Thursday, March 31, 2011

Scan Results & Radiation Planning

The scan results are in... Thankfully it seems that cancer hasn't spread any further than the lymph nodes that we knew about - several in my underarm and neck on the right side. Cancer cells can apparently move around the body via lymph or blood, and mine (touch wood) don't seem to be moving around in the blood at the moment (that would be worse, as that is how it would get into organs or bones). Nobody can explain why the Chemo killed the cancer in the breast but allowed more to develop in the neck, bit of a mystery and seems to be of concern but we will just get on with treatment...


I had another biopsy on the lump in my neck yesterday, a core one this time (a really big needle that requires slicing skin with a scapel to get it in!) so that it can be tested for estrogen receptors. I have started on one hormone treatment already, a monthly injection to shut down my ovaries, on the assumption that it will be receptive, as the breast cancer was. I'll also be taking hormone tablets everyday, but not until after radiation.


Surgery is still on the backburner - essentially it seems as if that horse has already bolted - once it has spread they don't recommend cutting bits out/off. So I'll be keeping the girls natural, at least for while and possibly I won't ever have surgery... More Chemo is also not recommended again at this point, but maybe in the future if it ever spread again.

Radiation will be starting the week after next and it is now going to be more intensive and for longer than was initially expected. I had a planning session this week, where we went through the set up position that I will be in for each session (every workday for 2 months!) They have even given me four attractive tattoos - little black dots - that will be used to lined up laser beams each time. I even agreed that the medical student could do the tattoos - I think she did a good job, fingers crossed she got them in the right place :)

Tuesday, March 22, 2011

Cancer Rollercoaster - Update

Unfortunately the biopsy of the lymph node on my neck showed cancer cells, so it seems that while the Chemo worked well on the initial cancer it has somehow still spread. Not good news. I am having more tests this week, CT and bone scans again, to see if it has spread any further than the neck - fingers crossed not. I'll get a new treatment plan next week, which depends on the results of the scans, but is likely to include even more radiation than had been planned, hormone treatment and potentially more Chemo. Mastectomy is on hold for awhile, as the focus shifts to controlling the growth.

All in all, not a great day. "A setback", as my oncologist says, "but it doesn't mean you'll die tomorrow or anything". Not particularly comforting. However, some googling seems to reveal that even stage IV isn't necessarily a death sentence and can be controlled for years with various drugs, so here's hoping I can successfully fight this. I'm feeling a little bit down, not to mention sore from the biopsy, but trying to stay positive.

Thursday, March 17, 2011

Cancer Rollercoaster

After the excitement of last week, this week hasn't brought quite so much joy...

Yesterday I met with a plastic surgeon to discuss reconstruction. I will post more information on my options for reconstruction and some amusing anecdotes another time, but one interesting thing I learnt is that if I choose to have a preventative mastectomy it would actually be done at the time of the reconstruction rather than the main mastectomy and lymph node dissection, in order to preserve the skin for use in the reconstruction. I wasn't expecting that, I assumed that it would be done as a double mastectomy.

This afternoon I met with the specialist/surgeon to get feedback from the multi-displinary meeting at lunchtime where they discussed my case and potential next steps. The verdict was unanimous - mastectomy. Not really a surprise there, I expected that was the sensible approach. It will be scheduled within the next few weeks.

Anyway, onto the (potentially) bad news... Last night I felt another lump, this time in my lower neck, just above my collar bone, on the same side as the breast cancer. It is about the size of a pea (or maybe a little bigger, perhaps a wasabi pea). I mentioned this to the specialist and he had a feel and sent me immediately off for a biopsy. The lump is apparently in my lymph nodes and from conversation previously with the radiation oncologist this is where breast cancer often spreads next, after lymph nodes in the armpit (she was planning to radiate the neck lymph node area anyway because of this). I get the results of the biopsy next tuesday, but I am expecting that it will show cancer cells, given the side and location. I don't know what impact (if any) that will have on the rest of my treatment plan, I need to do some googling and see what the specialist has to say next week.

Thursday, March 10, 2011

A Medical Miracle??

Having finished my course of chemotherapy, this week I had an ultrasound and met with the surgeon to discuss results and next steps. After getting "excellent, excellent" as the comment from him after a feel at our midway appointment, this time it stepped up to "incredible"! Apparently the ultrasound showed no cancer and he can't feel anything either, meaning I have responded really well to the chemo. Excellent news :) I think the lump actually disappeared after the very first chemo, from what I could feel anyway - perhaps eating grapefruit and sunbathing topless did the trick?? Not that I have done either for quite awhile...

However, because of this, I've not been booked in for surgery yet - he wants to discuss my case with the multi-disciplinary team (oncologists, breast surgeons, radiation specialists etc) at their meeting next Thursday before deciding on the next steps. He suggested that perhaps they would recommend an MRI to have a more detailed look at what is happening (or not happening, as the case may be). It doesn't appear to be a situation that they are commonly faced with - usually there is at least a small lump or something that can be seen or felt.

My guess is that the team will still recommend surgery, a mastectomy and lymph node removal, to be on the safe side. From what I have read, just because they cannot see cancer, doesn't mean that it isn't still there, lurking... A quick google reveals people on breast cancer forums who have been in the same situation and there are a variety of outcomes - people who still had mastectomies and nothing was found, people who had mastectomies and cancer was found lurking, and people who didn't have surgery and it didn't return years later. I didn't actually find one where they didn't have surgery and it did return, but I'm sure that happens too. It seems that generally surgery does go ahead, even if the cancer seems to have disappeared, just to be sure. To be honest, while I am obviously not too keen on the thought of a mastectomy (single or double) and I would hate to have one unnecessarily, I also think I would be very worried about it coming back if no further action were taken, so I'm not too sure what I am hoping for now, it is all a bit unnerving...

I have an appointment with a plastic surgeon next week to discuss reconstruction options and the breast surgeon wants me to still go to that appointment, so I think I will be boobless by the end of March, but I guess we'll have to wait and see...