Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments (1)

When Cancer Hits A Doctor’s Home

This year has been a weird one for me and cancer. In the ER, we see cancer patients pretty infrequently. The occasional chemotherapy with fever, but that’s about it. I think the oncologists try hard to keep the patients out of the ER — to everybody’s benefit.

But this year, I’ve had a weird rash of cases where I’ve made primary diagnoses of cancer in the ER — several times over and over and over again. In ten years I don’t think I’ve made as many cancer diagnoses as I have this year alone. Just very strange.

Unfortunately, it came home to roost. My wife was diagnosed with breast cancer last week.

This is an unusual case, in that my wife is quite young, and that the cancer was diagnosed shortly after our fourth child was born. Likely the pregnancy/nursing changes in the breast masked the lump; when she first noticed it, she thought it was perhaps a clogged milk duct. She showed it to her OB, who recommended watching it for a couple of months. When it did not go away, the OB ordered an ultrasound and mammogram (and thank the FSM that she was so meticulous), which showed a pretty obvious, relatively large cancer.

So it’s moderately aggressive and locally advanced infiltrating ductal carcinoma. We are expecting it to be Stage 2b or 3, depending on the number of lymph nodes involved (they are palpable and appear enlarged on US). Curiously, the one node they biopsied was clean, so we are holding out hopes they might not be involved. Most importantly, the receptor status is encouraging: ER/PR negative (as one would expect in such a young woman) but HER2 positive. This is good because it opens up some treatment options, notably Herceptin, and avoids the poor prognosis involved in what they call “triple negative” breast tumors.

Having said that, this is going to be a rough road for our family. We anticipate, after staging is complete, a mastectomy followed by chemo and radiation. The chemo will be adriamycin and cytoxan, which I understand to be pretty brutal, for 12 weeks, followed by Herceptin and Taxol for another 12 weeks or so. Having said that, with what we know right now, we believe that there is good reason to expect a cure.

Obviously, this has been a pretty huge shock to our system. It’s scary and maddening. We’ve been shuttling back and forth to tests and doctors’ appointments all week. We have also been suffering from emotional whiplash as we veer from despair to determination and back again. But so far we are holding it together very well. The kids took the news well and seemed to process it at an age-appropriate level.

We have been overwhelmed by the outpouring of support from our friends and family. Absolutely everybody seems to want to do something to help. It’s humbling, since my wife and I are the sort of people with a mortal dread of imposing on others, but the reality is that we are going to need it. I’ll be pretty focused on taking care of my wife, and I’ll have to go back to work, and the kids are going to need to get to school, laundry, dinner and the usual stuff will need to be done. So we are going to have to learn to graciously accept some help; the biggest challenge will be coordinating all the volunteers to match our needs.

It could go without saying that blogging will be light to irregular as my priorities have been completely turned upside down. Don’t list me as a dead blog — I hope to come back to my regular, industrial-strength blogging once the treatment is complete, which is probably six months or so.

For those who wish to follow her progress and know what’s going on, we have created a journal at the Caringbridge website which you can read.  A lot of our friends — both real and online — have asked what they can do to help. We thank you for all your support and warm thoughts. We don’t really have a lot of needs beyond those which are local, but we would love to have your notes of support and encouragement for Liza over at Caringbridge.

For those who wish to do something more tangible, I would encourage you to donate to a cancer charity. Longtime readers will know that my charity of choice is St Baldrick’s Foundation, which raises money for pediatric cancer research, and I do intend to shave again this year. So if you feel the urge to take action, you can click here and donate to St Baldrick’s online. And if you have breasts, or know someone who does, remind them to take a moment and do a breast self-exam.

Again, thanks in advance for all your kind thoughts.

*This blog post was originally published at Movin' Meat*


You may also like these posts

Read comments »


One Response to “When Cancer Hits A Doctor’s Home”

  1. Steven Piriano says:

    I wish your wife a full recovery and a lifetime of good health. I know that this can be a frightening time. I am also an ER physician. Just over three years ago I was diagnosed with renal cell carcinoma. I had a radical nephrectomy and a year of adjuvant chemo. I am doing well and am very thankful. I have learned so much as a result of my experiences. I truly beleive that keeping a positive attitude and taking care of your body will help so much in bringing about a recovery.

    God bless.

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »