Buh-Buh-Buh-BOOYA!

So I got my pathology report back.  I also saw the surgeon today who explained what it meant.  Two main points:

1)   NO RESIDUAL INVASIVE TUMOR IDENTIFIED.
2)  AXILLARY LYMPH NODE STATUS: TWENTY TWO AXILLARY LYMPH NODES, NEGATIVE FOR MALIGNANCY (0/22)

Say what?  That means the chemo got all of the invasive cancer (more on that later).  I had a complete response.

Please indulge me.  This deserves some background music.  Click on the link below.


http://youtu.be/Dft63gHqqKo


Why is this significant?  Let me back up. The 5-year survival rate for stage 3A breast cancer is about 60-65%.  Yuck!  The 5-year survival rate for someone with a complete response to chemo is 85-90%.

That pathology report did identify some residual DCIS (Ductal Carcinoma In Situ--Stage 0 Cancer).  I guess chemo doesn't really work on that, and the course of action is to just remove it.  Done and done.  The DCIS was negligible, and doesn't affect my prognosis.

This is the result that I have been dreaming about, scouring the Internet for any data or possible treatment that improves the chances.   Only about 20% of people have a complete response.  This is why I have been closely monitoring my nutrition, juicing, taking supplements, hanging out with my naturopath oncologist, and avoiding the bad stuff that I used to regularly indulge in.  All for the hopes of a complete response.  YEA! YEA! YEA!  Although academically, a 65% chance of survival doesn't sound that bad....applying it to your own life...it's beyond awful.  Although I tried so very hard to keep my spirits up, passing thoughts of my kids growing up without a mother, Breck left to raise them, my parents growing old without their only child to take care of them, and so on, sent me into panic attacks.   Eek.

And while I'd love to celebrate to the max tonight, I am still hopped up on Vicodin, and recovering from surgery--so I guess I'll take it easy.  If you get the chance, give my family and my wonderful husband a high five.  They deserve it.  This has been so hard on them too.

Love,

Cancer-free Carrie

Post-Surgery Update

I went in for surgery on Wednesday morning.  It went well.  The surgeon said it looked like the cancer was completely gone from my breast and possibly still in my lymph nodes, but then again, that could just be scar tissue.  This is good news.  We will have to wait for my pathology, which should be ready early next week.

The bad news is...they took my breasts.  Yes, I knew this was going to happen, but it is very difficult anyhow.  In a while, I can get reconstructive surgery. It wont be the same.  I am sad.  I am very sad.  I am bald with no boobs, with no guarantees, and this really really really sucks.  Breck has been wonderfully supportive; he helps me get dressed, runs for my Vicodin, and even strips and empties my surgical drains.

I understand the bigger picture.  My health is more important.  I hope with each passing week this gets easier.

Sad panda signing off

Surgery

Surgery is scheduled for Wednesday July 3.  After going back and forth, and meeting with two surgeons, I've decided on a double mastectomy.  Bummer.  Real big bummer.

Long story short, my surgeon at Group Health recommended that I get a mastectomy based upon my young age and the nasty nature of my cancer.  I met with three doctors at Seattle Cancer Alliance, one of whom was the director of breast cancer surgery department.  He suggested that I get a lumpectomy now, and pending the pathology from my surgery and a BROCA gene panel test, I may get a mastectomy later, or not. After thinking this was the better option, I discussed with my surgeon whether insurance coverage would be available to do this in a two-step process. She didn't think so--that a subsequent mastectomy would not be 'medically necessary'  unless something funky showed up on my pathology or gene panel.  If my pathology and gene panel are clean, I would be stuck with a lumpectomy.  I don't want to close any doors.  I'm not sure how paranoid I would be about the cancer coming back--but frankly, the tumor hid from me the first time around, and I don't feel confident I could find another lump if it came back--whether it were a recurrence of the same cancer, or a new cancer.  So back to mastectomy it is.  I go in sometime on Wednesday, and will come home on the 4th.

I wont be able to lift or carry West (or anything for that matter) for a couple of weeks after surgery. I'll have two or three drains that to deal with for about two weeks also.  Breck is off work for the summer, so he'll be around to help me and the kids.

My pathology results will be in about three working days following surgery.  My pathology results will dictate  my personal prognosis.  I definitely appreciate all of the good vibes, prayers, juju etc. coming my way that the cancer is gone or almost gone.

I will recover for a month, then start radiation.  In a year, I can get reconstructive surgery.  Not sure when that will happen.  I will probably make a decision based upon how I recover from surgery, my pathology report, and my gene panel results.  If something does come up on the BROCA panel, I may need to get my ovaries removed too.

 The Seattle Cancer Alliance also reviewed my pathology and determined that my cancer tested weakly positive for progesterone--in other words, there may be some benefit for me to take endocrine therapy--hormone therapy-- after treatment.  (I was diagnosed with  triple negative cancer, meaning that there were no hormone-positive receptors that would respond to endocrine therapy.  I was told that a cancer with weak progesterone receptors otherwise acts almost identically to a pure triple negative cancer)  It was suggested that I take Tamoxifen for five years.  The side effects of that are on par with menopause--awesome--so I may need to weigh the benefits on that.

An average woman's risk of developing breast cancer over her lifetime is approximately one in 8 (12.5%).  If nothing turns up on the BROCA panel, my risk of developing a new breast cancer is slightly higher-about 16%.  That isn't that high, but hell, I've defied the odds so far.  My stupid insurance denied coverage for this test back in March.  Since then, the Supreme Court held that a patent for testing on a specific gene isn't enforceable.  It will now be more affordable to conduct the testing--and my insurance provider may be more likely to change its mind.    I will appeal that after surgery.

Sooooo....grumble grumble grumble.  On another note, Breck and I went camping with our friends last weekend on the annual rafting trip down the Yakima River.  It was super fun, as always--despite the fact that we received an emergency text about a flash flood warning when we finished the float--oops--but no actual flood.  I have about a million bug bites on my feet too.  good stuff.

That's all for now.

Carrie

MRI

I had my last chemo on Friday. WHO HOO!!!  When the medicine was done dripping, all of the nurses came in and sang me a song.  And then I started crying.  Damn--I've turned into a hot mess.

Afterwards, we had lunch in Georgetown; I almost fell asleep at the table.  (Side note --Georgetown is really turning around with lots of cool places.)

On Monday, I went in for another MRI.  My doctor called me this morning with the results.  Everything looks normal!  NORMAL!  As in, they wouldn't otherwise know there is cancer there.  My doctor could identify a 9mm spot in my breast (along with the biopsy marker clip) that is either scar tissue or a small amount of residual cancer or both.  They can also see one larger node, it still looks normal.  This definitely has scar tissue.  An MRI is generally accurate at identifying issues, and can distinguish between actively growing cancer and scar tissue--but can't find really small amounts of cancer.  The only way to know what's going on for sure is to get the pathology report after surgery.

So thanks for reading.  I hope to have more good news soon!

Carrie

Last Chemo

Tomorrow is my last chemo treatment. I'm relieved, yet still anxious because the one thing I know is fighting those cancer cells will no longer be infused into my body.  I certainly won't miss the side effects of these treatments, and look forward to growing hair, normal taste buds, and regaining feeling in my fingers!

Next week, I'll get an MRI (to assess what's going on), meet with my surgeon, and hopefully schedule surgery.  Not looking forward to surgery; I've had more than my fair share of this horseshit.  They had better give me some good drugs.

That's all for now.

Carrie

More Chemo and progress

It's been a while since my last post.  Since then, I started a second type of Chemo called Taxol--I've had three rounds, with one more to go on June 7!  Taxol is supposed to attack the cancer cells in a different way from the first drug combo.

I get this kind of chemo in a hospital bed.  Some people are very allergic to it, but thankfully I am not one of them.  The drug can cause neuropathy, a tingling and/or numbing of the hands and feet.  To attempt to avoid this, I ice my hands and feet during infusion. Then I take glutamine for a few days.  I do have some numbing, but I can still type, so not such a big deal.  I also have a roaming itch from the Taxol.  Yes, I'm sure it's from the Taxol, despite Breck's questions about the possibility of body lice.  (He's a peach)  Starting the Mondays after chemo, I get terrible joint pain and hobble around feeling like an old lady.  This lasts for a few days.  Breck makes fun of me and says things like, "My HIP" in Grandpa Simpson's voice.  When this is over, he's going to get it!  The meals delivered to our house are total lifesavers!  Thank you soooo much to everyone who has contributed!!!!!  You guys have busy lives too, and I know making us a meal is a pain the ass.  Please know how appreciated it is!!

I had a scan about a month ago prior to starting Taxol.  At that scan, the ultrasound tech and physician told me that the tumor in my breast was undetectable and the tumor in my lymph node was still there, but much smaller.  After two rounds of Taxol, my doctor and I could still feel a lump in my armpit, so I returned for another scan last week.  I was very concerned that the Taxol wasn't working and the tumor was growing back.  Not fun.

Anyhow back at the hospital, I first got a mammogram, which I briefly saw on the computer screen.  There's the tumor.  SHIT!   I was then certain the cancer was growing back.. Maybe I should have brought someone with me!  Then, time for a scan.  The ultrasound tech found the tumor right away, and went to go get the doctor to discuss my results.  Certainly not the best moment of my life.  When he came in to greet me, he told me that everything was fine--the tumor was always in my breast, but was very close to my nodes, hence the mixup.  Also, my nodes look better than last scan a month ago--no trace of a tumor and only likely scar tissue.  The armpit lump was a displaced muscle left over from an enlarged node.  The breast tumor was about the same size, but based on the change in the appearance of the nodes, the Taxol does seem to be working.  PHEW! Of course I was very relieved that things were not getting worse.  The doctor said I'm doing great--that the chemo is doing exactly what it is supposed to do.  This roller coaster ride is BULLSHIT!

After my next chemo, I'll meet with my surgeon and get a second opinion from Seattle Cancer Care Alliance about what kind of surgery to get.  A double mastectomy?  A lumpectomy?  I've heard that getting just one breast removed is a bad idea (ending up with a fake one up high and the real one down low) Either way, they will remove a bunch of nodes from my right armpit.  I'll get to wear a sleeve and gauntlet to prevent/manage lymphodema (retention of fluid in my arm due to missing lymph nodes).  Maybe I'll get one with Ed Hardy graphics ; )  I'll also wear a medical bracelet on my arm.  I wonder if they make those in diamond-studded platinum?  Yay.

 I have good days and bad days.  Every SINGLE article written about Triple Negative Breast Cancer points out that it has a worse prognosis, is more deadly, etc. etc.  Some of that is true, and some of it is media hype.  It's hard to keep my mind in the right place sometimes.  Thanks for the support!  People are coming out of the woodwork to help us and it is so great!  We feel so loved :) and it really does keep my mind on the prize.   I've got a super awesome husband and three babies who need me to stick around!


So, that's the news for now.  Carrie

Chemo and ultrasound

I finished my last  (of 4) Adriamycin (doxorubicin) and Cytoxan (cyclophosphamide) chemo on Friday 4/16.  YAY!  That chemo sucked!  To keep my white blood cell counts up, I had to give myself shots for five days following chemo.  In the past, I had a little pain in my long bones. This time, it caused severe pain in my back. I was laid up all week, and Breck had to stay home with me for a couple of days. I could barely get up out of a chair, let alone take care of West.  I went through nearly 30 Vicodin!  I feel mostly better now, thank goodness.

Today, I went in for an ultrasound.  The purpose was to see if the tumor in my breast and the tumors in my lymph nodes had responded to the chemo.  If you've ever had or seen an ultrasound, you will probably appreciate as a layperson that they seem very difficult understand or analyze.  ("that's the baby's stomach?  if you say so!")  The ultrasound tech and the doctor couldn't find the tumor in my breast.  When they first found it in February, it was about 3 cm.  The fact that they can't see it now means it's shrunk down to just about nothing--maybe it's completely gone!  The enlarged lymph node is now about 1 cm.  (reduced from 5 cm as per the MRI prior to chemo)  The other nodes look pretty normal.  

So, FUCK YEAH!

A mammogram would be more accurate, and would at least find the metal markers they left during the biopsy.  I'll get another mammogram and MRI when I'm done with chemo.

I start a different kind of chemo, called Taxol, on Friday.  It's not supposed to cause nausea, which is a good thing.  There are other side effects of course, and I'll deal with those as needed.  

We are very thankful that the medicine is working.  The better my body responds to the chemo, the better my chances are of surviving this beast.  We are also so very very thankful for all of the love and support from our friends and family.  We've received several delicious meals that have really made this process much much easier.  Poor Breck has a lot on his plate, and a break from making dinner is welcome.  

I'm still not out of the woods, and I've got some touch decisions ahead about surgery and so forth.   But for now, I will enjoy my good news :)

Cheers,

Carrie