Week one in the books

 Having a first-degree relative with breast cancer, like a mother or sister, puts you at higher risk. Although not frequently seen, having a genetic mutation, such as carrying the BRCA1 or BRCA2 gene, two genes linked to breast cancer, also puts you at higher risk.Being a woman and getting older are the main risk factors for breast cancer. Studies have shown that your risk for breast cancer is due to a combination of factors. The main factors that influence your risk include being a woman and getting older. Most breast cancers are found in women who are 50 years old or older.

As of 10:30 this morning I have had 5 of 20 doses of radiation.  I also had a DXA scan this morning.  That was a very easy non-invasive test that took all of maybe 20 minutes or so.  That is in preparation of the next step on this pathway which will be aromatase inhibitors which is helpful in my case because my particular cancer is 98% estrogen positive.

In postmenopausal women aromatase inhibitors stop the production of estrogen. They work by blocking the enzyme aromatase which turns the hormone androgen into estrogen.  That means there is less estrogen available to stimulate my estrogen hungry breast cancer cells.  There are three aromatase inhibitors, Arimidex, Aromasin and Femara.  I am scheduled to take Arimidex (anastrozole).  Unfortunately, one of the numerous insidious side effects is bone loss, hence the DXA scan to establish a base line.

As I said, there are a number of nasty side effects and it has caused me to question seriously whether it is even worth taking them.  The problem is I cannot find a specific percentage of how much it can reduce my chances of a recurrance.  I have read everything from 6-10% reduction to 50% reduction over 5 to 9 years. the current projection according to my doctors is that if I take the AI for 5 years I have a 6% chance or less of the cancer recurring in the next 10 years.  I guess what it will come down to is what if any side effect I experience and how well I can tolerate them.  Of course if I don't respond well to the first AI there are 2 others. There is also the chance that in 5 years or even 10, someone will come up with something better.  

Radiation

 Today was day 3 of 20 visits for radiation.  My part is not difficult so far.  All I do is stay where they put me for 10 minutes or so.  Go home, put on aloe and aquaphor all day.  Met with the oncologist today so he could check on how I am doing.  That will happen weekly on Wednesdays.  The fun continues this afternoon when I see the gynecologist.  Gosh, how much excitement can a girl take?

I have a great radiology team.  These ladies are so sweet, gentle and positive.  I am never afraid to ask anything and they are quick to calm my nerves.  It is a little nerve wracking to walk into a room that looks like a Star Trek medbay. Truthfully, I think the reason I am so calm about all of this is because of the great people I have had taking care of me.  

Progress

 

Every minute, somewhere in the world, a woman dies from breast cancer. That's more than 1,400 women every day. A man's lifetime risk of breast cancer is about 1 in 1,000. Each year, it's expected that about 2,670 men will be diagnosed with breast cancer in the US, and about 500 will die.

It was a nice week.  Sunday I got to go out with friends some of whom (although they live within minutes of me) I have not seen since the pandemic began. One was visiting from Texas and I can't even remember the last time I saw her.  Considering how down I was for the majority of last week Sunday was emotional.  It was also very needed.  I needed to dig myself out and get myself back on a postive track.  So Tuesday I went and had my hair colored.  Purple! Not a lot, just on the long parts on the front but I love it and it is amazing just how much better I felt about myself.  When I got home, the hospital called about setting up my virtual simultation for Thursday and let me know my treatments would begin on Monday the 26th.

I had a gastrologist appointment on Wednesday and got set up for my necessary "old people" tests.  Let's hope that goes better than the mammogram went.

The Virtual sim on Thursday went well and we are a go to start rteatment on Monday.  Twenty doses, Five days a week for 4 weeks.  My last one should be on August 20. 

In the taking back my life and attitude department, I am making plans to attend a stitchers retreat and the Immersive Van Gogh event in Columbus in November.

This other stuff is a bump in the road right?

Facing Your Truth

In 2021, an estimated 281,550 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S., along with 49,290 new cases of non-invasive (in situ) breast cancer. About 2,650 new cases of invasive breast cancer are expected to be diagnosed in men in 2021.

 Last Wednesday I went for my CT Simulation. That innocuous appointment was almost my undoing. And was really just such a simple thing.

The next step in my treatment it 20 doses of radiation.  Simple they say.  Takes no time.  Take care of your skin and you will sail through it.  Piece. Of. Cake.

Originally they had wanted me to do this laying on my stomach but as a woman of (umm) size, I apparently had too many folds for them to do this.  So they took me off that very uncomfortable table position so they could rearrange it for me to be laying on my back. As I sat there naked from the waist up yet again, It all of the sudden hit me that nothing in my life was ever going to be the same again.  It didn't matter that I was determined to plow through this and not let it change my life. It didn't matter what I wanted. What matters is that forever more I have cancer.  They can take out the lumps and radiate my body.  They can block my hormone receptors. they can test me from here until I leave this mortal coil.  I will  always carry that cancer with me.  It will be on every form I ever fill out for every doctor I ever see.  It will be in the mirror every time I step out of the shower. Every time I don't feel well it will be lurking in my mind as hard as I try to deny it. This is my truth.   All of that hit me as I sat there in that chair for the 5 minutes it took them to rearrange that table. I felt like I was sinking.

The table was rearranged and I was repositioned to go into the CT scanner.  That didn't take too long but by then my mind could not shut off. My hospital unlike some others does not do permanent positional markings.  Our uses a sharpie and covers it with tegaderm. I was marked got dressed and I figured the next appointment would be scheduled.  Nope.  Everything has to be reviewed and a plan set up and "if you don't hear from us in a week to 10 days please call". What? Really? I was told I cannot lose these marks.  They have to be checked every day to be sure I don't lose the coverings.  Don't scrub them in the shower or with a towel. Don't soak (so no pool!). I have to basically keep these bandaids on me for at least 6 weeks now. Good grief.

I go home and decide to change into something cooler and make the mistake of looking in the mirror.  It looks like my grandkids got a sharpie and colored on me.  Seriously.  I have big black Xs and lines in 6 places on my chest.  I look like a toddler coloring book.  It took 2 days for the first two pieces of adhesive covering to come off.  I had to remark the spots and go buy more coverings so that I can keep things in place.  Just lovely. And now I wait.

The Trailhead

Current statistics show that 1 in 8 women will be diagnosed with breast cancer. I bet there is not one person who can not identify 8 women in their group of family and friends alone.  I think the number is way higher than that.  This may be my story but it is also the story of so many others.

I am trying to decide where this story actually starts.  I thought the start of it would be with my grandmother who was diagnosed with breast cancer in the 1970's and ended up with a radical double mastectomy.  I thought that might be the beginning because in 1996 my mother was diagnosed with breast cancer.  Things had progressed in 25 years though so mom "only" had a lumpectomy and radiation.  In the 25 years since my mother's diagnosis I was waiting for the next shoe to drop.  I was so much like them both that I thought it was inevitable. In that time period 3 of my first cousins on my mother's side were also diagnosed. Sure enough on May 4, 2021, My mammogram showed a mass.  Within days I was back for another mammogram and an ultrasound.  From there to a biopsy... and the train kept rolling.  

I was diagnosed with Invasive Ductal Carcinoma ER/PR+, HER2 -.  My mass was estimated to be about 15 mm which they assured me was small.  It was deep so I had never been able to feel it.  Grade 2. It was recommended that I have a lumpectomy followed by  radiation and Aromatase Inhibitors. Of course, that would depend on my oncoscore and lymph node findings.  

From there I went to genetic counseling.  With my strong family history they were convinced there was a genetic connection.  Nope, after a complete blood test I did not match with ANY of the known markers. Too bad I didn't have any of the information from the other women in my family that had been through this so I could see and compare what they had.

June 11 brought the uneventful surgery.  The mass was slightly larger than they had expected 23 mm and they also removed 3 sentinel nodes.  I came home that afternoon with pain meds that I never opened and 2 pretty large incisions that were thankfully glued so I didn't need to deal with dressings and stitches.  Met with my surgeon for my 2 week follow up and was released to the radiology department. Text book perfect for this situation.  

At no point from the day of my first call back for the mammogram to the day they sent me home from surgery did I have any fear or worry about this outcome. (We won't discuss the aborted MRI's...I never knew I was claustrophobic but oh boy....that is an experience I will not repeat.)  It was found early, I had no sign of further involvement or migration, my oncoscore came back at 19 so I did not need chemotherapy and I am set for 20 radiation treatments. I was going to just move right on with my life.  

I joined a great facebook group Hormone Positive Breast Cancer Support , Talk about Warriors! These women rock.  We discuss everything and the support is great.  So many women had so much more difficult situations than I did that I figured I was rocking my world.  Then I went for my CT appointment for getting my radiation treatments.  That is when my world changed. There is more to breast cancer than the physical aspects. So I think that is where I will start my journey.  I think the back story I just summarized will end up being far less significant than what is to come.