Sunday, November 13, 2011

My adventure continues ...

I have a confession to make.  I've never really paid much attention to breast cancer.  As a woman, I'm sorry to admit my avoidance toward being more aware.  I wasn't entirely ignorant, and I did/do care.  I just didn't understand it as well as my contemporaries.   

When I was diagnosed with metastatic breast cancer, my friends instantly understood the degree of trouble I was in before I did.  

I didn't expect to start chemotherapy so soon after diagnosis, but the surgeon determined the tumor, about the size of a baseball, was too large to safely remove. even as a mastectomy.  He recommended neoadjuvant therapy to hopefully shrink the tumor so later he could safely remove the breast, or better yet, just remove the tumor.

I had to immediately psyche and prepare myself to accept that dreaded toxic medication to be pumped into my veins.  If it meant a cure & a longer life, I was willing to hang my head over the toilet, nauseously puking my ever lovin' brains out.   I so dreaded and so feared the chemo, the sick stomach & the vomiting.  I cannot articulate how much all this troubled and scared me.  

So here I was, all prepared for my first bout of chemo and figuring I'd be bald by Halloween. I ordered headscarves and knitted caps for my future bald head from eBay.  My friend,  Terri, joked and encouraged me to be either lollipop'd Kojak;  Sinead O'Conner;  kick-ass Natalie Portman (V for Vendetta); or get my ass kicked & be Charlie Brown.  I was on my adventure, and the first stop was Halloween.
The day before my first chemo appointment, my oncologist  canceled the chemo & said we needed to talk.  She had the results from the Bone Scan & CT Scan that were performed just a few days before.

This is where everything went off the rails for me.  My doctor explained the cancer isn't just confined to the breast, but has traveled to my lungs.    It had metastasized.  It is incurable.  This changes everything, I'm told.  The chemotherapy is out - for now, but there is a drug that I will have to take the rest of my life.  This drug is used only in post-menopausal women, & it should shrink the tumor.

My reaction?  I wanted to shout "Yippee!"  No chemo for me!  No tummy aches! No vomiting over the toilet!  I remember the funny look the doctor had when I said this was a blessing in disguise.  Pills over chemo.  Yep, that was good news to me.

It wasn't until the drive home that it began to hit me, though, to be honest, it took longer than that to believe it.  

I am dying, and there's no cure.  My doctor told me during my last visit that she doesn't know how long I have.  She told me of a patient of hers that is 70 who asked her recently, as well, and the only answer the doc says she can give, is when the drugs stop working.

I'm not so sure why I wrote all this, most of it has already been blogged.  It could be that I'm trying to get a better grasp.  Right now I feel like I'm cheating, even though I'm not.  I know I am very sick, but refuse to accept it.  There is a difference between being positive and refusing reality.  I'm not so sure where I'm at, and to tell the truth, I'm not so sure I have to know. 

I recently blogged that I believe the tumor is shrinking.  I think that is wonderful news.  I'm hoping it's shrinking the cancer that spread into my lungs, too.  

There seems to be some good news on my cancer drug, anastrozole, (Arimidex). 

I confessed at the beginning of this post my ignorance to breast cancer.   But there's a lot of information out there on the web.  My doctor told me to be wary of what I read; and that she felt comfortable if I stuck with the Mayo Clinic and the National Cancer Institute. Below, from the National Cancer Institute I thought I'd add information on a couple of the tests one may need after the initial diagnosis.  I've included only one stage, and that is Stage IV.
Don't get me started about the hot hot flashes.  Oy ...

Staging

If the biopsy shows that you have breast cancer, your doctor needs to learn the extent (stage) of the disease to help you choose the best treatment. The stage is based on the size of the cancer, whether the cancer has invaded nearby tissues, and whether the cancer has spread to other parts of the body.

Staging may involve blood tests and other tests:
  • Bone scan: The doctor injects a small amount of a radioactive substance into a blood vessel. It travels through the bloodstream and collects in the bones. A machine called a scanner detects and measures the radiation. The scanner makes pictures of the bones. The pictures may show cancer that has spread to the bones.
  • CT scan: Doctors sometimes use CT scans to look for breast cancer that has spread to the liver or lungs. An x-ray machine linked to a computer takes a series of detailed pictures of your chest or abdomen. You may receive contrast material by injection into a blood vessel in your arm or hand. The contrast material makes abnormal areas easier to see.
  • Lymph node biopsy: The stage often is not known until after surgery to remove the tumor in your breast and one or more lymph nodes under your arm. Surgeons use a method called sentinel lymph node biopsy
These tests can show whether the cancer has spread and, if so, to what parts of your body. When breast cancer spreads, cancer cells are often found in lymph nodes under the arm (axillary lymph nodes). Also, breast cancer can spread to almost any other part of the body, such as the bones, liver, lungs, and brain.

When breast cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary (original) tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer. For that reason, it is treated as breast cancer, not bone cancer. Doctors call the new tumor "distant" or metastatic disease.

  • Stage IV is distant metastatic cancer. The cancer has spread to other parts of the body, such as the bones or liver.
  • Recurrent cancer is cancer that has come back after a period of time when it could not be detected. Even when the cancer seems to be completely destroyed, the disease sometimes returns because undetected cancer cells remained somewhere in your body after treatment. It may return in the breast or chest wall. Or it may return in any other part of the body, such as the bones, liver, lungs, or brain.

2 comments:

Anonymous said...

I never knew that it was still called breast cancer, no matter where it went. And I am happy it did not go into your bones!

I keep thinking about how the doctor shows that were so popular on tv when I was a young girl so often showed the patriarchal doctor grappling with whether or not to tell the patient that he/she had a terminal disease. It seems amazing now that doctors felt free to keep those kinds of secrets back then, but it points out how very new it is for humans to face the knowledge that they may die in the not-too-distant future.

Perhaps some degree of denial (and hope!) is healthy and helpful.

I sure hope you can just keep all this at bay with the hormone therapy for a good, long time.

Anonymously Yours, Valerie (Chemisse)

Craig said...

"I'm not so sure why I wrote all this, most of it has already been blogged. It could be that I'm trying to get a better grasp."

Denise, I think it is both coming to terms with reality - but also finding a kind of therapy and release in blogging it down - sharing it, releasing full burden on you to sharing with friends and loved ones.

"Right now I feel like I'm cheating, even though I'm not. I know I am very sick, but refuse to accept it. There is a difference between being positive and refusing reality. I'm not so sure where I'm at, and to tell the truth, I'm not so sure I have to know."

I don't think you are cheating - to my mind, you've got a job to do - and that is live! Put the problem into your doctor's trust, believe in the treatment and your new friend - the medicine that will fight this thing. From the little time I've known you, your delight in holidays, good food, snow, birds, nature - let them continue to delight as best as you can manage. I will look forward to your announcement in a little more than a week that we will be just one month from Christmas! And of your blogs of falling snow, and creatures showing up in your yard. And for a good long time to come!