And I’m Off on New Adventures…

I started writing this post several days ago but when I started reading it back to myself today- I decided to erase the whole thing.

It just didn’t sound like me.

It’s crazy how much more “myself” I feel like today than I did just a few days ago.

Anyway…..

So I wanted to give everyone an update on my cancer situation and where we go from here.

To recap:

• November 2019 I am diagnosed with triple positive breast cancer
• A couple weeks later, I have surgery to have a port inserted for chemotherapy
• December 5th I started 1/6 rounds of TCHP chemotherapy (one round every 3 weeks)
• After round 2 my tumor could no longer be felt on exam.
• After round 3 my cancerous lymph node could no longer be felt on exam
• March 19th was round 6/6 of TCHP
• A couple weeks later I had a breast MRI that did not detect my original tumor (Carl) but did show a possible second tumor(s) in a different part of my breast. All my lymph nodes looked normal in the scan.
• April 30th a had a single mastectomy of my left breast which included the removal of several lymph nodes. I chose no reconstruction at this time because I am not eligible to use my own tissues (I do not have enough) and for various reasons did not want an implant. (I can always choose to do reconstruction at a later time- legally my insurance has to cover any reconstruction for life).

That brings us up to speed.

What I haven’t talked about yet here is my pathology results from my surgery and what those results mean going forward.

Last Friday I received my pathology report. I went over with my surgeon then, and then went over it this morning with my oncologist. It has good news, not as good news, and kind of surprising news.

The good news is that overall, I had an incredible response to chemotherapy. About 60% of women with my type of cancer will have a “full and complete response” to chemo and about 40% will have residual cancer left after chemo.

I did not have a full and complete response, BUT I had a very very good response. There was a very tiny amount of my original tumor left (we are talking millimeters) which for a large tumor like mine was, is amazing. There also was a little area of pre-cancer near it..but again it was measured in millimeters.

Remember how the MRI indicated I may have had a small tumor in another area? Well…the night before my surgery I found it. Smaller than a pea, it was in the upper most area of my breast just like the MRI indicated. I started thinking that if it was cancer, it had to be a different type because I already knew the chemo had obliterated Carl.

Turns out, I was right. I did in fact have a small tumor around 1cm- except it was a different sub-type as I guessed. My original tumor was HER2 and Hormone positive (triple positive) and was grade 3- meaning fast growing. This new tumor was only estrogen positive and was grade 1- slow growing.

My oncologist explained that the slow-growing grade 1 tumors tend to not respond well to chemo- which explains why it stuck around while giant Carl was nearly gone.

In addition to the tumors, I ended up having 13 lymph nodes removed. I had 4 removed under my arm (upper area) and an additional 9- called the auxiliary tail- were actually embedded in my breast tissue (my breast tissue went into my underarm area) so they all came out as well.

Out of the 13 nodes, one had a very tiny amount of cancer in it. Again- measured in millimeters. This cancer was the grade 1 again- the slow growing type- which meant it wasn’t going to respond to chemo the way Carl did.

My oncologist is really happy with my response to chemo. With my type of cancer- you get staged initially and then after chemo and surgery- you are staged again.

My initial cancer was staged at 3A- because my CT showed a few lymph nodes that were possibly cancerous. Now after chemo and surgery I am restaged at 1A!! My oncologist said that makes my prognosis EXCELLENT!

So where do I go from here? You might remember that I mentioned (I think!?) that after surgery I would continue with targeted therapy up to the year mark of when I started chemo.

Well…that was only of I had a complete response to chemo (meaning no residual cancer left). Unfortunately, I had a few millimeters of cancer left which means my treatment will be a little different.

I WILL be getting targeted therapy- however the type I am going to be getting has a little chemo mixed in. The medication is called Kadcyla and though it’s been around for a while for metastatic breast cancer, it was approved last May in those who had residual disease after chemo and surgery. The study found that it decreased the chances of the cancer returning by 50%!

Which is huge.

Unfortunately I have to be on this medication longer than I would have been on the targeted therapy. I will be doing 14 rounds- every three weeks- which turns out to be 42 weeks.

Or as I look at it: The amount of time I was pregnant with Everett. (That kid did NOT want to come out!)

I was slated to start Tuesday- but as of Friday my insurance hadn’t approved it yet soooooo I am not exactly sure when I will be starting for sure. We will see!

In addition to this medication- I will also be starting radiation in a couple weeks. The radiation is important to kill any last tiny cells that might be hiding out in my lymph nodes.

But I don’t plan on stopping there. I have started working with a nutritionist who specializes in cancer patients and plan to work hard to support and boost my immune system over this next 10 months of treatment and beyond- by eating powerful foods and taking any supplements she recommends.

I also am hoping to work with the integrative cancer center at UCSF to get any additional feedback and tips moving forward.

So as you can see…many new adventures starting up in these next few weeks!

Of course, I would rather be starting some new traveling adventures instead…

But we will need to wait until cancer and covid are taken care of….

That’s about it for this update. Hope you are all well and staying busy during these crazy times.