Triple-Negative Breast Cancer

Caveat - my medical knowledge fits in a thimble, but this is what I've been told.

At Bumrungrad Hospital in Bangkok, the surgeon (4th from the left in the website photo) explained that breast cancer tumors may be "fed" by estrogen, progesterone, or another hormone they refer to as HER2. When that's the case, the patient gets just radiation therapy instead of both chemotherapy and radiation. Then she is given medicine for about five years in order to suppress the hormones and prevent recurrence. The surgeon in the US gave the same explanation.

Nancy's pathology tests in Bangkok indicated that she had a "triple-negative" cancer, so we had resigned ourselves to chemotherapy. As it turned out, there were some insurance complications in Bangkok so we decided to come back to the US and get everything done here.

We had all of Nancy's medical records from Bumrungrad except for the actual tissue slides from pathology and the surgeon really wanted to see those. No worries, she was removing the tumor anyway, so she just had it sent to pathology to confirm the findings.

Some people would say that the Bangkok hospital made a mistake. We'd love to have the slides to double-check them because we believe that the prayers of many people in many languages in many parts of the world were answered with a "yes" -- the second pathology showed that Nancy's tumor was 98% estrogen-positive and somewhat HER2 positive. We're skeptical that an hospital that is certified to USA standards would be that far off on two of their lab tests. We believe that God answered prayers.

After surgery, part of the tumor made the trip to the West Coast for Oncotype DX testing. We should hear the results next week. There are three possibilities: It may put Nancy in a low risk category, medium, or high. High means 4-6 months of chemo (depending on what's type is prescribed) followed by seven weeks radiation. Medium means a decision has to be made weighing the benefits of adding chemo to radiation therapy. Low means Nancy would not need chemotherapy; only radiation and the five years of homone suppressant.

We're hoping, of course, that Nancy won't need chemo. A radiation-only regimine would mean Nancy would finish her treatment in time to be in Florida for the birth of our grandson and we'd be able to return to Hanoi for the fall semester. That's what we're praying for but, not being doctors, we're willing to trust God for the best answer and leave the decision to His providence.

PS -- Soon after we left Hanoi in January, we found out that the sister of one of my Vietnamese colleagues was also diagnosed with breast cancer and was scheduled for surgery. For privacy, I won't include her name, but please pray for a full recovery for her.

Waiting For the Rest of the Story

Well, we're into our fourth week in Greenville. My brother & sister-in-law have been incredibly gracious and generous during our stay with them. Nancy's surgery went well, which you probably already know from her Caring Bridge posts. The tumor turned out to be Stage 1 and it is not triple-negative, which is good news.

Tissue was sent off to CA for Oncotype DX testing, which is supposed to determine whether or not she will need chemotherapy. We're obviously hoping she won't! We're expecting to find out on Tuesday when she meets with the radiation oncologist.

Surgery Scheduled

We met with the surgeon this morning and scheduled Nancy's outpatient procedure for Wednesday. About a week after that she'll have a follow up visit and then we should be able to find out how long the rest of her treatment will be. We're hoping for the best case because that would allow Nancy to be in Orlando when Hannah's baby is born in early July. But first things first.