Last week was a big week in Ava’s breast cancer journey. She got the post-surgery biopsy results. We had a follow-up appointment with her cancer surgeon on Tuesday morning. While all the pre-surgery indicators pointed towards early detection and a fairly straight-forward road to being cured there was still uncertainty heading into this appointment.
The doctor wanted to make sure Ava was healing nicely. She also had the answers to two BIG questions. During surgery, the week before, the doctor removed the tumor and also one lymph node. That was all sent to the lab for another biopsy. We got those results on Tuesday morning.
The two BIG questions were:
- Did the surgeon get ALL the cancer? In addition to the tumor, the doctor also removed extra tissue surrounding the cancer. That extra tissue is called the margin and they want to see that those margins are cancer free. If they aren’t then Ava needs to have more surgery.
- Did any of the cancer make it into the lymph nodes? This is the first place cancer travels from the breast. During surgery they also took out one node for biopsy. Did it have any cancer cells? In other words, has the cancer started to spread?
The answers to both these questions are critical to what happens next.
I’ll confess, I was feeling nervous heading into this appointment. A few days earlier I saw the obituary of a young woman, named Cindy, who died of breast cancer. She had blogged about her journey. I couldn’t resist. I probably should have. I read the blog. All of it.
Cindy’s early posts, after diagnosis, used the same language we’ve been using. Early detection. Excellent prognosis. And just like Ava, her first step was having a surgeon remove the tumor and some lymph nodes.
It all sounded very similar. Then Cindy had her first post-surgical appointment. Her margins weren’t clear. Cindy had another surgery. Still the margins weren’t clear so she had an even bigger surgery. Less than a year later I was reading Cindy’s obituary in the New York Times.
I didn’t tell Ava, but I couldn’t shake what I had read.
We arrived for the appointment a couple minutes late. Baltimore rush hour traffic is never fun. Even less so when you’re fighting nerves. Ava was a rock-star. She was expecting good news. I hadn’t told her about this other woman. She didn’t need to hear that.
In the waiting room we took a quick picture and then we were called back. Within minutes we were given the news. Thankfully, they didn’t bury the headline.
It ALL looked good!
That was followed with a lot of details. The margins were clear. No additional surgery was needed. The lymph node was clean. The cancer had not started to migrate. It was the best appointment ever.
The journey, of course, is not over. Round One is done. Still to come is the post-surgery treatment plan. We will learn more about that in a few weeks with treatment likely starting in December. For now, though, she gets a break and we can both relax a bit.
That said, while we were getting good news on Tuesday morning we were reminded this journey is different for each person. In the exam room next to ours, another woman was getting different news. While we didn’t see her or know her details, we did hear her reaction. We are praying for her.
We left the hospital and got some brunch and then came home. I had some walking to do to reach my 20,000 steps. Ava had a different agenda.
This was Week 7 of my 20k One Year Step Challenge. I hit my goal each day, but what I’ll treasure far more than those steps is hearing the words, “It all looks good”.