TAKE TWO - 21 October 2025
Office Visit - With Gloria having elected a peremptory strike against a future breast cancer in the left breast as well as eliminating the need for further boob-mashing scans on it, we fully expected yesterday’s office visit to be pretty routine. Since the recent cancer was HER+ combined with a positive lymph node, chemo therapy was a foregone conclusion. She already had a November 3 date with oncologist Travis Koeneke, so it seemed the ducks were all in a row.
But there must be something in Gloria's nature that seeks excitement. The pathology tests were only partially complete and those
completed had been received by Dr. Doering just minutes before Gloria’s 11:45 appointment. We could tell he was still processing
what he was reading while speaking to us.
The surprise was a 6 mm tumor previously unknown found in the left breast - the breast with the 2022 cancer. Treatment guidelines
are generally developed by digesting large numbers of previous cases and comparing them with various treatments and looking at the
outcomes. But just like her 1997 medical adventure, Gloria is now in a Venn diagram with very few previous cases. As a consequence,
the roadmap ahead is a bit fuzzy.
If the one just discovered was the only one, they would then do a sentinel node test under her left armpit, looking for signs of
spread. The cancer markers would tell their story as well. So if the nodes were clear, the cancer was HER-, and the margins were
clear, one could do nothing because the mastectomy had eliminated it.
But having had cancer in that breast before, the lymph circulation system may have been damaged by the previous surgery, making
the simple test less reliable.
Doering's nurse Sam, Gloria and surgeon Dr. Doering
Furthermore, if the markers match Gloria’s right-breast cancer, any chemo given for that one would
also target this third cancer, Messing further with lymph nodes on the left side would be pointless and have an increased risk of
edema problems - possibly with attendant pain with no really effective way to reliably treat it.
After some considerable discussion, it was decided the doc would reach out to others to see if some sort of other approaches have
been used and to wait for the complete biopsy so it would be known what possibilities are present, rather than trying to map one
out for all conceivable cases. In addition, since Gloria will be moving into Dr. Koeneke’s realm soon, a chat with him is called
for to see what his take on the situation is.
The "take" as of now - As we walked to the car, Gloria asked me if I was less optimistic than I had previously been. I told
her I wasn't, but, rather, the waters have somewhat muddied and we needed to wait until they cleared a bit.
For her part, Gloria had noted that several times doc had mentioned that while going after the nodes might make the situation
clearer, there was no indication it would have an impact on long-term survivability, but might be a risk to her quality of life. So,
for her part, she was currently leaning away from any additional nodal surgery.
Now we do what Gloria likes least - wait.