Percentages

I'm discovering that dealing with cancer long-term is all about percentages. Once the initial tumor or tumors are removed, it becomes a game of statistics, i.e. What is the chance that the cancer will come back to the original location or appear somewhere else in the body?

In my case, by opting for the double mastectomy, I've pretty well eliminated the risk of the cancer coming back in the same location. Now, I have to decide what my comfort level is with the risk that the cancer will show up someplace else. That risk factor changes depending on what adjuvent treatment I choose.

I met with the new oncologist yesterday. After talking with him and looking at the basic risk factors: tumor size, tumor grade, hormone receptor status and node status, my husband and I agreed with him that more data would be helpful. Basically, using those 4 factors, if I go with Tamoxifen alone, my risk of recurrence is 10%. If I go with Tamoxifen and chemo, my risk of recurrence is 5%. In the world of cancer, these are supposed to be very good odds. The oncologist said I am a pretty straightforward case, but he thinks having more data would be helpful. So, we are doing the Oncotype DX test. This test looks not at the 4 factors, but at 21 genes in the tumor to assess recurrence risk and it seems to be the best predictor test for my particular type of cancer. So, in 10 days, we'll have more data to help us decide what to do next.

Dealing with cancer in this way is odd at best, and more disconcerting than I'd like. I do understand that my risk of having the cancer come back is pretty low, but the thing I can't seem to shake is that my risk of ever getting breast cancer in the first place was even lower. And yet, here I am.