Health Status

Update 10-19-24

I am now post-treatment and am cancer free! I will continue to have checkups with my oncologist every 4 months for the foreseeable future. I'll also have echocardiograms to check on my heart health at those same regular intervals because the medications I was on can damage the heart. I have an increased risk of pancreatic cancer because of my PALB2 gene mutation, so at 50 I'll begin periodic screening at MD Anderson to watch for signs of pancreatic cancer. 

Update 2-5-24

I've finished chemo now and have had my double mastectomy.  My results from chemo were the best possible: no live cancer cells left in my tumor.  So amazing! God really came through, heard all of your prayers for my healing!  It's been about 7 weeks since my DMX and I've healed nicely.  I still have a bit of a limit to my range of motion because of scar tissue developing in my chest, and the tissue expanders that have been inserted to get my skin ready for my reconstruction are a bit uncomfortable, but it's not limiting any of my normal activities. I'm not able to sleep in my favorite sleeping position, which is partly on my side and partly on my stomach. This can interrupt my sleep a bit because I naturally roll that way but it's painful so I wake up. 

My reconstruction will be on June 7 and I'm planning to have a DIEP flap.  You can read up on that here.

I still visit MD Anderson every 3 weeks for HER2 cancer targeted therapy.  Two medications are infused through my port that are meant to find any remaining HER2 cancer cells that may have found their way into my bloodstream. HER2 therapy also trains your immune system to find cancer cells and attack them.  I do have some side effects from this therapy, which I'm a little disappointed by (many patients have no side effects from these at all).  I feel better now than I did while I was on chemo though, so for that, I am thankful.

Update: 9-16-23

I've had some obstacles thrown in the way that have slowed down my treatment.  On 8-25 I was admitted to the hospital for a staph infection that had traveled to my bloodstream.  The infection came from my port.  The port was removed and I was discharged from the hospital a week later, on 9-1, with a picc line to administer IV antibiotics at home through 9-25.  My doctors wouldn't sign off on chem for two Fridays in a row, for fear of dropping my WBC count and reducing my ability to fight the infection.  I was finally cleared for chemo again on 9-8.

At that second chem treatment, I had an anaphylactic reaction to my chemo less than 5 minutes after it began to drip.  The reaction was so severe that I stopped breathing, lost consciousness and my HR was at 20 bpm for a couple of minutes.  I was admitted to the hospital overnight to be monitored and assessed.  My doctors feared I had had a heart attack, but my enzyme tests all came back clear.

My chemo was switched from Taxol to Abraxane on 9-15.  I was VERY apprehensive going into my 9-15 treatment.  The taxane family of chemotherapy drugs are used on HER2+ cancers.  My oncologist was hopeful that I wouldn't react to Abraxane like I did Taxol because Abraxane is suspended in a protein rather than a solvent.  She suspected I had reacted to the solvent.  On 9-15 I did start to react to the Abraxane.  They slowed the rate of the drip by 75% of what is normally given, and that (along with extra Benadryl) controlled the reaction.  I was able to receive my full treatment, but it took 4 hours rather than the 1 hour it takes other patients because of the slow drip.

If things had gone to schedule, I would have just finished my 5th treatment of 12.  Instead, I've only finished two.  This is concerning to me and my team of doctors, because the cancer has had the chance to grow in these weeks.  I will most likely be ordered an ultrasound to be sure my tumor hasn't grown or been able to move to my lymph nodes.  If the 9-15 treatment hadn't have been successful, I would have been sent to surgery within a few weeks.  Abraxane was the last resort.  So, please be in prayer that my body will continue to tolerate the Abraxane.  

Because of the slow drip I have to receive, my short treatments will now last 5 hours rather than 2, and my long treatments will last 8-9 rather than 5.  This is a huge change, but I'm looking at it as a way God is forcing me to slow down, rest and heal.  

I will most likely have my double mastectomy around Christmas, about a month later than originally thought due to the infection and allergic reaction.

Previous Treatment Plan:

On 8-1-23, my team of doctors at MD Anderson developed a treatment plan for me.  On August 18 I will begin chemo.  I'll have chemo for 4.5 months, will take a 4 week break, and then will have a double mastectomy in January.  After the surgery, my breasts will be examined to find any smaller tumors that may have been missed.  All of the tumors will be typed at that point to be sure no other form of cancer besides ER+/PR+ and HER2+ is present.  At that time, they will also determine if the chemo has been fully successful at killing the cancer cells in the tumors.  If there is a "complete response," I will remain on what is called "cancer targeted therapy" through next August (to total one year).  This is not chemo, but rather a targeted therapy that targets and kills HER2 cancer cells by targeting the protein they produce.  If there has NOT been a "complete response," meaning the tumors in the breast weren't as affected by the chemo as they would have liked, I will remain on the HER2 blockers and will undergo another 10 months of chemo.  

I plan to do my reconstruction in the summer of 2024 so I don't have to miss time in the school year with my students twice for surgery.

Diagnosis:

On June 28, 2023 I was diagnosed with invasive ductal carcinoma and ductal carcinoma in SITU.  The tumors were ER+ and PR+ as well as HER2+.  The cancer was in the left breast at 6:00, about 6 cm from the nipple.  The largest of the tumors was about 2.7cm in size (about the size of an almond).

So, to put that in American English for those of us who don't speak in medical terms in our regular vernacular....

My cancer formed in milk ducts in my left breast, in the center of the breast below the nipple.  I had more than one mass, and the largest of the masses was "invasive" which means it  broke out of the duct and has begun to invade the surrounding tissue.  The smaller masses were still SITU, which means they were still contained in their original location (inside the duct).

The cancer had hormone receptors (ER+ and PR+).  This means it was fed by estrogen and progesterone in my body, both what I produce naturally and what I ingest.  It was also HER2+.  For more on what that means, you can read here.  But in general terms, HER2+  breast cancers have tested positive for a protein that promotes the growth off cancer cells.  Essentially, the cancer makes a protein that causes it to grow.  This makes the cancer more aggressive, causing it to grow at a faster rate.  My type of cancer, with two types of hormone receptors that is also HER2+, is also called "triple positive" breast cancer.

How did I get here......

Lots of you immediately ask if I found a lump on my own.  Especially when I tell someone my age (40) about my diagnosis.  No, I didn't find a lump that caused me to make an appointment with my doctor.  In fact, even knowing I have a lump and exactly where it is, I still can't feel it.  Scary, right?  Well, here's the skinny on my particular story.

I started to get mammograms at 35.  I had a lump my doctor found and wanted to have scanned at that age.  The mammogram showed no concern.  Then, about 18 months later, my mom's mom died of pancreatic cancer.  My mom had breast cancer at 55, a few years before.  Because of the two types of cancers in her and her mom, my mom was tested for any sort of gene mutation.  Her blood work came back positive for PALB2, which is sometimes called a cousin to the BRCA genes.  It increases breast, ovarian, pancreatic, and prostate cancer risk.  I also tested positive for the mutation.  So at 37 I started to go in twice a year to MD Anderson.  I would have mammograms in June and a breast MRI in December to keep a close eye on any changes.  I had a biopsy on my 39th birthday after they found a lump on the right side but the pathology was benign.  

I had dense breast tissue that always feels lumpy when I do self breast exams.  I couldn't discern what might be a lump and what is just my regular breast tissue. On one of my regularly scheduled scans they found my masses.  I had several on the left side, and even my NP couldn't feel them after seeing them on the scans because of how generally lumpy I feel everywhere.  READ THAT AGAIN.  Even my highly trained MD Anderson Nurse Practitioner couldn't find my lump(s)!!

So, the moral of the story here ladies, is go get your mammograms.  Don't rely just on the fact you or your doctor will be able to palpitate a lump.  They're sneaky little buggers.  Am I saying this to scare you? No.  I'm saying this because, as my mom says, "knowledge is power." Take your health and wellbeing into your own hands.  There's no better advocate for you thank yourself.