And so it begins...

Upon hearing my most recent news, I struggled with an efficient, yet personal way to disseminate the information to my closest girlfriends. After the first 72 hours and a couple of very uncomfortable phone conversations, I realized that telling this information over the phone was not my strong suit. I decided to send a mass email (that I had most recently thought inappropriate).

It's funny how quickly you re-evaluate all of this technology when faced with the challenge of notifying multitudes of people of the same information. Let me put it this way...I didn't even consider a blog for updates until all of the information dissemination became overwhelming. I mean, let's be honest, my mother simply can't call EVERYBODY.

Below is my letter to what I consider the most fabulous friends in the world (in no particular order): Armide, Laura, Adriana, Karen, Nailah, Alyssa, Lisa, Sheryl and Vicky. I thought sharing it here would be the easiest way to plot the beginning of this fucking adventure (I find the word "journey" to be ill-fitting and annoying...as was the pink ribbon, prior to Friday, December 12 around noon).

And so we begin...

Dear All:

I hope everyone is doing well. I have some news which I would rather disseminated in person rather than a mass email, but given the holidays and everyone's busy schedule this is probably the best way for me to get the news to everyone. I have told a few people over the phone (Armide and Laura), but my delivery over the phone really sucks and it makes me feel uncomfortable.

The Wednesday before Thanksgiving I found a lump in my breast. This was somewhat shocking since I had gone for my annual GYN appointment early October and everything was fine.

I had a diagnostic mammogram with an ultrasound last Tuesday which as I'm writing this it is hard to believe that it was only a week ago today. The radiologist said it looked suspicious and to be on the safe side suggested I have a biopsy. He made it seem that the biopsy was more standard procedure. When I pushed for data he said it was probably 50/50 chance of being malignant. UNC was able to work me in the next day (for which I was very grateful) for a core biopsy. The surgeon that I had to see before the biopsy said that there was probably only a 20% chance of malignancy. This made me feel a bit better.

So to make a long story, that is getting ready to be a lot longer, a bit shorter, the pathology came back on Friday as Invasive Ductal Carcinoma (IDC). With that, however, they are throwing around words like "early-stage" and "low-grade". In addition, it has what is called mucinous features and when you look this up it is described as "slow-growing" and a “better prognosis" than regular IDC. And, of course, mucinous carcinoma is rare and makes up less than 5% of breast cancers. I mean, for god sakes, if I'm going to have breast cancer, at least it is not the run-of-the mill breast cancer:)

The yet to be known scary parts are:

1) The pathology suggested that it may be in the lymph system but during ultrasound and physical exam my lymph nodes appeared fine. I will not know the status of this until surgery.

2) Two primary characteristics of the tumor (ER/PR and HER2/neu) are still unknown. ER/PR positive is good because this means the tumor is fueled by estrogen and/or progesterone and those can be turned off. HER2/neu positive is bad because this is a gene that if present may cause cancer cells to grow out of control. I will find this out tomorrow which will give me insight into the first stage of my treatment (lumpectomy and radiation; or mastectomy and reconstruction). .

3) Given my age (yes, even at 40 for the purposes of breast cancer I’m classified as young) I'm a bit worried that I may have the breast cancer gene but knowing this will give me and the MDs good insight into the treatment course.

Strangely enough I was better on Friday regarding the diagnosis than I am today. You know that saying, “ignorance is bliss”. Since Friday I have read everything I can put my hands on about breast cancer. On Friday I was thinking that I may still be able to run the Cooper River Bridge Run in early April, thinking, “Oh, I should have this whole cancer thing wrapped up in a month or two”. Well, the more I read, this is not so much the case and it appears there is a good long journey ahead of me which probably includes chemotherapy. Right now, I’m planning that this time next year I will be back to normal.

The hardest thing so far was telling my Mom and Dad. I felt so sorry for them because I know this is about one of the worst things a parent can hear. I went to Wilmington on Friday night and told them. They actually took it better than I thought, but I can see it in their eyes that they are very worried.

Tomorrow I have an appointment at UNC with a radiation oncologist, a surgeon and a genetics counselor. I also have second opinion appointment at Duke on Monday. If anyone knows anyone who has been treated for Breast Cancer at either Duke or UNC and can recommend a surgeon or oncologist I would appreciate it.

Needless to say, none of this was in my 2009 plan so I’m pretty pissed off. I mean I never even liked that pink ribbon, but now I guess I will be sporting it around everywhere, buying everything pink and running lots of races with my survivor shirt. It is not even a fucking option for Katie to be without a Mommy, so whatever horrible bullshit I need to endure to ensure that this cancer goes away and never comes back is what I’m going to do!

Please know that me disseminating this information in this fashion does not mean that I don’t want to talk about this in person or over the phone or that I care any less about you. As you might imagine the initial delivery of this information over the phone is hard for me to do. I love all of you dearly and I’m so grateful to have each of you in my life.

I will keep you posted and send an update tomorrow after my various appointments. I also think that I will be writing a blog of some sort as an easy way for folks to know what is going on. I hope we can all see each other very soon!

Love,
Gail

PS - PUBLIC HEALTH MESSAGE - EXAMINE YOUR BREAST OFTEN!

I always thought it was a waste of time because I never thought I would know if something was new or even be able to feel anything. I was wrong! You know immediately when something is new and not supposed to be there.