Two Years!

Two years ago today, I was diagnosed with Invasive Ductal Carcinoma of the left breast.  It was definitely a day that changed my life....in so many ways!  I am so thankful to God for every single day.  It's interesting to me that I can sincerely call this experience a BLESSING!  Who'd a thunk it?

I will be forever grateful to my family and friends who rallied around us....my Parish family who prayed endlessly (and are still praying)....to my online friends who have shown support in ways that I NEVER would have imagined....to the doctors, nurses, technologists and researchers who made my treatment possible and who allowed me the opportunity to have the BEST TREATMENT available....and most importantly...to all those women who have gone before me...who fought the good fight with dignity....for those who won their battle..and those that didn't.

My life has been forever changed.  For the rest of my days on this earth, I will view everything from eyes with a "special" set of glasses.

The ball dropped!!

I knew it was too good to be true. Everything was going too smoothly to not have a wrench
thrown in here somewhere. Let me try to explain this.....stay with me here....this is a long post.


First let me say that I do like my oncologist. He is a cute little round man with white hair and a white beard. Dan thought it would be nice to be receiving cancer treatment from Santa Claus! Too bad his big, red velvet bag will only have toxic drugs for me. I'd prefer a good book, or at least a nice toy!

Here's where the wrench appears.....I have two types of cancer (I already knew this). One is the original DCIS (Ductal carcinoma In Situ) which is non-invasive and the easiest to treat. This means that in that tumor area, the cancer is limited to the milk duct itself. I also have IDC (Invasive Ductal Carcinoma) in another separate area which means that the cancer has actually left the milk duct and entered into the surrounding breast tissue. This is a different ball game.
There a few factors that help to determine my personal prognosis with this disease. Here are some of the factors:

1. Type of cancer
2. Size of tumor
3. Grade of tumor
4. Lymph node involvement
5. Margins
6. Vascular involvement
7. Metastases
8. Hormone receptors
9. Kinetic DNA (agressiveness)
10. Her2/Neu

According to my pathology...we already know what type of cancer I have (see above) and the size (2.7cm x 2.0 cm x 2.1 cm). This is in the moderate range and therefore puts my tumor at a Grade 2 because it is greater than 1.0 cm but less than 5.0 cm. I had no lymph node involvement (37 were removed...ouch!!!). My margins were clear and that means that there was more than 1 cm of tissue around the actual tumor that was free of cancer. I had no vascular involvement and to my knowledge...I don't have any metastatic disease anywhere (more on that later). The DNA was good in so far as it shows slow growth and that I have a low risk for recurrence. Yippy.
I thought that I was hormone receptor positive. This means that my tumor thrives on the estrogen that my body produces. This would have been a good thing because there are drugs (like Tamoxifen) that block the estrogen from the cancer cells. However, that information was regarding only the one part of the tumor that is DCIS...the non invasive kind. Statistically, DCIS is hormone receptor positive 80% of the time. Unfortunately....they did NOT do this test on the invasive portion of the tumor. This is a totally separate type of cancer and therefore I cannot assume just because the one is positive...the other will be too. If it is hormone receptor negative...this is not a good thing. It doesn't necessarily mean that I will die tomorrow...but it does mean that one type of ammunition to fight the cancer is not available to me. Rats. My oncologist said he spoke with the pathologist about this today and they will do that test tonight and should have the results sometime next week. More waiting!!!

The Her2/Neu has to do with certain proteins and gene amplifications. Very confusing. All I know for sure is that high levels of this protein indicates that there is poorer survival and also this can make the cancer less responsive to certain types of chemo although they can be treated with something called Herceptin but I don't know much about it. The other part of the wrench here is that they also neglected to test my tumor for this too.

So....all of this to say that I am without two very vital pieces of this puzzle when I thought my puzzle was complete. The outcome here is directly related to my long term survival and this scares the "you know what" out of me.
On a slightly positive note.....he says I don't have to have radiation.

One last thing....in the next two weeks I need to have the following:

1. Port-a-Cath inserted into my right chest area under the skin which will remain there for one full year following the completion of chemotherapy. (Good bye drains....hello portacath).
2. Nuclear Medicine full body bone scan
3. Cat Scan (with contrast) of my chest, pelvis and abdomen
4. Muga Scan (I think this checks to see if my heart is strong enough for the effects of the chemo).

Needless to say, I'm a nervous wreck about all those tests...I mean, technically, I could have cancer all over my body and not even know it. I swear I will be totally gray from worry before my hair falls out!!

I'm walking around in a daze. The reality of it all has hit me yet again. This isn't something than I can fool around with. I'm fighting for my life here and I'm not sure I can handle it. I don't know what to think, how to be, or what to do. All I know is that today...for this minute, I feel very alone. I know there are tons of people praying for me everyday and I'm so thankful...but today, I'm having a "Garden of Gethsemane" moment. I don't want this cup...

0 for 37!!

There is good news to report today! Here is what the pathology report states (emphasis mine):

Left breast with axillary contents, Radical Mastectomy:

Invasive moderately differentiated adenocarcinoma, ductal type, 3.0 x 2.7 x 2.7 cm.

Associated moderately differentiated ductal carcinoma in situ is present.

No vascular invasion is identified.

Thirty-seven lymph nodes negative for tumor.

Negative surgical margins.

Nipple, no significant pathologic abnormality is identified.

This is most definitely an answer to prayer! I didn't even realize how so very worried I was until I was able to read the report. I could physically feel a weight being lifted from my shoulders and it was like I could instantly breathe easier.

I don't know what this will mean as far as treatment goes, but, I know that I will face it with more hope than before. These past few days have been very hard for me....both emotionally and physically. I want to be back to "normal" but I now have to consider what my new "normal" will be. Today, I am still very sore. My arm is sore all the way down including my forearm. The surgical tape is beginning to peel away and causing some burning and itching. Whenever I stand up (or sit down) or move around in any way, the muscles in my left chest and underarm area begin to pull and stretch! This causes great pain! Sometimes, it brings tears to my eyes. For the first few days, much of my upper left torso was numb. This was because of anesthesia and the fact that they severed many tiny nerves. The numbness is beginning to recede and thereby allowing me to feel more of the pain. I know this is normal but, it makes the reality of what has just happened inescapable. I thought I might be able to hide under the covers or hide behind pain medication for a couple of weeks and then be back in the normal swing of things. Apparently, that's not going to happen any time soon.

Peggy, who is one of the breast care coordinators that has been helping me through this, said that with this journey I will have times when it is one step forward and two steps back. She was right. I don't know if any of you are familiar with the game Chutes and Ladders (I've played endless games with my kids) but I feel like lately my life is a lot like that game. If you've played it...you'll know what I mean.

I made a point to get up, get dressed and go to mass as a family this morning. I purposely didn't take a pain pill because I didn't want to be loopy at church. Although it made sitting in the pew more painful...I felt surrounded by family and friends and I was strengthened. I didn't feel self conscious about my chest being flat on one side. I felt loved and supported. I am still overwhelmed by the love and care that our family has been shown through this time. A dear friend likened it to those Verizon commercials....you know the ones...where the whole Verizon team follows behind the customer. This is EXACTLY how I feel!! You guys are the BEST team I could ever have! Thank you from the bottom of my heart!!

2008 - The Year of Firsts

Some of the "firsts" in our lives are exciting. Your first kiss, your first love, your first dance. Then there is your first car, your first checkbook and your first place. The first time you were totally responsible for yourself and paid all of your bills on time! Other firsts are emotional "biggies" like meeting the man you will marry and knowing it in your gut. Feeling the life inside of you stir within your womb, holding your babies in your arms. There are other types of "firsts" too that aren't all that great. Like the first time you realized sharing a bathroom wasn't so fun, the first time you had a fight with your spouse, the first time you put your children in time out, the first time you had to call the pediatrician in the middle of the night.

I suppose firsts can be good or bad, depending upon how you look at them. This year...this month in particular, has been the "firsts of all firsts" for me. Just this month, I found out that I have breast cancer. I have a particular kind called IDC or Invasive Ductal Carcinoma. This is a cancer that first begins inside of the milk ducts, but over time, creeps out into the surrounding breast tissue. Hearing the word "cancer" in relation to my own physical person....was a first. Then of course, there are the first time medical tests.....stereotactic need biopsy, ultrasound guided core needle biopsy, MRI, estrogen receptor tests...and it goes on and on.

I also experienced for the very first time...my own mortality. The fact that I'm not going to live forever. Now, I know what you're saying to yourself....."Eeeevvverrryyybody knows that we don't live forever". Yes, I know that too. But when you are faced with the real possibility of suffering, separation from family and friends and death.....well, all I can say is that this first.....hits you as if you've been punched in the stomach. It's truly palpable!

Thankfully, my faith in God, and His Holy Catholic Church remind me that this life is only a journey! It's not the destination! There is other good news too....I am not angry at God. I'm not even angry at the cancer. So far, I just keep asking why. I know that in these next few months, there will be many answers to that question. Right now, as I wait for my next first...my mastecomy day (August 4th) and for the rigorous treatment that will surely follow, I surrender my fear and I offer it up to all the women of the world who will be told the breast cancer news and for all those experiencing firsts!