12/19/2014
In concluzie tu singura/r esti experta/ul in ceea ce priveste cancerul tau.Fii confidenta/t si intreba despre tot ce te framanta si nu te lasa sa dormi noaptea.Intuitia nu poate fi over-estimated.
Dupa diagnostic - alege operatie fara biposie daca este posibil ..Daca ai o tumoare de pana la 2 cm poate fi excisa si apoi se fac teste pe ea; nu este nevoie de biopsie pe tumoare ci doar la ganglioni.
Operatia:discuta specific cum vrei sa arate cicatricea in caz ca nu mai faci alte interventii.Flat sau vrei rezerva de piele pentru reconstructie?
Pentru reconstructia sanilor considera:
1.Sentimentele si emotiile tale
2.Starea sanatatii; se poate face reconstructive imediata sau intarziata?Eu am dorit imediata insa circumstantele mele au fost defavorabile.
3.Considera cate operatii si programari vei avea nevoie sa faci si cum se potriveste acel plan cu viata ta?Vei avea nevoie de interventie chirurgicala in viitor ?Pentru implant sunt mai mult eoperatii dar si pentru folosirea tesutului propriu se fac retusuri de multe ori.
4.Cicatricile
5.Lipsa de senzatie in sani
6.Aspectul estetic
7.Din ce anume "material"doresti sa fie reconstruit sanul
8. Perioada de refacere.
9. Vorbeste cu cineva care a trecut prin experienta; intreaba doctorul daca poate sa iti arate poze cu operatii anterioare si/sau daca poti contacta un fost pacient
10.Radiatiile modifica calitatea pielii ..Discuta prioritati cu doctorul oncolog
11.Informeaza doctorul chirurg inainte de operatie daca alegi reconstructia sau nu.In cazul in care nu mai doresti reconstructive dupa mastectomie trebuie sa ai o forma acceptabila a "sanilor" ramasi in loc de doua deformitati, diferite.Flat e forma general acceptabila cand nu doresti reconstructive dar daca alegi reconstructive atunci tesutul este salvat pentru urmatoarea operatie.
12.Informeaza-te daca operatia profilactica este benefica situatiei tale specifice
13. Alege bine chirurgul plastic pentru ca unii sunt specializati doar pe o anumita procedura care poate sa nu fie ce iti trebuie tie ! Cere dovada pentru cate operatii de aclelasi fel cu a ta are la activ.Cere dovada de certificare pentru chirirgul plastic.
14.Gaseste support si camaraderie in grupul tau de prieteni si/sau familie
15.Intreaba daca suplemente ca Biotin sunt recomandate.
RECONSTRUCTIE IMEDIATA VS INTARZIATA
Reconstructia imediata rezerva mai mult tesut pe care chirurgul plastic sa il manipuleze si o operatie mai putin. La operatia intarziata cicatricile trebuiesc indepartate impreuna cu eventuale semne lasate de radiatii.Operatia intarziata iti confera mai mult timp de gandire si ajustare emotionala, daca iti trebuie.Unele femei prefera sa se refaca dupa masectomie inainte de a considera reconstructia.Femeile ce fumeaza,au diabet sau sunt supraponderale sunt incurajate sa amane reconstrutia din pricina obstacolelor surgicale si modului lent de vindecare.Eu am optat pentru reconstructie imediata insa a fost refuzata deoarece nu am vrut tratament cu radiatii.
FARA RECONSTRUCTIE
Cateodata reconstructia nu este o optiune din cauza diagnozei (metastaza) sau a conditiei fizice.
De asemeni poate fi o alegere personala pentru femei care sustin ca frumusetea vine din launtru.Decizia este personala.Unele femei aleg sa poarte bustiea cu proteza care poate fi greu de suportat vara, am inteles eu de la un chirurg pastic - se incalzeste.
SECHELE
Cam la o luna dupa incheierea chimioterapiei bratul din partea cu ganglioni extrasi a inceput sa amorteasca usor.Ma trezea putin noaptea.
Azi,01/09/2015 ma trezesc cam de 3-5 ori pe noapte cu intepaturi intre varful degetelor si pana deasupra cotului, urmate de dureri ascutite.Misc bratul intens si ma plimb prin casa.Dureaza intre 15 minute si pana la o ora uneori.Cateodata si bratul al doilea amorteste dar numai la nivelul degetelor.Intepaturile se intampla imediat cum ma intind in pat uneori si alte ori la o ora dupa culcare.Nu ma odihnesc noaptea.
A TRECUT UN AN
04/08/2015 La trei luni de la chimioterapie nu mai am crampe, ma odihnesc noaptea.Unghiile se refac inca.Parul a crescut cam 2 cm,aceeasi culoare dar putin ondulat.PH este intre 7.5-8.0 si trebuie mentinut acolo.Am scanat creierul si apare normal.Urmeaza scanat de oase si piept plus test sange in luna mai.Ma simt bine dar nu neaparat strong.
Urmeaza sa introduc tumeric dimineata si la culcare - amestecat cu lapte caldut,iaurt,sau miere.Sau vezi aici : fiert 10 min in apa (TURMERIC,CURCUMIN)
https://www.youtube.com/watch?v=FXIIreujNyo
TAMOXIFEN
ASIGURA-TE CA PENTRU RECEPTORII TAI IN PROCENTE TAMOXIFENUL ESTE CEA MAI BUNA METODA DE TRTAMENT HORMONAL.DE ASEMENI CERE LA ONCOLOG UN TEST PENTRU ENZIMELE CE INDICA DACA TAMOXIFENUL ESTE BENEFIC PENTRU ORGANISMULTAU.
Medicamentul ce suprima hormonii il iau o data pe zi, la aceeasi ora, 20 mg.Simt hot flash de la el uneori si parca adorm mai greu. Se pare ca este un indiciu bun cand ai hot flash noaptea - cancerul nu revine.
Tamoxifenul nu se amesteca cu anumite medicamente deoarece interfera cu absortia.
REMISIA
If you take Tamoxifen, you will get two benefits. The first is a reduction in your risk of local (in the breast) recurrence. Tamoxifen can reduce your risk by approx. 45%. The big question however is "what is your risk of recurrence?". What is your age? How large was your tumor? Was it in a single focus or was it multi-focal? How large were the surgical margins? A clear margin is anything more than 2mm in size; an ideal margin (one that significantly reduces recurrence risk) is at least 10mm in size.
If you had a small single focus of grade 2 DCIS with no necrosis, and if you had very good margins (ideally 10mm), then your risk of recurrence might already be quite low. If it's 8% (as an example), then taking Tamoxifen for 5 years can reduce your risk to 4.5%. That might be enough to warrant taking Tamoxifen, or you might look at the 8% risk and feel that that's okay. On the other hand, if you had multifocal DCIS, if you had any necrosis (which is possible even with grade 2 DCIS), and if your margins were small, then your risk of recurrence might be quite high. If it's 20% (as an example), then taking Tamoxifen for 5 years can reduce your risk to 11%. That's a pretty significant benefit from Tamoxifen, although again here it's an individual assessment on whether it's worth it or not.
The second benefit you get from Tamoxifen is protection of your breasts (both breasts) against the development of a new primary breast cancer. Here the benefit is again approx. a 45% reduction in risk, but the benefit from taking Tamoxifen for 5 years will only last for maybe about 15 years. So depending on your age, this 15 year benefit might cover most of your remaining lifetime risk (if you are 70, for example) or it might not cover much of your remaining lifetime risk (if you are 45, for example). What you need to do is find out from your oncologist what your lifetime risk is to get BC again - generally once we've been diagnosed one time, our risk to be diagnosed again is about double the average for someone our age. Remember that this risk is calculated to the age of 90. Once you know your lifetime risk, you can figure out your annual risk (a rough calculation is to divide your lifetime risk by the number of years till you turn 90) and then you can determine the benefit of Tamoxifen (a 45% reduction of your risk for approx. the next 15 years). At the time of my diagnosis when I was 49, my lifetime risk to be diagnosed again was 22%; I calculated that 5 years of Tamoxifen would reduce my risk down to approx. 18%. I decided that this amount of benefit was not worth the risk of serious side effects and quality of life issues. But others would jump at the chance to get this amount of benefit, so it really is a personal decision.
For those who have invasive cancer, there is a third benefit to Tamoxifen, which is a reduction in the risk of distant recurrence, i.e. mets. That to me is the most significant benefit of all, but because those with DCIS don't face a risk of mets, it's not a benefit that's relevant to you or others with DCIS. This is important to keep in mind as different people respond - the benefit we each get depends on our diagnosis and no two situations are alike.
I hope that helps!
Dx 9/15/05, DCIS-MI, 6cm+ Gr3 DCIS w/IDC microinvasion, Stage
IA, 0/3 nodes, ER+/PR- “No power so effectually robs the mind of all
its powers of acting and reasoning as fear.” Edmund Burke"
