"If the rumor is tumor, then the issue is tissue, and the answer is cancer."

When Laura began chemotherapy, it seemed like a there was a long road in front of her, full of unknowns. We've seen her tackle each and every hurdle like a warrior princess - scared at times, but ready to face the next hurdle. Last week we had two important appointments concerning the next steps after her last chemotherapy treatment on September 27.

In a pre-op appointment with the general surgeon, Laura was informed that the surgery would likely take place two, possibly three, weeks after the final September 27 chemo session. Now that the team has been chosen -- general surgeon and plastic surgeon -- it's a matter of scheduling and we should learn the date this week. It will likely be the middle of October. The surgical procedure will include a "modified mastectomy" on Laura's right breast, which will include the removal of her level one lymph nodes, approximately 12-15 nodes, according to the surgeon. Laura will receive a "simple mastectomy" on the left breast, which has no involvement of the lymph nodes. We are anticipating Laura spending one night, possibly more, at the hospital for this surgery. The final pathology report on the breast tissue will be completed two to three days post-surgery, and the results will influence the course of treatment following surgery, either radiation or participation in a clinical trial for triple negative BC patients such as Laura, followed by radiation. Physical therapy begins quickly, two weeks after surgery, to help Laura regain strength and to avoid lymphedema, a swelling in the arm area caused by fluid retention and resultant swelling of tissue.

Because her treatment includes radiation at some point following surgery, Laura also scheduled an initial consultation with a radiation oncologist last week. There we learned that assuming a complete response to the chemotherapy (i.e., no live cancer cells in the pathology report), Laura's radiation treatments will likely begin 6-8 weeks after surgery. Laura will receive 25 radiation treatments, each lasting about 15 minutes, stretching over 5 weeks. Because of the level of involvement in Laura's right breast, the treatments will be comprehensive, not pinpoint, so her entire chest wall, the lymph node area, and some of her neck area will receive a 5000 centigrade dosage each time. Possible side effects Laura may experience include fatigue, possible swelling of the chest wall and arm, and sunburn-like effects on her skin such as redness, soreness, itching and peeling. The doctor described the various steps we can take to help lessen these effects, such as using certain lotions and soaps and wearing loose cotton clothing, etc. Because it is so important to keep her skin supple in order to prevent the buildup of scar tissue, Laura will have to massage the area, essentially circling at least 100 times, on a daily basis.

After meeting with the physicians that will complement the work done by her oncologist, Laura is ready to finish her last two sessions of chemotherapy, let the potent drugs do their work, and then let the surgeon and radiation oncologist add their expertise. We all feel confident that the Laura has a superb team, that she is receiving the best of care, and that she is handling the entire experience with courage and grace.

We are praying, and would like those of you praying for Laura to include in your prayers:

God, we thank you for the progress made thus far in the treatment of Laura's cancer, and now we ask that you renew her immune system's memory to seek and destroy any remaining cancer cells.