Recently diagnosed, Assistance with terminology.

Sampy,

Cancer is sneaky because you don't know what it's going to do. If you read through this board, you will find people who were initially diagnosed with a very aggressive cancer and who despite all their treatments still faced a high risk of recurrence, and yet they are doing well and have never had a recurrence, many years post-diagnosis. And you will find people who were initially diagnosed with a seemingly indolent cancer and who required minimal treatment, who may even have been told by a doctor that they were cured (silly doctor!) and yet they've been hit by a metastatic recurrence and now are Stage IV. There are probabilities about what might happen with every diagnosis, but there is no way to know what will actually happen for any one person.

Cancer is also sneaky because it only takes one rogue cell to raise havoc. Most breast cancers have been in the breast for several years before they become large enough to be detected. During all that time, before anyone even knew about the breast cancer, a few cancer cells from the breast might have found their way into the bloodstream or lymphatic system and floated away to another part of the body. These cancer cells find a comfortable spot and set up there. If it's only a few cells, it's completely undetectable. These breast cancer cells might lie dormant in their new home for a few years or many years. And then one day, they start to multiply and develop into a metastatic recurrence - in the liver or in the bones or in the lungs or somewhere in the body. This is why, unfortunately, once diagnosed with invasive cancer, we are never in the clear. While most recurrences happen within the first 10 years, some people are shocked to have recurrence after 15 or even 20 years.

It's because of this risk from these undetectable rogue cells that almost every patient with invasive breast cancer is prescribed one or more systemic treatment, such as chemo or anti-hormone therapy. The goal of these treatments is to track down these breast cancer cells, wherever they might be in the body, and kill them off. Thanks to chemo and anti-hormone therapy, many patients who otherwise would have developed a metastatic recurrence never develop one**. Unfortunately, no treatment is 100% effective, so despite treatment, some patients nevertheless face a recurrence. Here too there is no way to predict what will happen to any one of us.

That's why cancer is considered sneaky. You don't know what it's going to do. You don't know where it might turn up. And that's why treatment decisions are so hard - we make our treatment decisions based on possibilities and probabilities and hope we made the right decisions and that the treatment works.

** Within the PREDICT model, for someone with your diagnosis, the patients who otherwise would have developed a metastatic recurrence but never do are the 22% of patients who are alive at 15 years thanks to chemo and anti-hormone therapy.

Edited for typos only.

Quoting sampy from above "What truly stands out is "chemo is life" care of Moth - that refraining of the word has had a tremendous effect on me. If the situation were flipped and either my husband or our Maine Coon required chemo, I'd be insisting on chemotherapy and radiation, so why not for myself?...Bessie, you're absolutely right, for 48 years I've been in tremendous health (give or take a few partying years) that's held me in good stead, and now is the time that I should take advantage of this because I've had breast cancer. If others can withstand chemotherapy after chemotherapy while in a worse predicament than me, why the hell have I invested so much time in my health? So I can look pretty in my coffin? ...I think I need to challenge myself, I've had 48 good years, so from this point forward, things will be different, not necessarily tragic, it's just a change of circumstances.... I don't want to regret no having treatment because I was a afraid and didn't wish to be inconvenienced"

Sampy, what you said makes a lot of sense to me! I am very happy to know you are open to doing the recommended treatment now, in order to give yourself the best chance at a long and happy life! Invest now, big payoff later. The stage iv people like me, we like you, but we do not want you to join our stage iv club, the club nobody wants to join. There is something special about you that comes through your posts, I think you are a spirited person, and that you will ultimately handle things and triumph. I hope that does not sound corny; it is hard to find the right words.

No worries about saying you didn't want to scare me. I just smiled ruefully and said, "Honey, you can't scare me." But this was not my attitude when I was first diagnosed. I just had to have that courage that means though you may be afraid, you do what needs to be done anyway. Then you learn just how strong you can be. There are many, many bc patients in your position who end up saying it was not as bad as they had feared.

P.S. I am very sorry for the tragic loss of your mother.