First, thank you for all of the outpouring of love and support. It means a lot to me. I may not get a chance to respond to everyone, but know that I appreciate all of it.
There have been many questions since I announced the initial diagnosis, mainly centered around two things--what exactly do I have, and what is the treatment plan? I'll try to answer those both below. We've heard a lot of phrases and technical terms lately--so consider the information below directionally correct.
What Exactly Do I Have, and How Was It Discovered?
If you want to skim the post, here's the conclusion: my breast cancer is the most common type, called invasive ductal carcinoma. It is located in the right breast, and in approximately 10 lymph nodes located under my right armpit. Based on the tumor's size and the presence in the lymph nodes, it is considered Stage 2B breast cancer. It is E+, P+, HER2-, which is both the most common type of cancer and also a really "good" kind -- my cancer feeds on hormones, so blocking those hormones will be part of the overall treatment.
Many have asked if I noticed or felt anything that led to this diagnosis. Nope. This was discovered with a routine mammogram (insert public service announcement for you to schedule yours), which was the first of six investigative procedures I've had to date.
After the mammogram came back, suggesting further investigation, I had a diagnostic mammogram and ultrasound (procedure 2 if you're keeping track). That came back with further concern, categorizing a finding in the right breast with a BIRADS score of 5. That was highly disconcerting, as any quick Google search indicated that a Category 5 meant "highly suspicious of malignancy." Read a little more, and a score of 5 means a 95% chance of cancer. I spent a few nights (until the wine kicked in), hoping that I could be part of the 5%.
The next step (#3!) was a series of biopsies that I had at the UCSD / Komen center. There were three biopsies performed--one on that Category 5 mass; another mass that looked suspicious, and on one enlarged lymph node.
I'll say it many times, and I'll say it again--thanks to my dear friend Shannon (a doctor) who helped to minimize both the time in between these steps and the time in getting results after each procedure. We got the results within 24 hours of the biopsies, and darn it, no 5%--cancer was confirmed in both the Category 5 mass and the lymph nodes.
From there, it was on to Step 4--a PET Scan. The PET Scan shoots you up with a radioactive drug tracer that targets cancerous cells throughout the body (this is the time when I should remind you that I'm not a doctor, so I may be slightly off on some of these things). The PET Scan was done late on a Tuesday night ("thank you, Shannon" is now a shortcut on my laptop) so we could have the results for our Surgical Oncology visit the next morning. During that discussion, we met the surgical oncologist assigned to my case, who reviewed my file, stated that surgery would likely follow some type of medical treatment given where I am, and recommended both an MRI and an ultrasound of my left breast to be super sure that only one boob was trying to kill me (and based on my website name, you can probably deduce that all is good with Lefty. Oh and that was procedure #5). I can't say for sure I loved the idea of meeting first with the surgical oncologist when the plan was almost certainly a treatment, but she was great, and it meant just waiting one more week for The Plan.
Step 6 was the last, and by far the worst, to date. I don't recommend an MRI on a Tuesday at 9 pm. Laying flat, face down, in an MRI was a high anxiety and traumatic experience for me. The MRI was needed to evaluate the mass further to help define the best treatment and to confirm the presence in the lymph nodes. But the sound of the machine, the time of night, the fact I was there all alone--let’s just say that MRIs are not my friend.
We met the medical oncologist the following day---a summary of the plan is below:
I Love Plans....but maybe not this one?
In one sentence--chemo, then rest, then surgery, then rest, then radiation, then oh my goodness, it's the middle of 2021!
Okay, some more detail--
Chemo: We're going to start the first week of November with Chemo:
8 doses, every other week, for a total of 16 weeks. There are two different drugs I'll have--the first is the harder one to handle, followed by a second drug for doses 5-8.
We'll likely do these on a Thursday, and then I'll rest/recover on weekends with Rick, where I'm kid-free and can get some rest. We've been told fatigue, loss of appetite, and potential nausea are the biggest side effects.
You know what the real side effect is though? I'll be losing my hair within the first couple weeks of the first treatment. I don't think I'll look great bald, and I don't think scarves are my thing—more on this on another post at some point. But one more thing--what's crazy is that some people have their hair grow back in different colors and different styles--what if I get thick hair when this is all done?!
Surgery: After chemo, and approximately a one month wait period, there will be surgery. It’s very TBD now, and a lot depends on how responsive the cancer is to the chemo treatment. There are some long-term side effects/risks with lymph node removal--I'll be rooting for the chemo to do its thing and reduce the amount of lymph nodes needing to be removed. As for the type of breast surgery, again, that's TBD.
Radiation: After recovery from surgery, radiation will begin. It will be 4-6 weeks, 5 days a week (for roughly 10-15 minutes each day).
All in, this is likely 30 weeks. If we start in November, that likely means I'm finished end of May / early June.
Treatment in the time of COVID
On a positive note, there are great precautions taken to ensure my safety. Before I start treatment at each chemo session I'll have a COVID test. On a really unfortunate note, all doctor appointments, exams, and treatments will be alone. Rick has been on the phone for all meetings so far, and won't be able to be there during the treatments.
Many of you have already offered to be with me during the 6-8 hour chemo days, and for other appointments. I deeply appreciate the offers, but that's just not feasible given the pandemic, sadly.
You're Still Reading?!
Wow thanks! There are a few other details I didn't get to--I'll be doing some genetic testing; there was some discussion about a clinical trial I could get into, and we didn't discuss any of the hormone therapy that will go alongside the chemo in my treatment plan (a daily pill or injection for at least 5 years?!). More on those things at a later time.
Before chemo begins, I will have one more step--getting a port implant surgically installed in the chest. With me being poked and prodded constantly, this is the general practice to ensure doctors don't have to use up every vein in my body for treatment. That will happen in late October on an out-patient basis before I start chemo.
A few final thoughts:
I know this is treatable, and many have successfully dealt with this cancer. Add one more to the list.
Everyone asks how they can help--the honest answer is I just don't know at this point because
a) I am really uncomfortable asking for help in general and
b) I just don't know what and how I'll react when the treatment plan starts.
I truly and deeply appreciate all of the offers. Rick will reach out and likely be the one to respond to most offers for help based on where we are once the treatment begins. If we don't respond, please don't take it personally--I already feel guilty that people are worried about me! Truly.
Actually, here's how you can help--I'm gonna have some long days of chemo treatments, recovery days, etc. ahead of me. What should I be binge-watching?!
xo-
-Heather