So what's next?

The past couple of weeks I've been getting a lot of questions around the next steps and timeline of my treatment. So I made a process flow chart and a gantt chart to illustrate what's next. (That's normal, right?) 

Click on the chart to enlarge

My chemo started with two drugs that I had four rounds of in July and August. I'm currently half way through my second phase of chemo with another set of two drugs. If I have no delays, I would get my last treatment December 1st. That's six more weekly rounds of chemo. 

I need 4ish weeks to recover from the chemo before surgery. They want my platelets and WBCs nice and high before such a significant operation. This puts us right around Christmas/the first of the year for surgery.

Surgery will take place in Houston at MD Anderson. I will be getting a modified-radical double mastectomy- meaning that they will remove both breasts, a whole bunch of lymph nodes in my armpit, and a whole lot of skin. The modified part means they leave muscle behind. I will only stay in the hospital for one night but will stay in Houston for a few nights afterwards just to make sure my recovery begins smoothly. 

I will need 4ish weeks to recover from surgery before we start radiation. Radiation will also take place in Houston at MD Anderson. The plan is to have 44 rounds, twice daily, each weekday. That will take 5ish weeks to complete. 

All the treatments should wrap up late spring/early summer. This is assuming everything goes perfectly of course. There are a couple deviant paths I'm currently aware of. I've outlined those in the flow chart below:

Click to enlarge

The first hurdle is get through the trimodal treatment plan - chemo, surgery, radiation. Hopefully at the end of all of that I'm cancer free. Unfortunately though, I will not be home free even after all the treatments. The big question is did the treatments kill EVERY SINGLE cancerous cell? Because if not, it will re-assert itself when I don't have chemo going thru my bloodstream. If you remember this curve:

Survival curve

The curve doesn't really start dropping until after a year- when your treatments have stopped and the cancer has a chance to come back. So step one is get thru treatments and have "No Evidence of Disease". Then step two is wait to see if it comes back in the next five years. I think that might be the hardest part - waiting to see if it comes back. 

I'm going to take this one step at a time and keep giving this all over to God. I'm also going to fight this crazy hard and will keep planning on achieving a 5-year No Evidence of Disease until we have any evidence to the contrary.  So our target milestone is ~July of 2019 - right around David's 5th Birthday.  We're already planning a HUGE party to celebrate, so save the date - you're all invited.

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