cancer

TNBC by numbers

When I asked for the referral for a mammogram, I wasn’t concerned. Less than 2% of screening mammograms result in biopsies.

When they recommended an ultrasound, I wasn’t concerned. Twice before there were areas of concern that required a follow up ultrasound, but everything was fine.

When my doctor recommended a biopsy, I wasn’t concerned. Most biopsies (80%) are NOT cancerous! I had a biopsy previously that turned out to be benign. The odds were in my favor.

When my primary care doctor told me that I had cancer, I went home and started to do some research. No one wants to have cancer, but it is no longer a death sentence. Prognosis and survival rates are very good, unless the cancer has spread. The exception seemed to be Triple Negative Breast Cancer (TNBC). This subtype of breast cancer is rare (only accounting for 15% of cases) and very aggressive. It is more likely to spread and also has a higher rate of relapse.

On my first visit to the oncologist, I was determined not to get overwhelmed. “As long as it isn’t triple negative, everything will be ok,” I told myself as we waited for the doctor. She started explaining hormone receptor status and I knew where it was going. My heart sank. I looked over at my husband and he looked confused, but happy? He thought that being negative for all three was a good thing.

“Early-stage triple-negative breast cancer is more likely to spread to other areas of the body than other types of breast cancer. In fact, one study found that people with early TNBC were four times more likely to develop metastases. Other research suggests one-third of people with early TNBC will develop metastases. Doctors sometimes call TNBC an aggressive breast cancer because it is more likely to recur, often within the first 4 years after diagnosis.” [link]

So, here we are… playing the numbers. I feel a little like this cancer is playing Russian Roulette in my body. Will it spread? Will it come back? Time will tell, but for now I just have to hope for the best.

Happy New Year!

It’s a new year, with a new set of challenges. This is definitely not where I wanted to be, but there is no getting out of it. A couple of days ago, I went for my second treatment. This one was chemotherapy only, no immunotherapy. It didn’t hit me as hard as it did last week. Yesterday, I was able to work for a few hours. But this morning, I woke up feeling terrible.

Treatment 2: December 30, 2024

Taking a picture together every week before going in for chemo, as a way to document the year together.

The most stressful part of this, for me, is the worry. How am I going to feel? What am I going to be able to do? How are we going to pay bills? Buy food? There is so much that goes into making this household function that I’ve always done alone: budget, cook, clean, shop, organize.

So, my goal for the new year is to give up control and let things go. I need to trust my family to do more – for me and for themselves. I’m going to focus on the positive and try not to put so much pressure on myself.

“The greatest weapon against stress is our ability to choose one thought over another.” — William James

Merry Christmas

It’s Christmas morning and the kids (not really kids anymore) are asleep. My husband and I are drinking coffee and pretending that everything is normal. But it’s not. Just two days ago, we went over everything with my doctor and I had my first treatment.

The Plan

The breast MRI showed no lymph node involvement, which is fantastic. However, the insurance denied the CT scans and bone scans. Triple negative breast cancer is aggressive and can spread without lymph node involvement. The doctor was concerned about my weight loss and fatigue over the last few months. But, despite an appeal and additional documentation, the insurance company wouldn’t budge.

During our visit, she checked my breast, and the tumor is larger with another lump growing on it. My Ki-67 was high (69.75%), which indicates a rapid proliferation rate. Without the additional tests, it is impossible to know if it has spread. Because of the size, it is Stage II.

I will be having eight cycles of chemotherapy and immunotherapy. Each cycle lasts 3 weeks, with labs every Friday and treatment every Monday. Once I complete the 24 treatments, I will have surgery to remove the tumor. After surgery, I will continue with the immunotherapy and either chemotherapy or radiation along with it for another six months.

The Treatment

We spoke to the doctor for a half hour or so before starting the treatment. The facility is clean and bright, the people are friendly. It wasn’t scary or intimidating at all. I was given three pills right away: Tylenol, Benedryl and an anti-nausea medication. Then, they took blood and hooked up the machine to administer the meds. It was my first time using the port and it was so much easier than an IV!

It took almost five hours for the medication to get delivered. I was very happy to have the quilt because I got cold.

When it was over and we got home, my daughter had hung pink ribbons everywhere. Such a nice surprise and it put a smile on my face.

I’ve definitely been feeling sick, nauseous with a headache. My mouth is constantly dry and I haven’t been able to sleep. The worst part, though, is the fatigue. I don’t have much energy at all, so I feel pretty useless.

Still, I’m grateful that it isn’t worse. I feel a little better this morning, ready to celebrate Christmas with my family. Some of the kids are sick, so they won’t be able to come over. But this is our new normal: protecting my compromised immune system so that I can fight this thing.

And fight it we will… together!

The Beginning

It started in the summer. Not the cancer, I didn’t know anything about it then. But my health had been worsening for some time. The arthritis was getting worse and various autoimmune issues kept me in near constant pain. My weight had crept up to almost 260 and I felt terrible. It was a vicious cycle – I would drink sodas and eat sweets for a quick rush of energy to get through work and then crash. I tried to diet, but cutting out soda was too difficult. Finally, in August I reached a tipping point. Something had to change.

My rheumatologist put me on Methotrexate, a drug to suppress my immune system. He warned me that I may have some flu-like symptoms. I decided to quit sugar (including soda!) cold turkey and deal with the withdrawal at the same time. To my surprise, it worked. My pain decreased, and for the first time in years I was able to move easily. The weight started falling off.

In October, I noticed a lump in my right breast. My first thought was that it was easier to feel because of the weight loss, but I wasn’t overly concerned about it. I had a lump that required a biopsy in 2017 and it was benign. I called my doctor and asked for a referral for a mammogram. I have very dense breasts, so it isn’t unusual for me to have a follow up ultrasound. She ordered a diagnostic mammogram and ultrasound for the following week. They showed a 2cm mass at 11 0’clock, so she ordered a biopsy. The surgeon didn’t have an appointment until December 9, but she didn’t want to wait. I finally got in on November 14th.

The results showed invasive breast cancer – grade 3, triple negative with high Ki-67. Our main concern right now is whether it has spread. This type of breast cancer is aggressive. Unfortunately, my insurance company denied requests from the doctor for tests (CT for chest, abdomen and bone scans). Although I have filed an appeal, the doctor thinks it is unwise to put off the treatment.

And so, here we are. I’m looking at a year of treatment. Six months of chemotherapy and immunotherapy, surgery and then another six months of treatment. Radiation and possibly more chemo/immunotherapy depending on the success of surgery.

I have an appointment in a few hours to go over the plan with my oncologist and then my first treatment directly after that. The worst part, for me, is not knowing what to expect. Being informed and prepared is (usually) my superpower. This whole process has been humbling, for sure.