All the marginally bad news that’s fit to print.*

Written by John.

Nina had a second biopsy done on her right breast on Monday as follow up to imaging that revealed “things that the doctors did not like.” Specifically, these things were “microcalcifications,” which are normally an indication of some type of malignancy or pre-malignancy (invasive ductile carcinoma or ductile carcinoma in situ, respectively, in her case). Today she got back partial pathology from the biopsy, which revealed not only a second malignant area, which we pretty much expected based on the films, but an “additional cancer”: one not from the same source as the original tumor.

We do not yet know anything much about this second malignancy, except that it is different and they are saying it is grade 1, which is ostensibly good. We have to wait for the more complete pathology report to find out if it is hormone-positive or negative and which treatment follows (additional chemo, longer chemo,etc.).

We don’t feel like at this point the new tumor indicates any radical change in Nina’s overall prognosis. It almost certainly means a different approach to surgery. We meet with the surgeon on Friday and each of us fully expects him to recommend a mastectomy instead of a lumpectomy. But in terms of survival and recurrence, we don’t really know, but we also don’t have any reason to think this makes things necessarily worse. We will still have to await the results of the full post-surgical pathology for that kind of assessment. In the meantime, we are anxious to hear what the surgeon has to say and to discuss the full pathology with Nina’s oncologist when it is ready.

I think Nina is really sick and tired of receiving even marginally bad news. Because even marginally bad news is pretty dispiriting when it has to do with her cancer. But, I have to say, she is handling all this about as well as a person could from my vantage. She’s keeping herself active, mentally and physically. She’s reading, working, and doing a lot of gardening, which is a pretty good self-medication. And impressively physical for someone undergoing a chemo regimen as demanding as hers. She has some bad days, but those are the unavoidable “my chemo is kicking my butt” days. And they last astonishingly brief amounts of time with her. I attribute that to a lot of mental and emotional toughness. Still, at the end of the day, everyone needs some objective encouragement when they are going through a rough stretch and that’s the real missing ingredient. C’mon, objective encouragement!! Where you at, fool?!

*I have an R-rated version of this post I’ll share upon request, in which I share my true feelings about cancer, including explicit illustrative pictures of ducks. But it didn’t pass the decency test under Miller v. California. I’m not joking. Go ahead, satisfy your curiosity. Make the request. Just be prepared for federal indecency charges.

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