, they’ve developed great drugs for combating nausea and vomiting, which I can expect to more or less skip over. Too bad no one’s come up with a hair conservation technique yet. I’d take a night bowing to the porcelain gods to keep my flowing locks, but oh well. Chrome dome is the price you pay for admission to the Chemo Club.

Since I just outlined a treatment plan that involves being poked by needles about a million and one times, I’ve decided to get a PortaCath. The “port,” as the cool kids call it, like basically an implanted IV that’s threaded through the jugular vein and into the main valve above the heart, then connected to the outside of your body with a round resealing rubber access point that protrudes about 1/4-inch from the chest, below the clavicle. It’ll make me a lean, mean chemo machine. I also like to imagine it’ll make me part robot. And I won’t have to go through any airport TSA scanners for a year, since between it and the tissue expanders I’ll be like 50% metal.

The PortaCath means one more surgery, but at this point, who’s counting? (I am. That’ll make four. Four surgeries scheduled since diagnosis: mastectomy, port placement, egg harvesting and, eventually, the glorious implant exchange.)

One more quick thing – another beautiful bouquet came today, this time from the pledge class below mine back in my sorority days. Going Greek was one of the best things I ever did, and to this day my pledge sisters are among my best and closest friends. I was so moved to receive such a gorgeous gift from my sisters. Normally I like to thank my thoughtful friends with personal texts and emails (I’m still not into the phone since my phone cancer diagnosis gave me phone PTSD), but I don’t know which one of these beautiful and wonderful ladies to reach out to, so I’d like to thank them all here! You are such wonderful people and I’m so proud you’re my sisters! LITB and AXOXO. Thank you PC ’08! Don’t think I didn’t notice the carnations. 🙂

Why so serious?

My wonderful friend Sam sent me an incredibly sweet email yesterday about the Japanese art of kintsukoroi. Kintsukoroi, meaning “to repair with gold,” is the ancient practice of repairing pottery with gold or silver laquer and understanding that the piece is more beautiful for having been broken. Here’s an example:

I’m flattered that Sam thinks it’s an apt metaphor for my situation, even though my boobs look more like The Joker than beautiful Japanese pottery.

We made some big strides toward normal over here in my convalescence suite today. I took a shower, and it was significantly less traumatic than my last cleansing experience. I was able to do most of it on my own, although I had to stick my head out of the shower curtain for my mom to shampoo and condition my hair, since I can’t reach my arms high enough. I’m still not allowed to shave my armpits, and I have to say that frankly, I’m beginning to have some sick curiosity about what’s going to happen to them. The hair is as long as I have ever seen it. It’s practically long enough to braid. I’m turning into my own morbid anthropologic experiment.

Since I only have two drains now, it’s getting a lot easier to manage them. I tied a piece of twine around my neck and hung them from it like a sick tribal gourd necklace. I walked around like that for a while, but eventually my bizarre body fluid jewelry started to bother me, so I went back to just carrying them around like little bloody purses. I will not miss these awful accessories one bit once they’re gone. Wednesday can’t come soon enough.

Now that I’ve had a few days to think on it, I’m incredibly happy with my decision to undergo a bilateral mastectomy with reconstruction. Although I’ll always be scarred and I’ll never be able to breastfeed, I think I made the right choice for me. It’s hard to describe what cancer does to your sense of trust, but it truly makes you feel like a warrior who has somehow ended up in the enemy’s barracks. I don’t feel safe here; I feel like I could get any kind of disease next, like all bets are off when it comes to my health. Saying goodbye to both of my ticking time bombs, however, has weirdly given me back a little bit of peace and normalcy, like maybe I can let my guard down for a minute and there won’t be some other organ waiting to rise up in mutiny against me.

So now that things are slowly getting back to normal as far as my surgical wounds go, it’s time to start thinking about the next step in my treatment: chemotherapy. I have about 1,000 interviews lined up with oncologists at every research university from UCLA to Stanford, even though everybody seems to be recommending the same thing: a regimen called TCH, combining the drugs Taxotere, Carboplatin and Herceptin, followed by five years on Tamoxifen. So far, the doctors seem to be in agreement that my natural fertility will most likely return once my treatments conclude, so there’s no need for egg harvesting or embryo freezing. I’m thankful for that, because frankly, I don’t know if I could tolerate subjecting my body to more drugs, needle pokes and surgery. Each new day is some fresh hell in the medical world for me. I truly count my blessings that things are looking good for my future plans to have little ones running around.

Aside from temporary or (hopefully not) permanent infertility, this toxic cocktail (toxictail?) has a number of other side effects, including some deliciously fun things like nausea, vomiting, bone pain, body aches, fatigue, nail death, heart damage and, of course, hair loss. To be honest, however, I’m not totally dreading the hair loss. Without this impetus, I probably would have gone my entire life without knowing how a shaved head feels. I think the experience will be liberating. I’ve already started a desktop folder called “Pixie Power” that’s filled with pics of gals who rock the shorter hair. Give me the Emma Watson, please!

GUYS. I get to have big(ish) boobs one day!

I originally started this blog as a way to cope and organize my thoughts, not really expecting anyone to read it or care, but it seems like a lot of people are really enjoying my posts! I was trying to tell people individually and at my own pace, but Facebook spilled the beans about my battle with the Big C after I posted the news to a group I’m a part of, so thanks a lot for that, Mark Zuckerberg. Anyway, it really makes me happy to hear that people are reading along. I hope that if you or somebody you love has to go through this nightmare someday, this blog can help you and show you that this disease doesn’t have to be all about crying and pity parties. I did plenty of that, but at the end of the day, feeling sorry for yourself doesn’t cure cancer. Might as well laugh about it.

It’s been a busy morning on the cancer front. Since I have decided on a total mastectomy (F–K YOU, CANCER! I SHOW NO MERCY!), I had an 8am meeting with the plastic surgeon to discuss my options for reconstruction. Luckily, I’m a great candidate for an immediate reconstruction using tissue expanders and eventually implants. There’s another option, where they reconstruct your breasts using fat from other places on your body, but the surgeon took one look at me and told me I just didn’t have enough chub for that. Don’t worry though, I’m working on it. Eating caramel corn as I type.

So, immediate reconstruction means that when the oncological surgeon goes in and hacks off my real, evil boobies, the plastic surgeon will be right behind him, creating a little pocket for an implant and preparing me for my brand new hooters. I’ll actually only have to go about two or three weeks with a totally flat chest (well, slightly flatter than normal), which is kind of nice, since for some reason I was imagining living years as The Boobless Wonder.

As a size 30A, I’ve imagined plenty of times what it might be like if one day I got implants. I thought about how fun it would be to customize my breast size and finally wind up with a womanly, sexy shape instead of looking like a prepubescent boy on his way to gym class, where he’s gonna get beat up by the jocks and probably shoved in his locker and/or given a swirlie. (Did I take that too far? Whatever. Cancer card.) Fortunately, although the experience was dampened by that whole “you have cancer and we’re gonna cut off your breasts and rip out your lymph nodes” thing, it was still just as exciting as I pictured when the surgeon told me I could go as big as I want. Full B, here I come! Fun fact, they actually don’t even make implants as small as my real boobs.

I’ve done plenty of complaining about being so petite, but truth be told, my 30As might have saved my life. It’s unusual to catch a breast lump by self-examination when it’s less than 2 centimeters (mine’s 1.4cm), but because I have so little breast tissue and body fat, mine was easy to spot. Plus, my mastectomy will be a lot less traumatic than some women’s, for a number of reasons. First, I just don’t have to lose that much tissue. Second, my sexuality and sense of femininity has never been very wrapped up in my breasts, so emotionally, I’m not too distressed about saying bye-bye to them. The thing that makes the saddest is that I’ll never be able to breastfeed my future children. Although that gets me down, it’s more important that I get out of this alive and cancer-free before I start thinking about kiddos. Gotta look out for number one.

Baby’s First Mammogram

Y’all, I’m now officially a card-carrying member of the Cancer Club. (Sensitive info badly blurred out because, like, HIPAA. I dunno.)

BOOM! CANCER CARD!

Now I can play the cancer card whenever I want. Is that a ticket you’re writing me, officer? I don’t think it is. Oh, I can’t park in this space? Oh, but I think I can.

Okay, realistically, playing the cancer card – metaphorically or literally – probably won’t get me anywhere. Although it might make Gordie go easy on me for a game or two of Scrabble, which is the only chance I stand of ever beating him, except for the time I started recording all his scores in negatives and adding a bunch of zeroes to the end of all of mine so that in the end I was winning 430,000,000 to -361.

My new cancer card kind of sent me into emotional freefall this morning. Because I don’t feel or look sick, it’s easy to fool myself into thinking that all of this is like some kind of fake Truman Show experiment and some guy is gonna jump out of the bushes and yell “PUNK’D!!!” (I have cancer so I get to mix my pop-culture metaphors. BOOM! CANCER CARD!) But the more times I have to repeat my birthdate and age only to be met with, “Oh my gosh, you’re so young,” the more times I have to put a check next to the words “known breast cancer,” the more times doctors undress me and feel me up and make affirming sounds that they, too, can feel my lump, the realer and sadder it gets.

Today wasn’t all bad, however. I met with two surgeons and an oncologist to discuss the results of my MRI. I had to take two Ativan just to even begin to be calm enough to hear about the MRI, but fortunately, everything came back clear! There was no evidence of any malignancies other than the known tumor, meaning that my right breast is disease-free and I probably get to keep it. I always liked you better, Righty.

The MRI also showed the same enlarged lymph node that showed up on the ultrasound before all this got started. There’s a fair chance that that lymph node is enlarged because it’s harboring its own little colony of crappy, mutinous cancer cells, but it isn’t big enough to concern any of the doctors, and the rest of my nodes look clear. For now, the doctors have put me at a clinical stage I, but that could be amended after my surgery if any disease is found in the nodes at all. If it is, they’ll have to rip all those suckers right out.

The doctor wanted to run some additional tests on me, so I had to get my very first mammogram. I know most people complain about mammograms, and yes, it was wildly uncomfortable and weird to have my breasts squished between some plates and photographed, but compared to the biopsy it was a piece of cake. The best part was that I got nipple pasties. After it was over, I asked the nurse if I could keep them. What? I got some bachelorette parties coming up.

Because my cancer is triple positive – meaning it has HER2/neu receptors, estrogen receptors and progesterone receptors – there is a veritable armada of drugs available to attack this bitch. Most likely, it’ll go like this: Following my surgery, I’ll start a four-month chemo regimen using two traditional, lose-your-hair, barf-all-over-everything drugs and one new, awesome, super-special targeted drug called Herceptin. When the four months are up, I’ll continue on the Herceptin for a year while taking a pill called Tamoxifen to block my cancer’s estrogen receptors. I’ll take that for five years, and the end of the whole ordeal, every single cancer cell will hopefully be completely and totally dead and destroyed. We’re pretty much going to carpet-bomb my body with every drug we can find and all of the sad little cell-mutants are going to die horrible deaths, and I’m going to laugh and laugh. Cancer’s the worst. You deserve this, cancer. You brought this upon yourself!

Even with cancer, it can’t all be bad news

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.