A Little Piece of My Cancer Story

I was interviewed recently by a writer at Healthmonitor for the new Guide to Chemotherapy. It’s the kind of mini-magazine you’ll find in a doctor’s office, so be on the lookout because you just might spot the glossy guide while you’re waiting, waiting, waiting to see your medical people. The 36-page publication (which is free, and you can grab one for home) is filled with so much wisdom — chemo questions are answered, side effects are addressed, nutrition is covered, date nights are encouraged, and there are two pages devoted to a piece of my story. The article, called “Circle of support, chain of love,” is about my blogging (and my wig sharing), and if you wish to read just a bit of my almost-eight-year-long journey, this is your chance. Just click, navigate to pages 22 and 23, then read.

Run Amuck With the Duck for Lung Cancer

This post is not about breast cancer.

It’s about lung cancer — a disease with a survival rate of 15.5%.

In case you haven’t heard, that just is not acceptable.

Good news is that you can help change such a sobering statistic, and all you need to do is register for Run Amuck with the Duck and either walk or run a 5K.

It all happens in Gainesville, Fla. on March 31, 2012, and in the event you are not local (I realize many of you are not), then perhaps you can make a donation (even small contributions make a difference) to help fund a cure for a disease that is affecting Dianne Caridi, a young woman here in town. She and two other survivors are the girls sponsoring the event, and I know they would appreciate any support you can offer.

So, please think about (1) registering for Run Amuck with the Duck, (2) donating to Run Amuck with the Duck, and/or (3) spreading the word about Run Amuck with the Duck (feel free to tweak and republish this post).

Thank you!

UPDATE, 2/3/12: Dianne Caridi lost her battle with lung cancer.

Mastectomy Trend May Be Misguided

I asked my breast surgeon today for his thoughts on mastectomy for someone in my boat:

  • early-stage breast cancer.
  • no spread to lymph nodes or anywhere else.
  • lumpectomy + chemo + radiation + Herceptin.
  • seven years survival.

“Definitely not,” he told me.  “You’ve come too far, and you are doing so well.”

Plus, I am constantly monitored, and, at this point, my chance of developing a life-threatening breast cancer is slim.

There’s just no need for a such a drastic and major surgery, he said. The resident on service with him agreed.

I told my doc that it seems a trend that woman are removing their breasts after diagnosis rather than saving them when conservation is a real option.

“It is a trend,” he said, sharing that he spends lots of hours in lots of meeting discussing why women are moving in this direction.

If not medically necessary, mastectomy is just not something he supports. He even advises women who do need mastectomy for cancer in one breast to not remove the other one. Why? Because lopping off a healthy breast does not up the odds of survival.

Never did I actually want to cut off my breasts — I just wondered if it was a wise move for someone like me. The majority of readers who responded to my November poll Mastectomy — Do It? Or Too Drastic? chose “Do It.”

But my surgeon picks “Too Drasic,” and so I’m gonna roll with his wisdom.

For now.

Fight Cancer With Fitness (GUEST POST)

By: David Haas

Whether you have just been diagnosed with cancer, are undergoing treatments, or are in remission, the benefits of keeping fit cannot be understated. Exercise keeps the body healthy and functioning at its highest capacity, and for bodies fighting a rigorous chronic disease like cancer, exercise can make a tremendous positive difference.

When my doctor first told me I had mesothelioma, I felt like there was nothing I could do, but he encouraged me to get off my sofa and start exercising, even for a short time daily, so I could make a positive change. Conventionally, healthcare professionals have encouraged cancer patients and survivors to ‘take it easy,’ but Ciaran Devane, chief executive officer (CEO) of Macmillan Cancer Support, stated in an article posted by CBS News that patients would be shocked to know the benefits of physical activity on their recovery and long-term health.

Decreased Risk of Recurrence

Studies indicate that for those who have beat cancer, exercise can help keep the disease from coming back. In a recent article posted by webMD, Kerry Courneya, professor from Canada and research chair at the Physical Activity and Cancer organization in Edmonton, Canada, stated that not only did exercise reduce the risk of recurrence, but it also ensured a longer survival after diagnosis.

Elevated Energy Levels

Exercise is known to reduce fatigue and increase overall energy levels. It also increases stamina. Cancer treatment can be rigorous, and exercise helps build the muscle and stamina needed to better withstand its effects on the body.

Improved Quality of Life

Exercise reduces the risk of other chronic illnesses, like cardiovascular disease and diabetes, while decreasing the risk of other health issues, like osteoporosis and depression. It also enhances mood by releasing serotonin, a ‘feel-good’ chemical in the brain, and produces an overall positive feeling of well-being.

Even a little effort at fitness can go a long way while living with or beyond cancer. It doesn’t need to be anything too strenuous. Small choices like taking the stairs instead of the elevator, gardening instead of watching television, or walking the dog instead of playing a computer game make a tremendous overall positive impact on living.

Thank you, David, for this reminder that exercise is powerful medicine!

Today, I Got a Call

Regarding the the unofficial good news I’d received about my MRI results on Tuesday, I wrote:

(But you know what? There’s a teeny tiny part of my brain thinking that someone might call and say, “nevermind, there is something wrong,” and, in the spirit of being totally honest, I must admit this.)

Well, someone did call today, a someone who gave me the official good news that my MRI was normal, that the wonky results that showed up the first time around were, in fact, due to hormonal fluctuations.

OK, I feel better now.

(Next up on the imaging front is a routine mammogram in June, then another routine MRI in November.)

Seven Years Ago

.Seven years ago yesterday.

On November 23, I had a biopsy. A large needle was placed in my breast and a piece of the lump was pulled out. The surgeon had a hard time getting a piece, however, because it moved around so much. He said this was a good sign, the movement. He sent the tissue to pathology and told me to call his office the next afternoon for the results.

.Seven years ago today.

The next day, November 24 and the day before Thanksgiving, my phone rang at 10:00 a.m., and the doctor who did the biopsy said the pathology report was back already. He said that unfortunately, cancer cells were found. He said I would need a lumpectomy (surgery to remove the lump), radiation, and possibly chemotherapy. He told me to buy a book called Dr. Susan Love’s Breast Book. I got the book that day.

Live and Learn, MRI Style

So, here is what you should know about MRI:

  • Your MRI will pick up everything. Great if you have certain types of breast cancer, because they will likely be detected, and this could save your life. Bummer if it’s not cancer, because you’ll be forced to chase it down like it is cancer in order to confirm that it’s not, and this could take a really long time, and even if it doesn’t take a really long time, it will seem like forever, and you will worry and fret and panic until you find answers.
  • Your MRI should be scheduled for a day that is between something like seven and 15 days after the onset of your period. This is very important. Should you schedule off this track, your MRI (remember, it will pick up everything) will zero in on all sorts of hormonal tissue changes, and this could lead a concerned radiologist to indicate in test results that “malignancy is considered.”

Get where I’m headed here?

In a nutshell, I caution you to (a) realize MRI is a very sensitive screening tool, and (b) make sure you are scheduled properly when you plan to use this very sensitive screening tool. If (a) and (b) converge, you might have a stressful time on your hands, like I just did.

Why for my past five MRIs no one has ever asked about my cycles when scheduling me, I will never know. And WOW, how lucky I’ve been for all those five times to not have happen to me what happened last Thursday. You see, my period started the day after my last-week MRI, and it looks like this just skewed everything. Yesterday’s MRI, though, implemented properly, apparently showed that the worrisome issues had resolved.

<sigh>

No.

<big sigh>

You just can’t imaging how relieved I am, given the fact that seven years ago TODAY, I had a biopsy for a lump I’d found in my left breast. The next day, the day before Thanksgiving, a doctor called me to say, “unfortunately, cancer cells were found.” That just can’t happen twice, with such precise timing.

It just can’t.

And it didn’t.

Now is when I get to declare that I am the happiest girl I know!

(But you know what? There’s a teeny tiny part of my brain thinking that someone might call and say, “nevermind, there is something wrong,” and, in the spirit of being totally honest, I must admit this.)

MRI Monday

The re-do MRI is over, and I fully expect I will get a call in the next day or so from a medical someone who will declare it normal. I really do believe this, even though there were machine technical difficulties this morning requiring a start and stop and start again, an interruption to fix one boob that might have been receiving too much pressure in the apparatus in which it hung, and marks on my body from said pressure that I never noticed after my past five experiences in the tube. Surely, none of that will matter, because my sense, really and truly, is that this whole scare that’s been going on is just a fluke, a false alarm, bad monthly “cycle” timing, something other than the “malignancy considered” wording that appeared on the first MRI.

I’m sure I’m right. I just need someone to confirm it for me.

Waiting.

 

Surgeon Says

Today, I met with a breast surgeon to review what’s happened over the past almost-week. To recap:

  • there was the annual MRI.
  • then the MRI report featuring the awful words “malignancy considered.”
  • then three days of pure worry (and lots of well wishes and prayers).
  • then an ultrasound that prompted docs to utter the happy word, “benign.”
  • then another couple of days of pondering it all.
  • then this afternoon’s consultation with the guy who operates on women with breast cancer.

First of all, who knew the gowns had gotten so lovely in the past seven years. Wow, check out my beautiful blue poncho-style paper cover-up, complete with hanging-open sides that are just perfect for peering in at boobs and muffin tops. It didn’t really matter, though, how substantial that pretty paper is because in a matter of minutes, I was on the exam table, boobs fully naked and prime for examination. And here’s what I learned about the troublesome twosome:

They feel fine. No lumps, bumps, masses, or tumors. No thickening or dimpling or other changes in the skin. Maybe a little nipple redness (we’ll monitor that). No swollen lymph nodes. No infection. No inflammation. No apparent cause for concern.

The game plan: The surgeon will review my MRI and ultrasound Monday morning at a weekly “breast conference,” where all sorts of doctors converge and weigh in on cases. While he’s at the meeting, I’ll be getting a re-do MRI, and he says if it looks better than the first, we’ll sum up that I am A-OK, and I will check back with him in January. If it looks the same as the first, we’ll call it a mystery and continue digging by way of MRI-guided biopsy. No matter what, I’ll watch the nipple (not, like, every two minutes, though, the surgeon said), and I’ll report any continued or worsening redness.

I learned so much from the surgeon today, like if I ever get cancer in my right breast, it won’t be a spread of the cancer I had in the left breast, because cancer doesn’t spread from one breast to the other. It would be another new cancer, and the chances of that happening are something like .5% per year.

I also learned that MRI catches more than 95 percent of invasive breast cancers (there are others, but these are the types that present as lumps). Awesome, right? Of course it is, but the bummer side to the story is that MRI picks up everything else, too. And what the heck does one do about that? Chase it all down, that’s what, just like I’m doing right now, to see if the iffy stuff turned up by that loud and annoying tube is cancer-related in any way, shape, or form. No fun, I admit, but it’s a necessary evil — unless of course, the boobs go away, which is totally an option, and thanks so much to everyone for sharing opinions on whether or not I should just chop the breasts right off (well, the surgeon would do it, not me). Still thinking on that one, but I’ll keep you posted.

Today was a good day. No pure worry, but still plenty of well wishes and prayers, and news that is more hopeful than not.

Oh, and to make the day even better, the skin biopsy I had last week came back normal. I didn’t see that coming at all, but what a treat!

Benign

Docs have talked, and the call at this time is “benign.” No need for biopsy right now. Follow-up MRI at end of month, and, if it shows concerns, we’ll take it from there. <sigh>.

Ultrasound Not Alarming

Initial news is good: no mass, tumor, lump — ultrasound showed a bunch of dense and enhanced tissue + a lot of shadows. What does that mean? Not sure, so ultrasound doc will follow up with doc who read MRI, and she will compare with my previous MRIs to determine what exactly has changed and if there is anything to biopsy. If not, a repeat MRI will probably be scheduled. Surgeon will also be looped into the mystery. So, while I did not get a definite “everything is fine,” I am at peace knowing there was nothing alarming discovered!

Suspended State

“I’m sure you’ll be in a suspended state until you know.”

Suspended state.

That’s it.

Exactly.

Credit for these words, which are so fitting for my situation, goes to Anna. She’s my boss, a faraway friend, someone I’ve never even seen in person — that is so strange, isn’t it? The virtual world makes it possible for me to work at home in Florida with a staff of others who fill a New York City office building. I am so lucky. (Not to have never seen Anna, of course, just to have the great gift of working in my house so I can be a professional and a mom.)

So, if you have not read the posts that come before this one, I am waiting. waiting. waiting. for an ultrasound (hopefully on Monday) that will give a second look at a “new conglomerate of small enhancing foci in the retroareolar region” of my right breast (not the one where I’ve already had breast cancer) and a non-mass-like something in the posterior of the same breast. Malignancy and infectious/inflammatory etiologies are considered, says the MRI report.

The MRI I had on Thursday was just a routine follow-up — a test that was supposed to reveal I am still cancer-free.

Maybe I am still cancer-free. Maybe I’m not. The ultrasound, and probably a biopsy, will flesh it all out. While I wait for that second look, though, I’m sorta just going through the motions and hanging in a balance. I’m up and down, and, well, this is what I feel:

Yes, a suspended state, Anna. I don’t know whether to feel panic or peace, nervous or calm, worry or hope. It’s crazy.

There is still plenty of happy in my world, though. I mean, how can I not count my blessings with a boy who is willing to dance his little heart out at the Gator basketball game last night just to get on TV (and in the newspaper).

All in all, I am fine. I know deep down that if cancer is back, I will just fight it again. And if it is not back, I will be the happiest girl I know.

Quick MRI Results Not a Good Sign

1. Incomplete MRI of right breast with new conglomerate of small enhancing foci in the retroareolar region and non-mass-like enhancement of posterior breast as detailed above. Malignant and infectious/inflammatory etiologies are considered. A second look with ultrasound is recommended to evaluate for discreet lesion that would be amenable to biopsy. If ultrasound in unsuccessful, MRI-guided biopsy should be considered.

2. Normal left breast MRI.

Next up: ultrasound, early next week.

Funny thing: seven years ago, just before Thanksgiving, it all happened pretty much like this.

Of course, it could be nothing.

Or it could be something.

I just want to know.