The Follow-Up Appointment

We met with Dr. Steiner yesterday to go over pathology reports from the surgery and overall it's good news. We are still waiting for the reports to come back from a 2nd doctor, when hopefully things will be finalized. There are some conflicts between what was seen in surgery and what has been reported from pathology hence the desire/need to get a 2nd opinion to confirm all of this. So this is info from the first pathology report, but a 2nd opinion is still coming.

We discussed again everything that was removed, but I'll only mention the couple of new things that I learned here. The full list of everything removed is in one of my other blog posts. A couple of enlarged lymph nodes were removed (they were about 2 cm big!) but fortunately turned up negative for cancer. Those were particularly concerning in surgery because they could've indicated metastasis. There were some pre-cancerous cells found in the cervix too, meaning I most likely was headed for cervix cancer, but now that the cervix is removed, it is not much of a concern. We will do some follow-up testing to be sure that's OK, but after 3 negative pap smears, it will be considered OK.

One ovary that was removed had been twisted and tucked into a little "cave" (my words, not the doctor's!) and is the one that had become quite enlarged with a tumor and tested positive for cancer. It is the one my doctor was most concerned about in surgery and thought that it looked like a potential sarcoma. (This is when we all had our brief freak outs about mortality rates and prognosis.) The pathology shows it to be a normal ovarian carcinoma, not a sarcoma. That is the best news we could hope for and we cross our fingers that the 2nd opinion will concur with this pathology. The five year survival rate is 80% and gets up to 90% with chemotherapy. My doctor has suggested that we will do 3 - 6 "cycles" (appointments) of carbo/taxol chemo and that they will be about 3 weeks apart from each other. This particular ovary had become attached with fibroids to the walls in my body and was very difficult to remove. Even though the fibroids tested negative, the fact that there were so many make this a likely stage II Ovarian cancer.

The other ovary was negative for cancer however was filled with blood, which is indicative of endometriosis. So, the position of the cervix, the endometriosis in one ovary and the funky position of the right ovary are all possible reasons that I was never able to get pregnant. A certain clarity is gained through the fog now. Phew!

Brian asked the question about my immune system functions since I have now battled thyroid cancer previously and am now dealing with the above issues. Due to the lack of family information that we have, the doctor has decided to refer me to a geneticist to find out more information. Ovarian cancer can be linked to breast cancer and particularly if there is family history of either. Since we have scant information on my family history, a geneticist will potentially do some testing to find out more. I am actually excited about the idea of finding out more about my genes - I think we will definitely get more information about my health concerns (which could be scary too!) and how it relates to genetics.

I also asked about hormones and menopause - that's one of the joys of womanhood that I get to face early. I always figured I had another 10 years or more before I had to figure out the meaning of menopause, dammit! Basically, my doctor has recommended that we not look at hormone replacement until we see how the side effects are treating me. I forget specifically what she said, but basically the hormones could trigger the cancer, so we'd rather wait and see if it's really a necessity before jumping into hormone replacement. In the meantime, some of the fun potential effects of menopause are: brittle bones, hot flashes (and yes, I have started to have some of those, but they have been short in duration), lack of libido, weight gain, hair in startling places, memory lapses, and more. So many cuss words running through my head!

Lastly, a referral has been processed to an oncologist. I will soon meet with an oncologist and talk more about the future chemotherapy treatments. The Longview/Kelso Kaiser clinic has just opened a new oncology wing and Brian and I got a tour of it last week. It's very nice - modern and clean. However, I have to admit that it seems a bit scary too. There were several rows of brand new chairs set up next to each other - kind of like at a dentist office. They have their own spaces, where one could watch movies, or listen to music or play on the computer, but you could also just look next to you and see a long line of other people getting their chemo treatments. Freaky!

I've never liked the idea of filling my body with chemicals. I suppose I've been doing it my whole life, to a lesser extent - what's in that beef I've been eating, or the spray on those veggies, let along the alcohol I drink or the medicines I take. But the idea of knowingly allowing a whole lot of toxic chemicals that effect both the good and the bad cells of my body - that's scary. The wig section of the oncology department in Longview freaked me out. What's the likelihood that I could lose my hair? Holy hell! My hair is a strong identifier of me - but I better get used to letting that identifier go. I suppose this is a good lesson in letting your soul shine through - your outer appearance is something we all strongly identify with, but my appearance could become altered - it's all physicial. I am still me on the inside. And then again, some people don't lose their hair and have no real side effects from chemo. Which will I be?