A whole new world

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Del Mar Beach, San Diego, California

It’s been a crazy busy period in my life and I haven’t had much time to update. I had a PET scan right before surgery that showed the cancer was becoming active in my breast again and my tumor markers supported that finding, jumping 14 points in just two months. The positive however was that the damage to my spine and bones was greatly improved. A silver lining to a bad situation.

Things had been going so well that honestly most days I forget I even have cancer. This was a reminder that cancer will always be there waiting for the perfect opportunity to rear its ugly head. Waiting to come back.

On July 1st I had a lumpectomy. Honestly I was pretty scared for surgery, but it went much better than I thought and my surgeon did an amazing job. Once the incision fades, there will be little evidence that it even happened.

I returned to my job for a few weeks, but left on July 26th after 3 1/2 years. It was hard to leave, but it reinvigorated my desire to begin a new career in travel nursing. I started hunting in ernest and signed my first travel contract on August 15th. I will leave Kansas on August 30th to head out to San Diego, a city I fell in love with when I was there in December.

As I write this my nervousness is starting to creep in. I am starting a new job as a palliative care clinic nurse at a new hospital, learning a new charting system, in a new city. It is a fresh start, and one I am excited to begin. San Diego is a beautiful city and offers me new and innovative cancer care while I am there. I am already working to schedule my first appointment with an oncologist who is involved in clinical trials. Anything to live forever so I am not forced to haunt my children from the great beyond.

On August 22nd I had my monthly appointment with my oncologist here. Considering my previous two tumor markers had increased, my nerves were on edge. The bad thing is that tumor markers is a test that is sent out, so while I had the results of everything else, I was forced to wait for that crucial one.

All of my blood work was terrific and my platelets were almost back in the normal range (those had jumped dramatically pre-surgery as well). I then began the tense wait for my doctor’s nurse to call me back with the number that seems to control my life. On May 2nd it was 39 (one point above normal). On June 27th (the week before surgery) it jumped to 53, and on July 25th (first markers post-surgery) it went up again to 55.

Needless to say, I was very nervous to see whether it continued to go up, or if it would start to drop again. I almost cried when my doctor’s nurse called the next day to report it had dropped down to 46. A nine point drop. Cancer was starting to creep away again!

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Del Mar Beach, San Diego, California

This last couple weeks has been a flurry of activity. New checking accounts, finding housing in San Diego, finalizing paperwork for my new job, packing, and most importantly, getting my medications for the trip. When one of your medications costs over $12,000 a month, nothing goes smoothly. With my insurance change it also required a new specialty pharmacy. I was starting to panic as the process was taking so long, and I leave Friday. Late yesterday I finally got the call that my Ibrance was filled and would be overnighted to me to arrive today. Just in the nick of time!

So I am down to my final two days before I leave. I am nervous thinking about the things I will miss, but am excited for the new adventure ahead of me. I’ve been asked many times why I don’t just quit working. You have incurable cancer they say. I always respond with I love being a nurse and I love my patients. I refuse to let cancer take that away from me. In my new job I will be working with patients like me, and I am excited to show them that even in the face of what could be considered a death sentence, you can find strength and hope.

It’s a whole new world ahead of me and I can’t wait to begin the new adventure!


Jennifer – Extensive mets to bones. Diagnosed de novo at 43 of ‘unknown cancer’ on 9/25/2018, official diagnosis of metastatic breast cancer with bone metastasis on 10/9/2018. Cancer won’t win. I won’t let it. Life’s too short not to fight for every minute.
Dx 10/9/2018, invasive ductal carcinoma (IDC), left breast, 1.5cm, Nottingham Grade 2, hormone receptor positive, ER+ (estrogen receptor)/PR+ (progesterone receptor), HER2- (human epidermal growth factor), BRACA- (genetic mutation), Stage IV, metastasized to bones
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)
PET Scan 2/22/2019 Breast tumor showed no appreciable FDG uptake (essentially inactive), mets to bone improved from MRI
CA 27.29 5/2/2019 39 (goal <38)
CA 27.29 6/27/2019 53 (goal <38)
PET Scan 6/28/2019 Activity in breast that suggested new or recurrent disease, activity in skeletal lesion appeared to mostly regressed slightly since prior PET scan
Surgery 7/1/2019 Left breast lumpectomy with biozorb placement
First CA 27.29 post surgery 7/25/2019 55 (goal <38)
CA 27.29 8/22/2019 46 (goal <38)

But you don’t look sick…..

I dont look sickI 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.

2019-06-26 CA 27-29My 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.

2019-06-26 Platelets

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.

2019-06-28 PET

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.

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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.


Jennifer – Extensive mets to bones. Diagnosed de novo at 43 of ‘unknown cancer’ on 9/25/2018, official diagnosis of metastatic breast cancer with bone metastasis on 10/9/2018. Cancer won’t win. I won’t let it. Life’s too short not to fight for every minute.
Dx 10/9/2018, invasive ductal carcinoma (IDC), left breast, 1.5cm, Nottingham Grade 2, 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

A (scary) new development (part 2)

Cancer Word Map

The one constant with metastatic breast cancer is that just when you think you know where things are headed at the last minute you find out yourself on a different path.

Today I met with the radiation oncologist. I really do like her. She is straight and to the point. She is honest about statistics and facts. We discussed her role in my treatment plan and she broke it down in plain language to make it easier to understand.

That being said, I’ve been forced to re-examine everything I had been planning on. As my medical oncologist has said, the evidence remains inconclusive as to whether radiation will extend my life. She then told me that she has consulted with her partners and there is no evidence to support brachytherapy in my case and that it is only for early stage breast cancer. She said that while she would not be able to do brachytherapy, she said that we could consider external beam radiation. This would entail fifteen treatments over the course of three weeks.

As I drove home from my appointment things became very real. It’s easy to pretend cancer doesn’t exist when you are taking a couple pills a day. Three weeks of radiation and surgery are enough to remind you that cancer is there. It forces you to remember that yes, I really do have cancer.

The toughest part of this for me is I know this may or may not help me in the end. I am just afraid if my cancer were to return tomorrow and I hadn’t gone down this road I would blame myself for not doing everything possible. This might be the toughest point in my treatment plan so far and I would be lying if I didn’t say I am scared.

When I go to sleep tonight I am going to drift off and hope that when I wake up tomorrow this will have been a bad dream. Unfortunately the rational part of me knows that’s not the case. This is as real as it gets.


Jennifer – Extensive mets to bones. Diagnosed de novo at 43 of ‘unknown cancer’ on 9/25/2018, official diagnosis of metastatic breast cancer with bone metastasis on 10/9/2018. Cancer won’t win. I won’t let it. Life’s too short not to fight for every minute.
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 bones
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)