Update #1: Tuesday, March 17, 2009

Below is an abridged version of the St. Paddy's email I sent members of my father's family. I sent this to the growing list of friends who had been told about my diagnosis. One girlfriend later commented to me that she found the upbeat, matter-of-fact tone of my email a little "frightening." I guess some of my friends didn't understand how I wasn't falling apart at this point. But I wasn't. I mean, I had my bad moments but as you can tell from the content of these emails, I was just too darn busy to fall apart!

Subject: Update #1

PLEASE DO NOT “REPLY ALL” TO THIS MESSAGE

Happy St. Paddy’s Day everyone!

Earlier today I had my first of several appointments to select an oncologist. The appointment went as expected: The doctor (Dr. Elkas, who practices at INOVA Fairfax Hospital and comes highly recommended from multiple sources) laid out three likely scenarios ranging from very good news to pretty bad news and we discussed next steps in my diagnosis and treatment, including all of the various places where I will be getting second and third opinions (by the way, they include the Georgetown University Lombardi Cancer Center and Johns Hopkins University – both for my pathology, diagnosis, and treatment). The potential scenarios are as follows:

1. I am very lucky and simply have Stage I endometrial cancer confined to my uterus and really bad endometriosis on my ovaries. In this scenario, it is likely that a doctor would “zap” the endometriosis and do another D&C on my uterus to make sure all of the cancer was out. After that, I’d probably be treated by taking progesterone only (estrogen is NOT my friend these days) and monitored very closely. But I’d get to keep all my parts, so that would be great.
2. I am pretty lucky and have Stage I endometrial cancer in my uterus and Stage 1 ovarian cancer in my ovaries. In this scenario, it is a given that a doctor would perform a total hysterectomy (so my ovaries, uterus, appendix and some lymph nodes would be removed). It is also highly likely that I would receive some targeted chemotherapy but they won’t know about that until they see what’s inside. This and the next scenario are unfortunate because I would be left infertile and would begin menopause…and I’m not anxious to join that club anytime soon!
3. I am not so lucky and have Stage III endometrial cancer (endometrial is a kind of uterine cancer) that has metastasized onto/in my ovaries. In this case, like the last, I would have a total hysterectomy and would likely have six rounds of chemotherapy three weeks apart (total treatment time of about 4-5 months including the surgery).

What next?

· At the end of this week or early next, I should receive my pathology consult results back from a renowned Hopkins pathologist. It is likely that his consult will simply confirm my results from Alexandria Hospital but Dr. Elkas, and probably all others, are anxious to see what he says.
· In the meantime, I’m working with Dr. Elkas’ scheduler to schedule a CAT scan, pre-op appointment and my surgery, which will likely be the week of March 30 or April 6.
· During all of this, I will be meeting with a reproductive endocrinologist and two other oncologists for their opinions on my case.
· Fortunately, my fertility is an “all or nothing” scenario that can only be addressed after my surgery and diagnosis. I will either be cleaned up and fine or I will have a hysterectomy and be infertile. This is somewhat of a relief to me right now because the last thing I feel like spending energy on is figuring out who can freeze my eggs, etc. (FYI – no doctor will touch my ovaries for various ethical reasons until they know they are cancer-free.)
· Oh, and in addition to all of this Western medicine, I’m also seeing an acupuncturist, a nutritionist, and my cousin Heather might try some Reiki therapy on me as well.

That’s all for now. Please feel free to route further questions/concerns to either Kristin or Melissa S., both of whom are copied on this email. I’m still working on the blog so stay tuned!

Hope everyone has a great day and I’ll talk with you soon!

xoxo,
J.