Dad's update - February 20 2008

There are lots of things that continue to encourage us. Just to list a few of them -- Rebecca's tumor is not attached to the muscle, or to the skin. Ir's only within the breast tissue, which means it has not invaded other areas, and it is very operable. Her other breast appears completely clear. We are still optimistic about lymph nodes not being affected, although there is one node which is "firm". However, that could be due to agitation from the biopsy and prodding during exams. No way to know for sure prior to surgery, but it does not appear to have impacted any more than possibly that one node -- and maybe not even that one.
Rebecca's tumor is "estrogen and progesterone receptive" -- which is a plus because one of the most effective breast cancer drugs is tamoxifen, which works best in this situation -- and it is NOT producing a certain protein, which is also positive.
We discovered that there is a big difference between "grade" and "stage" of cancers. It turns out we had some misinformation. Stage refers to the metastisis of the cancer -- how far it has invaded other organs and tissues. There is no way to know for sure about Rebecca's until surgery, but she appears to be at stage 2, not 3 as we originally thought.
Instead, Rebecca's "grade" is between 2 and 3. Grade has to do with the density of the cancer nucleus and how differentiated the cells are from surrounding tissue. I dont know a lot about it yet, but the higher the grade, the more "aggressive" it is considered. There are only 3 grades -- Rebecca's is considered to be between 2 and 3.
However, that's not necessarily bad news. Even aggressive brease cancer actually grown much slower than we fear. Also, chemotherapy works because it targets "rapidly" growing or dividing cells. So it is possible that chemotherapy actually works better with highly differentiated, rapidly growing cells in some situations. However, the size of her tumor is slightly above average -- her's is at 3.4 cm, average is 2.5 to 3 cm. A large tumor is anything over 5cm. So, this isnt the best news, but given the other factors working in her favor, it's not the worst thing either.
We are still learning about our treatment alternatives. Surgery is a certainty -- but we dont know yet whether it will be a mastectomy or a lumpectomy. A lumpectomy requires radiation after surgery. A mastectomy doesnt necessarily require radiation unless there has been some invasion into lymph nodes or other areas. We are weighing the pro's and con's of the most drastic surgery (mastectomy) vs. radiation. Both approaches seem to have about the same percentage of recurrence, which is very low (5%). Fortunately, both surgical techniques are light-years ahead of where they use to be in terms of recovery, invasiveness and reconstruction.
Regardless, we will have to have chemotherapy. We dont know how long, or if it will be altered by having radiation or not.
We have a meeting tomorrow morning with a panel of doctors (surgeon, radiation/oncology, and someone else) at LDS Hospital. A second panel of similar doctors are meeting at Huntsman. Hopefully, we will get a lot more answers to our questions after tomorrow.
Apparently, there is no "emergency" in making a decision right away. Both doctors we spoke with told us we could probably wait a month to determine our plan of attack -- though we will certainly NOT take that long.
Rebecca and I plan on asking lots of question, studying, praying and fasting for guidance before we make a decision, which we think we'll make early next week. - As always, we welcome all of your fasting and prayers that we might have all of the information possible, and the ability to make the best informed choice we can with the Lord's help.
We want to thank all of you who are keeping us in your thoughts and prayers.
Love,
Mark