Refreshed

Well, believe it or not, I actually feel BETTER after my doctor's appointment yesterday, despite my very negative feelings about it, and me pretty much convincing myself nothing good would come out of it, and it would only promote further anxiety, if that was even possible. That's no reflection, at all, however, on the doctor. He is wonderful and amazing. And he was yesterday. I brought up the concerns I had planned to, and he listened and responded, both patiently and intently. I have never, ever felt rushed by him, and I have never, ever felt that any of my questions or concerns were stupid or unfounded. Everyone should have a doctor like that.
Anyway, a lot happened yesterday, so I'll do my best to sum everything up. My outcome, emotionally and mentally speaking: I'm feeling a little bit better. And I'll take that!
We talked about some of the testing I've had done since I last saw him in April, including an echo/EKG, which came back normal, a bone density test, and numerous genetic tests (the BRCA1, BRCA2 and BART - which I've discussed in previous posts - and all came back negative or normal.)
We also talked about my breast cancer treatment, and it made me feel really good that his thoughts were consistent with those of my breast surgeon. I also brought up my risk for developing breast cancer in the other breast, and my desire for a preventive mastectomy on my other side.
He said my chances, given my specific diagnosis, were low for both having a breast cancer recurrence on the right side, and for getting a new breast cancer on the other side. I told him my many reasons for wanting a preventive mastectomy, and he said my reasons were real, and that they made sense, and he made me feel like I had every right to get it done. I also asked him if other women who had DCIS on one side got another mastectomy on the other side for prevention, or what he recommends, or his opinions on it. He said most women with DCIS don't do it, although of the ones who do, most of them are older (60+) and when they had DCIS, had multiple sites of it. But my concerns, such as having breast cancer once already, having dense breast tissue that could lead to more screenings and biopsies and anxiety, and my age, he said were completely valid in considering a preventive mastectomy.
We also talked about Tamoxifen, a hormone therapy drug, women take for 5 years after having breast cancer, to help prevent its recurrence and prevent a new breast cancer. However, this drug is only recommended as a standard of care for women with HR/PR+ breast cancer. I was hormone negative. So although it's not recommended for me, my doctor brought it up anyway because he wanted to present every possible option to me. The reason it's not recommended typically for ER/PR- breast cancer is because the benefits are unknown - in that they actually haven't been studied.
Hormone therapy is something I have chosen not to do, for reasons other than the obvious "results have not been studied in ER/PR- breast cancer." There are a variety of risks associated with it, and those risks are not only higher, but more front and center, in someone of my age. First there's the risk of uterine cancer, and apparently, in young women who are still menstruating, this is extremely hard to detect, so if on Tamoxifan, I would need additional screening and testing all the time, and, ha, I'd have a higher chance of another cancer, which is ironic, because this drug is supposed to lower my risk of another cancer! So one cancer risk lowered, but another becomes higher? Nope. And then there's the issue of early menopause, and the fact that while on the drug I wouldn't be able to have children. Considering I'd take the drug for five years and Sean and I have been talking about starting to try for kids in the 1-2 years after we're married, well, it doesn't fit into the picture. Obviously, needless to say, the risks associated with this drug significantly outweigh the benefits - and even FURTHER - the benefits haven't even been studied in women with my type of breast cancer! Although hormone therapy is not on the table, I appreciate my doctor bringing it up and discussing it with me, because I like to know all my options, and even all the options out there, even if some don't fit into my picture.
And another thing needless to say, but I'm saying it anyway, if given the option, my doctor recommends mastectomy over hormone therapy. He is in no way telling me to get a preventive mastectomy, or even recommending I consider it. I just asked him if he had to choose one, which he'd choose.
So other than that we talked about my bone density levels, which have been low for like 7 years now. I have osteopenia, the stage before osteoporosis. He ordered a Vitamin D test to check those levels, and depending on what they are, may or may not recommend a calcium supplement. He also ordered a CBC - complete blood count. AND! (this guy is wonderful!) - got me into a very well-respected doctor, through Hershey, for my primary care physician. I have one currently, but will be seeing this new woman because my doctor recommends her specifically for me, and they got me into see her next week (which is fast!) so I'll have that established.
So all in all I am on the ups from this last appointment, and feel good about the decisions I've made, which is to consider a preventive mastectomy. I'll either set up a phone conference with my breast surgeon in Hershey before my April appointment to discuss my concerns and reasons, and to get her input, or I'll wait until April. Either way I am going to move ahead in making her aware of my wishes, and I think the sooner she knows what I'm thinking, the better I'll feel.
So yesterday was a good day, and today was better than yesterday.

Photo: Me in my Lifetime shirt made for the movie, FIVE! I absolutely LOVED the movie! I think it captured perfectly the many different emotions, feelings, perspectives, types, and faces of women who get breast cancer. I fell in love with each character, and their stories, and was sad when the movie ended. I wanted the movie to continue so I could feel like I was living their lives WITH these women - both during the breast cancer and after. Good job, Lifetime, and THANK YOU for making this movie!