Sunday, October 26, 2014

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.

5 comments:

  1. Ashley, I'm not sure if my first comment went through! Sorry if this is a repeat...

    I hope you remember me from Georgia Tech - I was Betsy Sugg back then. I just want you to know that you are in my regular prayers. I saw on Facebook earlier this year when you were first diagnosed. Our sons are about the same age, and I was so heartbroken to read that you are having to go through all this, imagining how I would feel if I received that diagnosis. I wrote your name down on a page I keep in my Bible and I've been praying for you ever since. Reading your blog post now, I have to tell you, I'm so encouraged by you. We had some very difficult stuff to work through as a family this past week, and your blog post spoke to me about my situation, too. Thank you for that.

    Beyond that, I'm encouraged by your determination and perspective about your treatment. I'm keeping you in my prayers for uninterrupted therapy and for complete recovery. Sending my love.

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  2. I loved your charts. Very you and very helpful to the rest of us. :) Can't wait for that big party, expect lots of presents for everyone. ;)

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  3. Loved your diagrams. Uncle John was right when you said you knew a whole lot! Thanks for making them so the rest of us can keep up. Just spoke face to face with a friend of mine who had the whole double mastectomy, chemo, radiation and a bunch of lymph nodes removed. She looks great and has a ton of energy. I hope that encourages you like it did me! Keep fighting the good fight of faith Ashleigh, we're behind you all the way!

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  4. You let me know what you need here in Houston!!! I don't care how little or big the request!

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  5. Ashleigh, I am praying for you often. I am praying for healing, nothing less! I am praying to Jesus, in his name, with his authority. We are all praying! I am amazed at how often and at the most random times God places you on my heart, a woman I have never met and probably will never meet. God is good at that. He must really love you girl!

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