“Hi, This is Dr. Rugo. Sorry to call so late, I was in clinic and couldn’t call before this.”
It’s 9 p.m. I guess I’m not the only patient who gets such detailed care from Dr. Rugo.
“We’ve got the oncotype test results back. And the results are interesting. The test showed negative for Her-2, when all the others had it as borderline. And the Oncotype recurrence score is high, 53. Without chemo, this tumor has a 25-40 percent chance of recurrence. But it seems crazy to do aggressive chemo on such a small tumor.”
I suck in my breath. If the recurrence score is less than 19, then a patient with early stage cancer may be able to avoid chemo. A score of 19 to 30 is considered “intermediate risk.” But 53. Even with my still-sketchy knowledge, I know that’s bad. And yet, it’s good. The tumor is small, it’s out and in a freezer. Thank God for the paranoid radiologist who sent me for a biopsy. If this nasty little thing had been allowed to grow for another year, I suspect I’d really be in trouble.
“I’m prepared for the fact that I’m going to have to do chemo,” I say with false bravery. Actually, I’m not prepared at all. I have an inkling that it’s going to be unpleasant, but I don’t know exactly how my body will react, how bad it’s going to be.
“Yes,” Dr. Rugo says. “I think we’re going to have to go with six courses.” Then she goes into the pros and cons of different drugs, some of which I haven’t heard of yet. She says that the cocktail she’s considering is not as bad as some others, but that she’s not sure.
“I’m going to present your case in clinic tomorrow,” she says. “I’m going to see what my colleagues think is the best course. I think I know what I want to do, but I want to get their input. This is one of those cases where there is no right answer.”
My cancer has just gone from garden variety to interesting. I’m not sure how I feel about that.