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Hanging on to Fitness and a Few Strands of Hair Through Breast Cancer Treatment

I am a Medical Oncologist, a wife, a mother of 4, runner of 12 marathons training to run my 13th with a goal to qualify for Boston when the diagnosis of breast cancer caused a significant detour in my well-planned life. When I asked for guidance on how to continue to stay fit while receiving treatment, I received blank stares and found little data. While I never intended to be in this experiment, I find myself now generating my own data about fitness through the diagnosis and treatment of breast cancer. I am writing this in hopes to help others who find themselves in this same situation.

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The Post-Op Visit

I just got back from seeing my surgeon for my post-operative visit. Lots of good news: The incision is healing well. I get to resume normal activity. That means I get to start running again! This is earlier than I expected and I am so happy. I also got some of the other details about the pathology. The margins are negative. That means that there was no cancer at the edge of the tissue that was removed. To rephrase this in the way that surgeons like to put it: "they got it all". Which means the surgeon is done with his work! But as a medical oncologist, I know that they may not have gotten it all and that is why some kind of systemic therapy and more local therapy will be needed. I know that I will definitely need radiation which is considered another local therapy. The remaining question now is if I need chemotherapy, aka one of the potential systemic therapies. I know that I will receive hormonal therapy which is another systemic therapy since I know my tumor is ER/PR positive (estrogen receptor/progesterone receptor), but that will be at the very end of this treatment and continue for many years. The other detail about the pathology is that they found some cancer cells in the sentinel lymph node biopsy (about 200 cells, which is a very small number and they only found them by doing a special stain). This is that lymph node that they took out guided by the radioactive dye that was injected into the tumor the day before surgery. Although I would like it even more if there were no cancer cells in that lymph node, the fact is they are there and the miracle is that they found them and this is important because it will help to guide the best treatment. Just to point out what needed to happen to find these cells: The radiology tech that injected the radioactive dye, had to do so in the correct spot. Although this spot was marked by my surgeon before going over to radiology, still this requires skill on the radiology tech's part to do it just right. Then my lymphatic system had to take up this dye and carry it to the correct lymph node. Then the next day, the surgeon had to find this lymph node after making a very small incision in my arm-pit. Of course he had the guidance of this radioactive dye that went to the lymph node. Then the pathologist needed to slice this lymph node just right and also make the decision to use special stains to look even more closely to find these cells. For me, getting this information only required a small incision and removal of one lymph node. If I was going through this just 10 years ago, I would probably have had a complete axillary lymph node dissection which is a bigger surgery and higher risk of post-operative complications. With all of this, I am very grateful for the amazing care I am receiving. I am going to enjoy at least 2 more weeks of recovery before beginning whatever is next in this treatment journey.

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