“I see.” Big Al quietly nodded, then knelt down to rub JoJo’s head.
The huge man always felt better if he could touch his dog. The grounds had cooled off enough that he could walk the perimeter with JoJo.
“Don’t worry, Daddy. I’ll protect you!” the mixed breed promised.
Al stood up; his knees creaked a little. “Jewish lightning.”
“Beg pardon.” Greg’s eyebrows raised upward.
“When I was a kid, they called arson Jewish lightning.” He sighed deeply. “I hated that, and I hate this.”
What do I do now?” Harry sat next to Dr. Regina MacCormack as the doctor pulled up information on her computer screen.
“You have choices. I can offer my advice, but you have to make the decisions.”
Harry exhaled deeply. “Tell me again what Stage One breast cancer means. Sorry to make you repeat yourself.”
Dr. MacCormack had known Harry as an acquaintance for many years, and liked her enormously. The feeling was mutual. Their hobbies were so different that when they saw each other it was usually at a fund-raiser or down at the Paramount, the rejuvenated old movie theater that had transformed itself into a cultural hot spot.
Harry, with a hint of defiance, said, “I’m not going to cry.”
“No harm in it, but I know you’re not a crier, and I also know you’ll fight.”
“I will.”
“All right. Stage One breast cancer means the cancer is in your breast. Although it doesn’t look like it, there’s the possibility that it has spread to your lymph nodes. We remove them, because they are the body’s dispatch stations. However, I don’t think your cancer has spread, and I’ve seen a lot of breast cancer. Far, far too much, really.”
“It’s an epidemic, isn’t it? An unacknowledged epidemic.”
“That’s a later discussion, but”—Regina leaned back in her seat, taking her hand off the mouse—“something is wrong. It isn’t just breast cancer, Harry. It’s all forms of cancer. Well, I’m already getting off the track. Stage Two. The eight-year survival rate is seventy percent, quite good, and you are an excellent candidate as you have Stage One. Better survival rate.”
“Do I have to have surgery?”
“I would suggest it.” She paused. “The two best surgeons, I think, are Cory Schaeffer and Jennifer Potter.”
“I’d have a hard time trusting myself to a man who bought an electric car.”
Dr. MacCormack burst out laughing, for she knew of Harry’s fascination with cars. “He’s in love with that car.”
“Yuck. Besides, if someone is fooling around with my boob, I want it to be a woman.”
“Many women feel that way. But there are some fabulous men out there, and they are as sensitive as any woman oncologist I know.”
“Cory Schaeffer isn’t one of them,” Harry posited.
Dr. MacCormack lowered her voice, even though it was only the two of them in her office. “He does think highly of himself. You already have a relationship with Jennifer Potter. You’ll need to consult with her before your final decision, of course.”
“All right.”
“We can make an appointment for you,” Dr. MacCormack offered. “Let’s consider what’s possible. Obviously, the absolute safest course is always a radical mastectomy, because everything goes. No nasty cancer cell escapes if the cancer is contained in the breast. This is such radical surgery. But I must say, it is the most complete, and you can have the reconstructive surgery done while you’re on the table. Saves two surgeries. I don’t think you need a mastectomy, however.”
Harry slumped a little. “Thank God. I know there are worse things. I think about the men and women coming back from Iraq and Afghanistan who are blown up. This is small beans, but then again, it scares me even though I know there’s a lot more bad stuff that could happen to me or anyone.”
“You’ve got the right attitude. I knew you would. What I think will provide you with the least trauma is a lumpectomy with post-op treatment A lumpectomy means the tumor and some surrounding tissue are removed but not your whole breast.”
“That means chemo and radiation, doesn’t it?”
“Depends. It is possible when your tumor is removed you may not require chemo and radiation, or you may not require chemo.” Noticing Harry’s quizzical look, Dr. MacCormack continued, “Based on your biopsy, the location of the tumor, it will definitely grow if unchecked. Stage One is a proper diagnosis based on the size of your tumor, just shy of one centimeter. Again, I don’t think the cancer has spread to your lymph nodes, but we won’t be one hundred percent sure of its size until it’s out. If the tumor is over one centimeter, then you are considered Stage Two. It’s not as bad as it sounds—Stage Two, I mean. We won’t know until the tumor is actually removed. But—and I emphasize but—to be as safe as possible, a regimen of radiation and possibly chemo after surgery is prudent. If the surgeon missed any cells or some actually have migrated—it only takes one—the treatments will kill them.”
“Might kill me, too.”
“No. You’re forty, strong, not overweight at all, no diabetes or any conditions that could compromise healing. You’ll live through it, but I’d be a liar if I said it won’t have a cumulative effect. The farther along you are in those treatments, the worse you feel. Some patients report nausea, especially with chemo, but some also feel a bit off that way with radiation. Both radiation and chemo make you tired. And I repeat, it’s cumulative.”
“How long must I submit to treatment?”
“Again, Harry, we won’t know until we have the tumor. I hope it will be a short course.” Dr. MacCormack’s voice, soothing, was a tonic in itself. “Let’s just knock this right out of you.”
“I’m for that. Is there a course of treatment that doesn’t have such awful side effects?”
“Herceptin is a new drug used to treat women with metastatic breast cancer who are HER-two-positive. You aren’t HER-two-positive.”
“Should I be glad about that?”
Dr. MacCormack nodded, then added, “About twenty-five percent of women with cancer have an excess of the protein which makes the cancer spread quickly. Called HER-two. You don’t fall into that twenty-five percent, which I know from your bloodwork.
“However, you are premenopausal, so your body is still pumping out lots of hormones. There are drugs to inhibit the cancer getting the hormones it needs to grow. But again, you’re lucky because you don’t have hormone receptor–positive cancer. You’ve got a straightforward type of cancer. We can treat it in a straightforward way.”
“Well, it’s hard to think of myself as lucky at this moment, but I guess I am.”
“You have no idea.” Dr. MacCormack looked serious. “Again, we’ll know a lot more after the surgery, and I am already assuming you will have the tumor removed.”
“I will. I want to talk it over with Fair, but I will.”
“He’s a vet. He knows a great deal. In fact, some of what we have learned we’ve learned from cancers in dogs. Some breeds are especially prone, like golden retrievers and boxers. You’d be surprised how much veterinary medicine helps human medicine. An obvious example: The research and surgeries on dachshund back problems have proved invaluable for human treatments.”
“Sounds like you think I should go under the knife straightaway.”
“I do. I’ve seen so much, Harry. Get it out.”
“All right.”
“We’ll make you an appointment to consult with Dr. Potter. We have a roster of wonderful surgeons in our area if for some reason you don’t click with Dr. Potter on a patient level.”