Oncology 101

Well, my friends, here we go.  I think I'll say up front thank you in advance for all the meals, rides, grocery shopping, errand-running and hand-holding support you will offer and provide over the next, gulp, six months or so while I undergo some pretty harsh treatments.  They say it takes a village to raise a child - well, now, it's going to take one to save my life.  While I waiver between inconveniencing everyone's lives to help me and knowing I would do it for any one of you, this is one of those times where I just don't have a choice.  The friends I've spoken to about what's to come have already planned to rally the troops and set up an army of support.  I'm so very thankful that you all care so much.  And for the record, I hope I never have to return the favour.

As TeeTee and I got closer to the Cancer Clinic, my stomach knotted up and I truly thought I could lose my breakfast.  Instantly, I was comforted by the welcoming staff who all had compassion in their eyes and kindness in their words.  I commented that there were a lot of sick people, thinking, of course, I'm not one of them.

The first step was to fill out a lot of forms, get weighed (I've managed to gain 30 pounds) and then wait for the doctor.  He went over the forms I'd filled out and just confirmed basically that what my surgeon said was accurate: I have a very aggressive form of breast cancer, I would have to undergo harsh chemotherapy, possibly radiation, and he would do everything he could to save my life.  He confirmed that the lymph system is clear, which is great news.  He also said the ultrasound testing I underwent the day before the mastectomy showed two "issues" on my liver.  Yikes.  He said it could simply be blood vessels or something but they have to investigate further to ensure whatever therapies they administer will be the most effective overall.

Then we moved to a physical examination of my breasts.  The "non-breast" is healing well, he confirmed.  He checked the surgical site, which felt weird because it's numb in places and oh-so-sensitive in others.  He also checked my unshaven, ready-to-braid, left armpit.  There's no feeling under there yet so I'm not allowed to shave in case I cut myself and it causes problems.  Then he felt the "good" breast and underneath my sweaty right armpit.  Of course, I apologized for sweating and he said it just goes with the job.  He took my blood pressure and listened to me breathe.  All of that was good.  I said I was surprisingly relaxed and he said my blood pressure confirmed that was true.

Got re-dressed and ready for "the news".  And what a lot of news it was.  My head was spinning but TeeTee was taking notes and gulping alongside me at what we heard.  To confirm the liver findings, I must undergo a CT scan.  He has also ordered a bone scan to ensure my other organs are all functioning normally and my system can handle the chemo.  We discussed a port being inserted in my chest since the chemicals are so harsh and he agreed that would be the way to go.  That requires surgery.  So I will undergo this testing and having the port inserted (to hopefully avoid nerve and vein damage in my arms and hands) before starting chemo, which is currently scheduled to commence the week of November 7th.  He assured me this extra time will allow for more healing from my mastectomy and that's a positive.

As for the chemo itself, I will undergo two types, each for three sessions, for a total of six sessions, three weeks apart.  The regimen is to go for blood work one day and if my blood count is sufficient, chemo the next day, then feeling crappy for the first week, moderately better the second week and then just as I recover in the third week, the process is repeated until 18 weeks later.  I think my math is right - which would definitely be a first!  If the "team" decides I need radiation, that will follow.  The oncologist felt the surgeon removed so much of my breast and since the lymph nodes were clear, it may not be necessary, but it's up to the wisdom of his "team".

So far, as tough as that all sounded, I was pretty much ready to hear that.  It was the numbers and side effects that hit me harder.  Because of the type of cancer I have, the "wonder" drugs would prove useless.  I will be taking anti-nausea medication because, as I said to the doctor, I don't like vomiting and have only done so twice since the birth of my second child over 17 years ago: once upon waking from my mastectomy and the other in Vegas - oops, that was supposed to stay there.  I told him throwing up is a fear second to needles, hence the anti-nausea pill request and the port.

He said since my grandmother had ovarian cancer, albeit only diagnosed in her final days at the age of 90, it is something to consider for genetic testing.  Another "team" will decide if that's part of my journey.  This would determine if I carry a particular hereditary gene and would be something my girls would have to be alerted to so they could be tested as well.  After meeting so many "early twenties" women at the Run for the Cure who have undergone mastectomies to avoid the cancer developing, that really upset me.  The thought that I could pass this to my beautiful children is the worst part of all of this.  As a mother, I want to protect my children, not make them sick.  I've done a lot over the past few years to protect them, probably to my own detriment, and one day they will understand this.  I'm grateful they have tests that may prevent them from avoiding cancer, but if it means going through what I have gone through and will go through, that makes me very sad.

While my treatments will be gruelling, it's the side effects that have me the most freaked out.  I can handle losing my hair, which will happen two weeks into treatment, the fatigue and the loss of appetite but what has me most concerned are the "gross" possible side effects, such as the mouth sores and change to my fingernails, even the possibility of them falling off.  I may suffer nerve damage to the tips of my fingers, either being permanently numb and tingly or very painful.  I kept trying to bargain with the oncologist, opting for numb and tingly and to please keep my nails.  In some cases, people experience heart muscle damage or leukemia.  Okay, isn't that kind of counterproductive?  Are they just trying to make more work?  The thoughts that were going through my mind were frightening and I'm sure my eyes widened appropriately throughout our lesson in oncology.  I thought it would be unique to put a henna tattoo on my head that read "K3 4EVER" but it's not to be.  Apparently, the dye can absorb into my skin and cause infection.

Speaking of infection, it turns out if I get a fever of 38C, I have to call my care team and they will direct me to the emergency ward of the closest hospital for antibiotic treatment.  Seems my own body produces bacteria that could make me sick.  If left untreated, this can be fatal.  Wow.  So I will need to get a thermometer and test regularly for fever.

The doctor used a white board to list the side effects and write down the "numbers".  If I decline treatment, I have a 46.5% chance the cancer will rear its ugly head elsewhere in my body.  So treatment it is.  Unfortunately, since the most current drugs won't work for my form of cancer, I have a high chance of reoccurrence, according to their scales, of 24%.  The oncologist said, of course, no one gets a zero percent chance, as cancer is what it is and there are no guarantees.  They always hope for about 5%.  He said it's a high number but we'll just fight the best we can.  We definitely don't want it to reappear, as there's not much they can do if that happens.  So kill it hard and kill it big is the plan.

I keep reiterating I'm not really afraid to die, as we all have to go sometime.  I've made it a lot further than others and will be grateful for every day.  I just really don't want to suffer through the next six months to be told it was for nothing.  I don't want that for my family and my friends: to watch me complete the prescribed treatments only to fail.  For someone who doesn't ever get sick (except obviously for breast cancer and Vegas) or take medication, this is going to be a very different way of life.

I know it's going to be hard on all of you but I promise I will do my very best.  Again, I thank all of you who truly love me and who will help me, especially emotionally, to survive this beast called breast cancer.  It will take everyone who loves me to be there in order for me to be successful.  So dig deep, please, and reach out in whatever way you can to help me.  Hopefully, in the end, we will all be celebrating together!  Oh, and I don't look great in hats but I may need some funky toques (no itchy wool please) since it's supposed to be the coldest winter in a century!