I have waited to post this until I had an outcome; spoiler alert: This story has a happy ending.
You may recall that in July I had a full body scan. This was done because one of my lymph nodes came back positive from the Sentinel Lymph Node Biopsy. Shortly after those tests were done, I called Dr. Cancer, and she confirmed that the scans came back clean, with “no distant disease.” Excellent news!
But I’ve learned to be cautious about such statements, especially left via voicemail as this one was. When I started getting call-backs from my mammograms, I was told not to worry – until I was told I needed a biopsy. When my biopsy was positive, the initial assessment was lumpectomy + radiation only. Then that turned into a mastectomy due to the multi-centricity of my cancer. But still very unlikely that I’d need chemo; in fact, after surgery, both surgeons said, “your lymph nodes are negative, yay!” Then a few days later the pathology report came back and they were positive. At the microscopic level, true; but from a treatment protocol perspective, positive is positive – time for chemo.
(Sidebar: I’m actually glad I’m doing all this – full mastectomy + chemo + radiation. It seems like the most aggressive possible treatment for what seems to be a highly treatable cancer. I plan to live a long time, and I can take it: give me what you got, let’s nuke this bastard!!!)
Anyway, with this ongoing saga, I was actually not incredibly surprised when, at my visit with Dr. Cancer for my first round of chemo on August 16, she said, “Your CT scan actually showed a cyst on your liver. The radiologist does not think it’s anything of concern, and liver cysts are very common, so we’re not worried. But we want to check everything at this point and leave no stone unturned. I’d like you to have an abdominal MRI.”
Positive lymph nodes mean that the cancer has just started to spread. Right now the goal of my treatment is to blast everything with chemo to prevent it from spreading from the lymph nodes and “settling” in a distant body part – such as the liver. If this were to happen, that would be considered Stage IV, or “metastasis,” and would swing my prognosis from “curable” to “not curable.” And that’s as much the research as I’ve done on this, for obvious reasons.
Well, I tried to schedule an MRI, but was pretty sure they would not let me, because of the breast expander that Dr. FixIt put on during the mastectomy. He gave me a little card about this medical device that was pretty clear that an MRI would be a bad idea:
I called to schedule the MRI anyway, just in case, and the scheduler put me on hold to speak to the MRI folks. They asked more info about the exact model of device I had. So, I called Dr. FixIt’s office and got more details. I found the following info on the company’s website (red highlight mine):
“The ARTOURA® PROFILE® Tissue Expanders can be used for breast reconstruction after mastectomy, correction of an underdeveloped breast, scar revision and tissue defect procedures. The expanders are for temporary subcutaneous or submuscular implantation and are not intended for use beyond six months. Do no use the ARTOURA® PROFILE® Tissue Expander in patients where an MRI may be needed. The device could be moved by the MRI causing pain or displacement, potentially resulting in a revision surgery. The incidence of extrusion of the expander has been shown to increase when the expander has been placed in injured areas.”
(Also note the comment that the device is not intended for use beyond six months. I’ll have mine in place for over a year! Something to ask Dr. FixIt about next time I see him.)
So I called Dr. Cancer to ask what to do. I did not hear back but this was just before my Friday hydration visit, so I figured I’d wait until I was there. I brought the card with me, along with a print-out of the above text. Dr. Cancer pushed back a bit – “Didn’t you have an MRI with the expander in place?” (The answer is “no.”) But she seemed to accept all the paperwork I’d brought in. I figured if she still pushed back I’d just have her speak to Dr. FixIt and/or the MRI technicians directly.
She changed the order to an abdominal CT scan, and the following Friday I drove back up to RB to have that done. Fortunately the technician immediately asked me how my veins are. I said they’re crap – I need to tell people that from now on – and she got an RN to put in my IV, which was a great call.
Given my past experience with “you’re fine – oh wait just kidding,” this time I decided to wait until my next office visit with Dr. Cancer, which was my second chemo day on Sept. 6. So this is all a very long story to tell you that she confirmed that the cyst they saw on my liver really is just a cyst. Still no “distant disease;” no need for me to read up on Stage IV cancer. Apparently liver cysts are very common (although I have intentionally not Googled anything on this).
Welcome to my new normal. Aren’t you glad I waited until I had the whole story before telling you about it? I will now add my 2nd CT scan to my “past appointments” page…