It's Off To Siteman We Go - 12/17/20

Tim and I had an appointment with a new Oncologist for a 2nd opinion at Siteman Cancer Center yesterday and it went very well. We actually heard someone "ring the bell" 🔔while we were checking in and I told Tim what it meant. The woman checking me in said that she gets choked up every time she hears it because they get so used to seeing and getting to know patients and while they are happy that their treatment is over, they miss seeing them come in at the same time. The Dr. that we met with was very thorough and detailed but caring and concerned about ME as well as my treatment plan. Her PA was also amazing and Tim and I were both very impressed with her as well. Dr. Bisi is in agreement with my current treatment plan, the endocrine therapy Tamoxifen that I am on, but said if we wanted to up the "ante" a little bit more to reduce the risk of recurrence, she would suggest adding Lupron or Zoladex injections once a month to start suppressing my ovarian function and shut them down basically forcing me into menopause. She said if we don't want to do the injections now, we can wait to see if my body goes into menopause on its own but that she'd want me on Tamoxifen for at the most 2 years. At that point, if I haven't gone into menopause, then I would need to do the injections or have my ovaries removed and be switched to an Aromatase Inhibitor medication that is given to postmenopausal women to prevent breast cancer recurrence. Which we are going to do, we don't know yet. It's a lot to take into consideration. I think Tim and I are BOTH more comfortable now hearing that she's in agreement with my current oncologist but like that she has more of a "timeline" for treatment as opposed to "let's just put you on Tamoxifen for 5 years and see what happens". She said that while I am ER+\PR-, Her2- (or single hormone receptor +) my Estrogen (ER)#s were high enough (50 & 65%) to be considered HR+, where if they were more like 5-10% then I would be considered Triple Negative, which is a more aggressive form of breast cancer. Why my current Oncologist's PA told me that I was considered TN was incorrect and wrong and truly sent me into a panic attack. Dr. Bisi did recommend counseling with a therapist who specifically works with cancer patients because of the anxiety & fear (cancer patient PTSD she said is truly a real thing) that I am dealing with on a daily basis. It's easy for people to say that "the cancer was removed during my mastectomy surgery, the margins were clear and is gone" but there is no guarantee and that scares me. My BP was 153/101 at our visit which is higher than it typically has been at most of my Dr. appointments. My current oncologist has never even brought up any sort of counseling to me at all. I have talked to a few different people through our health insurance provider because THEY initiated it shortly after I was diagnosed but no other Dr. has asked ME how I AM and how to treat ME as a person and not just the disease. Dr. Bisi did that and it meant a lot to us.

Tim and I brought up my OB visit in October and the ultrasound and uterine biopsy that I had due to a thickened uterine lining and large ovarian cyst. I explained that it was about a week after I started taking the Tamoxifen and that my OBs initial reaction was that it was most likely my body's reaction to the Tamoxifen. Dr. Bisi said that there was no correlation between the two b/c I had not been taking it for long enough. She said that we will need to monitor that with my OB and if I end up having a hysterectomy (which I really want to do to eliminate the risk of uterine cancer which can be caused by Tamoxifen) we can consider removing my ovaries at that time but that comes with its own set of side effects that are sometimes hard to handle. As I said, we are definitely more comfortable hearing we're on the right treatment path, and that gives us a sense of relief but think that we’re going to switch to Dr. Bisi so that 1) we have a more definitive game plan and treatment timeline and 2) if my breast cancer at some point does metastasize elsewhere, we will be in the best place possible to be for additional treatment and not have to scramble at that time. I take things a day at a time & as the bracelets made for me by sweet friend Shannon constantly remind me - #LOVED, BRAVE, STRONG, WARRIOR, YOU GOT THIS!