Time for another Q&A! (Post #45)

 

It's funny how celebrations so often mean a trip to the Duchess Bakery. 😋

Having completed the worst of my treatments, my mind is now a jumble of thoughts. Rather than trying to make sense of them all (Ha...good luck!) I thought I would just lay them out here, Q&A style.

So you're done! That's so exciting. How do you feel and what are you going to do with your time now?

Well, I'm not entirely done, but I'm certainly through the worst of things. I had an echocardiogram yesterday and have my usual Herceptin infusion on Monday. The echo is because the Herceptin (and chemo) can damage the heart. It's just a precaution; my last echo was normal. According to the people in the know, the next two weeks will be spent giving myself saline soaks and creaming my skin, since apparently, radiation continues to work, damaging cells for at least 10 days post-treatment. 😳 At my last visit with my radiation oncologist, she warned me, "Things will get worse over the next two weeks, then gradually improve over the following two weeks." Bummer. I was really, really hoping to come back to church on my birthday, February 19th. Unfortunately, that might be a bit premature. I am hoping to return to work on a part-time basis sometime in late February. By then I will have organized every closet, and completed the spring cleaning. Bahahaha, not likely. I will probably, however, read many, many books (provided I can find some that aren't either insipid or triggering) and knit several sweaters. (Yesterday, on our way to my echo appointment, hubby showed me the spot where he was praying the night after surgery, when I was fighting for my life and God gave him the assurance that I would be okay. We discussed erecting a plaque but thought that might be considered weird. 😁)

As for how I feel...can I get back to you? I'm still not certain. A bit at loose ends, to be sure, but beyond that...? 🤷‍♀️ Battling cancer has been my full-time job since mid-June and I'm not sure when I'll be going back to work, so I feel a bit in limbo. I also feel like I need to rediscover who I am. For the past 7.5 months, I've been "the woman fighting breast cancer." Oh, I never stopped being a wife, mom, and friend, though those roles certainly suffered, however, in light of my cancer battle, everything else sort of dimmed. I feel like I need to rediscover normal life, now that I'm not anticipating treatment milestones. At the risk of sounding overly dramatic, when you've been fighting for your life, what once filled your days can feel rather banal. Emotions such as unalloyed joy are blunted, while hearing about the trauma's of other people can trigger a tsunami of agitation. When I try to remember life BC (before cancer) it seems like a dream. I still catch myself looking at my reflection and thinking "Is this really me? Am I really that bald person in the mirror? Yikes!" 

Ringing the bell after finishing radiation. Yes, I got to ring the bell twice!

So when do you plan to return to the land of the living?

Hmmm, good question. There's this little annoying fact that has impeded my return to public spaces... TMI warning! When you have radiation, wearing certain foundational garments is not an option. (Think "hammocks for two.") Radiation is not unlike getting a sunburn, but instead of thinking "Oh dear, I better slip on a shirt, slop on sunscreen, and slap on a hat," you decide to go out in the sun repeatedly to see if you can get your skin to blister. Not smart and very painful when clothing rubs against the affected areas. (Have you ever been bent over while gardening and not noticed that your shirt has ridden up revealing skin without sunscreen? No? Just me? Okay, well then. You'll just have to believe me when I say that waistbands become your enemy! 😄) So, until I can resume wearing a particular foundational garment, I will only be going to places where I can wear a hockey jersey. (Who knew that having 5 hockey jerseys would be such a wonderful thing! The big patch on the front does a wonderful job of hiding the...er...wobble. 😏)

The good news is that my oncologist doesn't think I'm immunocompromised anymore. So will I continue to mask? I'm not sure yet. Frankly, it's been kinda' nice not being sick (except for hospital-acquired Covid) for the past three years! I've really become fond of breathing through my nose...😊 The other reality is that I'm still recovering from treatment and the thought of battling an illness while still dealing with side effects including fatigue does not sound very lovely at all. And it's been nice to only paint half the barn! (Why wear makeup under a mask?) Then again, masks and claustrophobia don't always get along! 

Have they figured out why you got cancer?

Nope. And they probably never will. 😐 My type of cancer is not hereditary, (Whoop! Whoop!) though I still plan to have genetic testing. (I have a daughter, after all.) Oh, I could beat myself up and say "it must be all the McDonald's fries," or "I didn't start using organic, aluminum-free deodorant until five years ago," but that wouldn't be helpful. I could go completely off the deep end and think "God must be punishing me," but that would be completely wrong. Or, I could decide that sometimes things happen for reasons we do not yet understand. I may never know, and that's okay. I'll just take the good (lessons I've learned) and try to forget the bad (ICU PTSD is a pain), being grateful for all the amazing support I've received. Also, when I completed a Breast Cancer Risk Assessment questionnaire, my results indicated a 1.7% 10-year risk of getting cancer. (Using parameters prior to my diagnosis, obviously.) Bahahaha! Told you I was an overachiever! 

My 10-year risk of getting breast cancer was calculated to be 1.7%. Or not.

Wait, do they know why your surgery recovery went sideways and why you had a rough time with chemo? 

Nope and not really. I honestly didn't think my chemo was that awful...until I heard from other women. Some people continue working through chemo! How?!? I couldn't even drive, and some days walking from my bed to the couch was a major feat! And my chemo brain fog is only beginning to lift...though I did make myself a Nespresso coffee the other day...and forgot to put my mug under the spout first. I have always been prone to strong reactions to medications, etc, so I guess I shouldn't have been surprised. 😬 At times I wondered whether I was "imagining things worse in my head" but upon speaking with staff at the Cross, I  was quickly reassured that though my medical teams (at home and at CCI) were doing a fabulous job of controlling my symptoms, I did seem to be doing a great job of trying to get every single side effect on the list and several that weren't. Having said that, I am beyond grateful that I didn't need to go to the hospital! I can only borrow the words of David in Psalm 116:6b-8, "I was helpless, and He saved me. Return to your rest, O my soul, for the LORD has been good to you. For You have delivered my soul from death, my eyes from tears, my feet from stumbling." 

What was harder, chemo or radiation?

Chemo. Without a doubt. There is really no comparison. While driving to the Cross every weekday for four weeks wasn't fun, constant nausea and being looped out on morphine due to muscle and bone pain was even less enjoyable. Having said that, I must admit that not unlike giving birth, the worst of the horrors of chemo have already begun to fade. 👶 Funny how that works! 

Were there any surprises along your journey?

And how! 

• the discovery of ICU PTSD (Apparently, you need 1 week of recuperation for every day spent in ICU, and that's just the physical part!😬) and just how challenging my recovery from surgery was - I was so weak!
• that they call chemo a "systemic treatment," because it really does affect every system in your body. It is so much more than losing your hair and throwing up! 🤮
• for me, radiation was a cakewalk compared to the other treatments. (However, others, some of whom I encountered in the halls of CCI, have horrific radiation experiences - it really depends on your cancer.)
• I was so impressed with every HCW I encountered; they were all amazing, despite working in a crumbling healthcare system.
• that fatigue (defined as exhaustion not relieved by rest) means your body is healing and it's okay to rest. Actually, it's imperative that you rest!
• how weak I am, and how amazing it feels to rely on God completely

Were there any positives to having cancer?

I've mentioned my improved walk with God enough times to be annoying, 😇 but beyond that, there are actually a couple other things I'll miss:

• putting on your hair and wah-la, you're ready to go! I cut at least 15-30 minutes off my "morning ablutions" by using a wig
• no need to shave or derma blade
• an excuse to be lazy and lay on the couch...a lot
• encountered some amazing people
• was overwhelmed by the support I received 
• lost 20+ pounds! 

With all the treatments you've had, how do you know whether you've been cured by medicine or healed by God?

Why limit God? Is He not the Creator of all? So, yes, He could have cured me without treatment, but that's not the way He directed me. There is no doubt in my mind that my treatment plan was also His treatment plan. So whether or not He used science to cure me is really a moot point. 😊 Besides, God made a way for the Israelites to go through the Red Sea, He didn't just remove it.  

What was the big deal with Mepitel?

Oh boy...covers face with hands...😖 Yeah, this is a bit embarrassing in hindsight. After having a rather negative surgical experience and a rather rough chemo ordeal, I was worried about my radiation treatment. I mean, my track record wasn't exactly stellar at that point. I don't think I actually realized how concerned I was prior to starting, which made Mepitel seem like such a wonderful idea. You also have to realize that I'm a total control freak and after not having a lot of control over the previous two treatments, I was determined to influence the outcome of radiation! However, I was placing my trust in Mepitel, not God. I didn't need it, my skin is fine (-ish), and I think that if I had used it, I would have given Mepitel all the glory and not God. That would not have been cool, since I know there were many prayers said on my behalf. Obviously, I am not against using it; I'm debating sending my leftovers to a friend about to begin radiation treatment! (I have also started using one small piece of film over the worst of the reaction, where my radiation oncologist predicted that I would peel and get open sores...we'll see! God is still in control. 🙏) 

What are these boosters you mentioned?

Boosters are extra radiation treatments given to the surgical bed only. They are usually the last 4 treatments of a total of 20. They involve different angles than the previous treatments (my treatments went from 2 angles to 4) and are a bit more complicated. I needed a CT scan every day I received a booster (4 in total) as my surgical clips (pieces of titanium left to mark where your tumors were) were difficult to see. I was totally amazed that the radiation machine could also do CT scans! Oh, and the two shapes used for my boosters were a kidney bean and a heart, rather than the shape of Alberta which was used for my regular treatments. Because the boosters require different angles, the bed moves quite a bit. The way it jerked around reminded me distinctly of a carnival ride. 🤡

The sign reads "Surgical Reception" and beyond the next set of doors is where I waited before my surgery. Yes, walking past here every day on the way to radiation felt kinda' weird; I'm just grateful that I was able to do so!

So now that your treatment is over, what is your prognosis?

Well, my treatments aren't quite over yet; I will be receiving a Herceptin infusion every 3 weeks until the end of July for a total of 17 treatments. However, these are a breeze. They only take half an hour and have very few side effects, other than the usual nausea and fatigue. Incidentally, I did a little more research on Herceptin and I'm blown away by what I learned. Cancer cells can have a genetic mutation causing them to multiply uncontrollably. (Yes, I know - I'm a mutant! 😄) These cancer cells have too many copies of these genes and make too many of the proteins that control cell growth and division, causing the cancer to grow and spread. My cancer is HER2 positive. (This stands for Human Epidermal growth factor Receptor 2-positive. I'm certain not knowing this was keeping you awake at night!) The HER2 gene makes a protein known as a HER2 receptor. HER2 receptors are like ears, or antennae, on the surface of all breast cells which receive signals that stimulate the cell to grow and multiply. Breast cancer cells with too many HER2 receptors can pick up too many growth signals. This causes them to start growing and multiplying too much and too fast, which is why HER2+ cancer is always Grade 3/3, making this type of cancer more aggressive and difficult to treat. Herceptin works by attaching itself to the HER2 receptors on the surface of breast cancer cells and blocking them from receiving growth signals. By blocking the signals, it can slow or stop the growth of breast cancer. Herceptin is an example of an immune-targeted therapy. It can also help fight breast cancer by alerting the immune system to destroy cancer cells to which it is attached. Now, if you are not incredibly impressed, I'm not sure what it will take to impress you!  Because I know that I often wake up in the morning and think "today I'm going to find a way to block the receptors of a certain breast cancer cell, thereby decreasing the chance of recurrence by 40-50%." 😬 Right. 

Oh, and I'll also begin taking Letrozole as soon as my skin has healed. Letrozole is in a class of medications called nonsteroidal aromatase inhibitors. It works by decreasing the amount of estrogen produced by the body. This can slow or stop the growth of some types of breast cancer cells that need estrogen to grow, like my triple positive cancer. I will be taking it daily for a minimum of 5 years. Side effects are not going to be considered; I had enough of those during chemo, so I'm pretty sure I'm off the hook. (Places fingers in ears and begins humming loudly as the pharmacist tries to explain side effects...) Okay, okay, so the side effects are basically like menopause on steroids, which I'm already experiencing, so no biggie, right? Oh, and there may be muscle/bone pain, but as I already had that during chemo, I think I'll skip that one. 

Right. Prognosis. I'm not sure? 🤔  I mean, Job 14:5 says, "You have decided the length of our lives. You know how many months we will live, and we are not given a minute longer." However, based on my treatment plan, I am considered cured. How long I will remain that way, without a recurrence of cancer remains to be seen. Because the use of Herceptin only became mainstream in the last 10 years, it is impossible to compute my long-term prognosis. The latest stats suggest that the 10-year survival rate for people with my cancer is 85%, which means that out of every 100 cancer patients, 10 years after their diagnosis, 85 are still alive. This is much improved from before the use of Herceptin! Do I have a chance of getting cancer again, either breast cancer or cancer in a different part of the body? Yes, yes, I do. Are my chances higher than average? Yup. Definitely. So I guess I'll just keep treating each day as the gift that it is and hold on to 2 Corinthians 4:16: "That is why we never give up. Though our bodies are dying, our spirits are being renewed every day."

So what does follow-up look like for you?

While I am still receiving Herceptin, and beginning Letrozole, I will see my oncologist every 3 months and have an echocardiogram and blood test every 3 months as well. They found dacrocytes (tear-drop-shaped cells) in my blood during my last test, but these are probably just the result of chemo and nothing to be concerned about. (They are commonly seen in chemo patients...but can also signal leukemia, which can be a side effect of chemo. 😱  See why consulting Dr. Google is not recommended?!?) I'll see my radiation oncologist in 6 months and have both a mammogram and a breast ultrasound prior to seeing her. I'm not sure what will happen past the 6-month mark. I imagine it varies depending on your results. 

I received this sign as a Christmas gift which immediately made me think of the song "For the Good," by Riley Clemmons. Psalm 27:13 says, "I remain confident of this: I will see the goodness of the LORD in the land of the living."

Any words of wisdom for those beginning cancer treatment?

Yes. Do not, under any circumstances, rearrange furniture or otherwise reorganize anything. I still haven't found my folding headphones which I stored on a side table I moved to another spot! 😏

Seriously though, cancer sucks. However, 1 Thessalonians 5:18 says, "Be thankful in all circumstances, for this is God’s will for you who belong to Christ Jesus." I interpret this verse to mean that we should search for things for which to be grateful in every situation, remembering that God is sovereign and He's got this. Were there bad days in the past 8.5 months? Oh yeah. Will I encounter more bad days? Absolutely. I recently came across a quotation by Charles Spurgeon: "Anything is a blessing which makes us pray." Oh, man. Seriously? Anything? Even cancer? Yes, even cancer. 😕 This is easy to say when you're having a good day, but rather challenging when times are tough. Romans 5:1b-4 sums it up well: "And we rejoice in the hope of the glory of God. Not only that, but we also rejoice in our sufferings, because we know that suffering produces perseverance; perseverance, character; and character, hope."