Hmmm ...

I've just had my upbeat disposition given a bit of a knock.

I'd understood this afternoon's appointment was to sort out my radiation treatment, possibly a tattoo or two, a schedule of sorts, that kind of thing.

It turned out that this was actually my first meeting with the Oncology team.

Up until now I've been under the influence of the surgeons.  Not unnaturally they see their role as the main one, the bad bit has been cut out, no trace of any more bad bits, job's a good'un, a bit of a zap and some tablets and all will be well.

Things didn't start well when it took three hours for me to be seen.  They were a doctor short and of course these things happen, but it did make for a very long afternoon.

The charming chap I finally saw had a very thick accent, which meant I had to really concentrate on what he was saying - no bad thing really.

I got a summary of where we were at the moment, (operation, nothing in the nodes taken from my armpit, no history of this disease in my family - we came back to that a couple of times), there is no disease in my body.  But ... but ... this is Oncology, basically they always recommend Chemotherapy as well as Radiotherapy and tablets.

I felt the wind coming out of my sails (if that's an appropriate way to describe it) at every point in this process to date I'd been told Chemo wouldn't be necessary.  I had to piece together for myself that what I was really facing was the different disciplines beliefs about what is best for the patient.  I know it's all coming from a good place, but Chemo was the one thing I really didn't want to experience.

I focused back on what was being said.

The current tests show two markers, the one that's about hormones  is positive (bad - therefore the tablets are a given) the other one is negative, but I got the impression that this group of doctors always know better and would rather make absolutely certain with more chemicals.  (I'm probably being very unfair, his accent was very thick and I probably shouldn't be trying to read a subtext into someone else's discussion).  

In actual fact what is happening now is more tests.

Thank goodness the use of Chemo is subject to cost benefit analysis.  The tests are the gene therapy ones (that to be fair were mentioned as a possibility during the biopsy discussion) and the numbers will fall into one of three groups.  Less that 18, the cost outweighs the possible benefits and the decision is likely to be no.  Over 31 and the benefits outweigh the costs (2% increase in a long-term lack of return of the nasty) so that'll be a yes.  A number in the middle and it gets fuzzy.  So fingers crossed I'll have a low number.  And that I might get a say in what happens?  I sort of doubt that, but I can dream.

They like to do Chemo within two months of the operation so the clock is ticking.  They'll see me again in three weeks when they'll have the results of the gene tests and then the next steps will be decided (and they'll discuss side effects - cheers!)

I left in a bit of a daze and a bit upset - but I've had a chance to think and really I'm where I've always been - there is more to be tested, more results to get and further action to be taken when we know what we've got.  

Onward