San Diego

The long wait is over. The Oncotype DX came back today and was favourable. It looks like Ann will not need chemotherapy and we will go to see the oncologist and the radiation therapist over the next few days to determine a treatment plan. More information tomorrow.

San Diego,CA

Change of Plan
We had some further meetings with our radiation oncologist today and we have decided to wait for the results the Oncotype DX prior to making a decision regarding the type of radiation therapy to choose. We have been told that will get a result by next Monday and if this indicates that chemotherapy is required then she will have the short, partial breast radiation delivered by a special catheter next week. If the Oncotype DX test is favourable then she will opt for whole breast radiation over 16 days. We will have to anxiously wait and see. In the mean time, the weather remains perfect and there is much to keep us occupied.

View of San Diego from Cabrillo National Monument

San Diego, CA

Time has passed slowly since my last post and I must admit to a little boredom and despondency over the past week. Those of you who know me, will understand that waiting patiently is  not one of my strongest attributes so this has been a difficult time for they Admiral and I.
The days do pass and I even got some beer can racing in on Wednesday with my old pals in Coronado. Other excitement includes renting a machine and shampooing all the carpet in the apartment. What joy!
The Oncotype DX test did not get sent until after Labor Day and was only received in the lab yesterday so we will have to wait now until the 19 th.  of September to get a decision regarding chemotherapy.
There was some activity today and we went to see the radiation oncologist at UCSD who thought that  the  admiral was a good candidate for partial breast irradiation delivered  through a special catheter. The good news is that this can be given in one week only, as opposed to 6-7 weeks of external beam  whole breast radiation. Ann starts on Monday with a CT scan and  treatment beings on Tuesday.
So at least one mode of therapy will be done before we have to consider chemo.

San Diego, CA

It is a calm and beautiful San Diego Sunday morning and there is much to enjoy. We went to see the head of breast oncology at UCSD on Friday and she was quite delightful and spent ample time with us and again went through the decision making process in determining Ann's optimal treatment going forward.

She recommended an aromatase inhibitor as the most effective way to block estrogen as the tumour is hormone sensitive. This will continue for at least five years. She also mentioned an alternative to external beam radiotherapy, namely a technique called partial breast irradiation which I had not heard of before. I will have to research it further to be sure that it it is at least as effective as the standard treatment. This method has some significant advantages in that it takes only one week instead of six weeks and can be given immediately following lumpectomy instead of waiting until after chemo if indicated. 

She really did not think that the option of subcutaneous mastectomy either bilateral or on one side in order to prevent recurrence or diminish the risk of new disease was reasonable.

We also discussed the $64,000 question regarding adjuvent chemotherapy and as we surmised we will not get the answer to that for  another two weeks while the Oncotype DX gene test is being done.

This is a little frustrating as neither of is very good at waiting but there is little choice. At least,we can look into getting an opinion on partial breast irradiation and we will try to get to visit with the radiation oncologist at UCSD next week.

In the mean time we will take advantage of all that San Diego has to offer.

San Diego, CA

This has been a difficult week. Ann is recovering very nicely from her lumpectomy and sentinel lymph node biopsy. She has very little discomfort and the wounds are healing well.The staff at Eisenhower Medical Centre were all excellent as expected.
We have  the pathology reports most of which are favourable. and suggest good prognosis. The big question is the need for adjuvent chemotherapy and we are going to see the chief of breast oncology at UCSD on Friday to get an expert opinion on this. One further genetic test, Oncotype DX,  is cooking as we speak but we will not get the result for another  two weeks from now.
We certainly hope that chemotherapy will not be necessary for obvious reasons but will have to wait and see.

Rancho Mirage, California

Some good news and some bad news

We have had an eventful week. We left Sun Valley a day early due to the massive Beaver Creek wild fire that destroyed more than a hundred square miles to the south and west of Sun Valley and Ketchum. Up to 2300 homes were evacuated and we were next on the list. The smoke was so thick it reminded me of the London fogs I remember from the late 50's and early 60's. Most activities were cancelled including the famous Sun Valley Symphony and the writer's conference.

There didn't seem to be much point waiting for a mandatory evacuation order so we left a bit early. Even so, the only route out of town, highway 75 was jammed solid and it took almost two hours to go eleven miles to get south of Hailey. This usually takes about twenty minutes. We saw the smoke and flames in the distance and the fire camp where more than a thousand firemen were assembled to fight the fire.

We are pleased that their efforts were successful and no significant fire damage happened in Sun Valley and Ketchum. Tourism, however, suffered greatly.

And now for the bad news. Ann has noted some skin tethering over the right breast for the past two months and despite having had normal screening mammograms for the past ten years, we thought it would be best to have some further testing done.

A diagnostic mammogram, ultrasound and a core needle biopsy done on a suspicious area on the right side on Monday was positive for breast cancer.

Fortunately, an MRI scan did not show any spread to lymph nodes but confirmed the mass on the right side.

We are currently back in Rancho Mirage and tomorrow Ann will undergo lumpectomy and sentinel lymph node biopsy with one of my former associates.

We expect to return to San Diego on Saturday to await the results of the biopsy, the various tumour markers and the lymph node status which should be available by Tuesday. We should then have a better handle on prognosis and be able to make some decisions about adjuvant treatment. We hope that Ann will not need chemo but we will have to wait and see.

We had planned to leave for London on September 10 and go back to SE Asia in November but all plans are on hold right now until we have further information.

We both hope this turns out well.

Sun Valley, ID

The Admiral and I have been enjoying the quiet life in the mountains and the days pass quickly. All the new painting and decorating has been done and we will put the condo up for rental again when we leave on Saturday. There have been some devastating forest fires in the surrounding areas and our usually glorious mountain views have been marred by heavy smoke and ash.
We have been enjoying the Sun Valley Symphony, which is an annual feature here. Mozart tonight, followed by martinis at the Sun Valley Inn.
On a much sadder note, we received the news yesterday that one of our fellow cruisers had lost his battle with a very rare and aggressive CNS lymphoma and passed away at the tender age of 48. We will miss him very much and we must learn to live our own lives to the fullest.
We leave for San Diego on Saturday via Las Vegas and Rancho Mirage.