I can’t tell you how many times I have heard these words. Oh, I’m so glad you beat cancer, you look great! Since you aren’t doing chemo, your cancer is gone, right?
I’m not sure I can blame people. I live in denial myself. Once the pain in my back subsided and for the most part I had weaned myself off of pain medication, it was easy to live that lie. I take a total of three prescription medications a day (only two more than my pre-cancer days). I am able to work and live a fairly normal life with scattered doctors appointments. Basically I live my life as though I have a chronic disease such as diabetes or high blood pressure. Unfortunately, the chronic disease can turn into a terminal one at the blink of an eye.
I had a sad reminder of just how serious metastatic breast cancer can become last week. My appointments have always been positive spots in my month. A reminder that I am beating this. I had my lab work done the day before my appointment so that I could have the results when I met with my oncologist.
My tumor markers every month have been improving, a sign that the cancer is taking a back seat for now. Until this month.
My oncologist normally has such a positive tone to his voice. Thursday there was a different sound and when he talked about my lab work he didn’t mention the tumor marker. I finally asked him for the number and he told me it went from just under 40 to just above 50. He also said that the number could fluctuate, so not to worry too much about it.
We discussed how I was already scheduled for a PET scan the following day and unlike the previous scan he told me he wanted to meet with me after the test so we could discuss whether I would have surgery on Monday. Again, a change from my previous appointment where he was enthusiastic about removing my primary tumor. He went from let’s do this to let’s see what the scan says.
It wasn’t until I saw the final results that I noticed a second lab that had jumped dramatically. My platelet count which had been improving to almost normal levels had also taken a significant increase, the second highest result since I first found out I had cancer in September. For those unfamiliar with what these labs mean, ‘A high platelet count may be referred to as thrombocytosis. This is usually the result of an existing condition (also called secondary or reactive thrombocytosis) such as: Cancer, most commonly lung, gastrointestinal, ovarian, breast or lymphoma. Anemia, in particular iron-deficiency anemia and hemolytic anemia.’
I was more lucky than others in my situation. I already was scheduled for a PET scan the following day so I didn’t have long to worry, but that night was one of the longest since this ordeal began. The last scan was one I was excited about because it would determine whether I was healthy enough to return to work. This one had a darker cloud over it. This one would show whether my cancer had returned. This time I was genuinely terrified of what it would reveal.
The wait following my test seemed like an eternity. The term ‘scanxiety’ is real. The wait is something I can’t begin to describe. This is another reason I absolutely love my oncologist. He fit me into his already busy schedule so that I wouldn’t need to spend the weekend worrying about the results. When you are already nervous, having a doctor that is compassionate enough to make sure you don’t have to wait is something I can’t appreciate more.
There is a lot of positives to be gained from this scan. It showed that the mets to my bones has improved quite a bit. Even with the positive, there were the words that spell out my worst fears, ‘a new area of activity in the outer left breast. New or recurrent disease is possible here.’ The tone of my oncologist’s voice returned to his normally positive sound. He was very impressed with my scan, saying that the new area was most likely ‘background,’ but either way the tumor would be removed a few days later and the improvement to my bones has been terrific. He did however admit that the dramatic change in my lab values has given him something to worry about.
As I drove home from my scan the breast cancer navigator called me and we talked about the test. I told her that for the first time I was reminded how quickly I can go from healthy to facing recurrent cancer. She said unfortunately that is something I will have to live with for the rest of my life. Cancer can rear its ugly head at any time. I can go from completely healthy to sick in a matter of months.
My week of ‘cancer patient’ continued into Monday. I had a lumpectomy to remove the tumor from my left breast. Due to the location of the tumor my surgeon couldn’t remove it using an ultrasound, instead needing me to have a wire marker placed by the radiologist using a mammogram. While this mammogram was much better than the last one (where I had spasms of pain running up and down my back and legs), multiple mammograms while placement was found still was not the most pleasant experience.
The surgery itself wasn’t too bad as it was done under a general anesthetic. My surgeon told me that everything went very well and my scar should be minimal and hidden. He also inserted a biozorb to help maintain the natural shape of my breast as well as give the radiation oncologist a marker for when we start radiation in a few weeks. I have been able to remove the larger dressing and the incision is covered by steri-strips so I am not sure what it looks like, but hopefully it will be as small as my surgeon told me it would be.
One more hurdle has been passed in this journey. Three weeks or so from now I will begin radiation therapy. Radiation was one of the things I had wanted most to avoid and here I am, getting ready to begin three weeks of five day a week external radiation treatments.
Most days I do my best to not to dwell, but I just want my life to be the way it was a year ago. I just want to go back to a life before doctors, surgeries, radiation and labs. I just want to go back to a life without fear or anxiety about whether I will be here six months, a year, five years from today. I just want to be me again.
It’s been a long week of ups and downs and I’m still processing all of it. Today I’m still a little numb just thinking about it. Today I’m feeling like the cancer patient I am. Hopefully tomorrow I will wake up and be able to go back into cancer denial again and just be the happy me I want to be.
Dx 10/9/2018, invasive ductal carcinoma (IDC), left breast, 1.5cm, Nottingham Grade 6, hormone receptor positive, ER+ (estrogen receptor)/PR+ (progesterone receptor), HER2- (human epidermal growth factor), BRACA- (genetic mutation), Stage IV, metastasized to spine, pelvis, sternum and right scapula
First CA 27.29 10/9/2018 83 (goal <38)
Hormonal Therapy 10/12/2018 Tamoxifen (Nolvadex, Apo-Tamox, Tamofen, Tamone) pills
Targeted Therapy 10/12/2018 Xgeva (Denosumab) injection
Hormonal Therapy 10/19/2018 Lupron Depot (Leuprolide Acetate) injection
Surgery 11/29/2018 Vaginal hysterectomy with bilateral salpingo-oophorectomy
First CA 27.29 post hysterectomy 12/10/2018 73 (goal <38)
Hormonal Therapy 12/11/2018 Femara (letrozole) pills
Targeted Therapy 12/23/2018 Ibrance (palbociclib) capsules
First CA 27.29 post medication change 1/10/2019 60 (goal <38)
CA 27.29 5/2/2019 39 (goal <38)
CA 27.29 6/28/2019 53 (goal <38)
Surgery 7/1/2019 Left breast lumpectomy With Wire Localization, Mammographic, Biozorb Placement