Thursday, March 29, 2007

Thursday, 3/29/07

Feeling better today. My mouth is not as dry which is good, and I'm off the pain meds and on Tylenol. Not as good as the pain meds, but the Tylenol does not make me loopy. Still have a bit of a headache, but nothing unbearable.

Went to the cardiologist for an echo and an EKG. Apparently, chemo may damage your heart so they want to check it out before you start. It appears I'll live one more day.

Wednesday, March 28, 2007

Wednesday, 3/28/07

Got my mediport put in today. It is a devise that is implanted under the skin to allow the chemo to be administered directly into my veins. The doctor said that many patients find this procedure to be more painful than the lumpectomy. She was right! It doesn't really HURT, just very uncomfortable. The port is on my right side, between my collar bone and shoulder. (At least that's where the bandage is.)

As far as side effects go, I have a very dry mouth and a splitting headache. They gave me a different kind of pre-op "la la" drug this time. The nurse did say it would cause a dry mouth, but she didn't say anything about a headache. I would have thought the dry mouth would be gone by now! (It's now midnight, 12 hours after surgery.) Before I left the hospital, they gave me a pain pill for the ride home. Since I hadn't eaten anything since the day before, the nurse brings me a saltine cracker. Remember I said I have a dry mouth? Ever try to eat a cracker with no saliva? Not much fun. I did manage to wash it down with a gallon of water.

Anyway, this too shall pass. Have more tests tomorrow with the cardiologist. Apparently (a rare but serious) side effect of the chemo is a damaged heart.

Monday, March 26, 2007

Monday 3/26/07

I went to see the Oncologist today. My first treatment is scheduled for Easter Thursday 3/5/07. I am currently scheduled to have four treatments, three weeks apart. I will have a mediport put in this Wednesday morning to facilitate the administering of the chemo. I have several pre-chemo tests that need to be done; chest x-rays, EKGs, etc. The doctor says I'll lose my hair 2 -3 weeks after the first treatment. So if y'all have any suggestions on scarves, hats, wigs, I'm all ears!

I also found out I will have the 6 week version of radiation that will start after chemo. Therefore, it'll be mid-July or so.

So things are beginning to happen!

Friday, March 23, 2007

Friday 3/23/07

Re Radiation

As far as radiation is concerned, I’m not sure if it’ll be before or after. You see, I’m in a study for partial vs whole breast radiation. My radiologist randomized me a tad early into the “no chemo” group. I got the whole breast (6 week) with the no chemo. But now that I am in the chemo group, I’m not sure what happens. Do they re-randomize me? Do I stay in the 6 week group? Don’t know. I should find out next week about that tidbit.

Thursday, March 22, 2007

Thursday, 3/22/07

Short story: I have to have chemo. Have an appointment on Monday to nail down specifics.

Long story: My Oncotype DX score is a 19. This puts me in the middle group. Remember, if my score was <= 10 I would not need chemo, if it was => 26 I would need chemo and if it was 11 - 25 the computer would flip the coin. The computer flipped the coin and I got randomized into the chemo group. Which I'm not too upset about since 19 is closer to 25 than 11. I'd rather be on the safe side and get the treatment then risk a recurrence.

For more info on the trial: http://www.breastcancer.org/research_chemotherapy_012606.html

I have an appointment with Dr. Abernathy on Monday to get the scoop. Previously, there was some mention of having to have a port put in, but I'm not sure if that is still the case. Will know more after I talk to her.

Monday, March 12, 2007

Monday 3/12/07

Still waiting for the oncotype results....

Had a WONDERFUL time this weekend at my parent's 50th wedding anniversary celebration. I had 6 cousins and one friend staying at me house. They all were very helpful with getting ready for the lunch on Saturday at my home.

Even though I had a great time, I'm exhausted. I'm glad to be back at work so I can rest!

I'll post more when I get the blood test results back.

Friday, March 9, 2007

Friday, 3/9/07

I got about 20 pints of blood taken yesterday. Yes, I know that I'm only supposed to have 10 pints in my body, but as y'all have been saying, I'm "above average"! :-0 Anyway, it sure felt like 20 pints. Actually it was 8 very full, very large vials. I have to get all of these tests prior to being accepted in the clinical studies. Fortunately, I was able to coordinate the drawing of the blood with both studies, so I only had to have one stick. I am lucky that my cancer was on the left side. (I can not have blood drawn or a blood pressure taken on my left arm) I have a vein in my right arm that makes a phlebotomist pee all over themselves in excitement.

The other bit of "excitement" is that Dr. Boyer (radiologist) apparently randomized me a bit early. She put me in the "no chemo" group. If it turns out that I need chemo, it will make the research nurse's like a tad difficult as she will have to file a ton of paperwork to get me changed to the chemo group. Therefore, I am looking at this as a sign that I won't need chemo!

Other than that, I'm very busy getting ready for the 50th this weekend.

Wednesday, March 7, 2007

Wednesday, 3/7/07

Went to Dr. Abernathy today. She's the medical (chemo) oncologist.

Short story: Still don't know if I need chemo. Should know in 10 - 14 days.

Long story: My FISH test was negative, which is good. However, she wants me to get the Oncotype test done. (see the March 1 post for information on the tests.) This will be the definitive answer on whether or not I get chemo. I've signed up for yet another study. This one is sponsored by the ECOG (Eastern Cooperative Oncology Group). If my Oncotype score is less than 10, I will NOT get chemo. If the score is greater than 26, I WILL get chemo. If it is between 11 & 25, the computer will randomize me to determine if I get chemo or not.

For more info, kick it here --> http://www.breastcancer.org/research_chemotherapy_012606.html.

Misc information: All y'all (that is a nod to Andy G. who, bless his heart, just couldn't quite grasp the concept that all y'all is the plural of y'all, but I digress) have been asking about what I can and can not do.
  • I have resumed the majority of my daily activities - working, shopping, cooking, driving, etc.
  • I am almost back to normal. I tend to run out of gas around 10 pm or so and sleep on average 9 hours a night. My incision is healing nicely.
  • Yes, I can stitch, but I haven't had much time to devote to it. You see, my parent's 50th wedding anniversary EXTRAVAGANZA is this weekend. We have 4 parties in 3 days. Relatives and friends are coming from Chicago, California, New York, Oregon, even Germany for the event. I will be having 7 cousins of various sorts staying at my house for the weekend. In addition, I will be hosting a luncheon on Saturday for about 35 people. So my time has been spent getting ready for the party.
  • I am not yet traveling because of all the Dr appointments and such.

Again, thanks so much for all the cards, emails, food, flowers and plants. It is greatly appreciated. I can't say it enough, I am very lucky to have such wonderful friends and family.

Monday, March 5, 2007

Monday 3/5/07

Heard from Dr. Boyer this morning. (She is the radiation oncologist) The computer flipped the coin and I'm in the 6 1/2 week group. So I'll get the traditional radiation treatment.

When the radiation starts will depend on the chemo decision. If I have chemo, radiation will start after. If I do not have chemo, radiation will start "right away". I'm guessing next week sometime.

We are still in a holding pattern on the chemo. My appointment is Wednesday afternoon. I'll post and update Wednesday night.

Friday, March 2, 2007

Friday, 3/2/07

Went to the Radiologist today for a CT scan. Apparently they do this preliminary exam to get the data needed for the physicist to calculate the path of the radiation beams. And in my case, to get the data for acceptance into the NIC study. The calculations are needed so they can miss your vital organs - like your heart and lungs, along with your rib cage when undergoing radiation. Who knew that a physicist would be your best friend when you get breast cancer?

Any-who, they lay you down on this table that moves in and out of the CT tube. I could have fallen asleep but for the fact that you had to hold your left hand just so, and move your right hand up some, no down. Now move your chin up, tilt your head... that's it!!! I once had a photographer tell me that if it felt unnatural, it'll make the best picture. If that translates to CT tests, this will be a Monet!

Then they mark you up with Sharpie Paint pens - red and blue - and put stickers on you. I look like a cross between a K-4 masterpiece and a Tim Burton movie. They do the marks so they can line you up each time when you go for the radiation treatments. At the end of all this, they TAKE YOUR PICTURE "for their records"! I asked if they were going to post it on the Internet. They assured me they would not... So all you Internet surfers out there, let me know if my picture ends up in cyberspace, will ya? Although I do feel a bit cheated... someone had told me that the radiation techs she had seen where buff young men. Me? I get two twenty-something young women, skinny, blond and WAY too perky. Just my luck.

Still in the hurry up and wait mode on the test results. And still drinking from the fire hose.

Thursday, March 1, 2007

Thursday, 3/1/07

The amount of information available about breast cancer is a bit overwhelming. It is like drinking from a fire hose. So the following is as I understand it at this time...

I went to see the Radiologist this morning. Apparently the NCI (National Cancer Institute) is conducting a "randomized phase III study of conventional whole breast irradiation (WBI) versus partial breast irradiation (PBI) for women with stage 0, I or II breast cancer". I have applied to be part of this study. For more information kick it here: http://www.cancer.gov/search/ViewClinicalTrials.aspx?cdrid=409590&version=patient&protocolsearchid=3098706

What does this mean? (Excellent question....)

WBI is the conventional radiation therapy. It involves 6 1/2 weeks of radiation - every day for approximately 15 minutes a day. If chemo is indicated, radiation will be AFTER the WBI.

PBI is given twice a day, about 6 hours apart, for 5 days. If chemo is indicated, the radiation will be done BEFORE the chemo.

This study is the first multi-institution study of PBI/WBI done in the US. There have been three single site studies done - one of which was Ochsner's in New Orleans. Ochsner's study began in 1991, so they have 16 years of data. Also, this treatment is standard in both France and Hungary.

According to Dr. Boyer, the Radiologist, the long term prognosis is the same for both the WBI and the PBI.

Remember I said randomized? Even though I've signed up for the study, I still need to be accepted by NCI (National Cancer Institute) Dr. Boyer didn't think this would be an issue. More importantly, the computer randomly will assign me to one of the two treatment options. So I may still get the WBI (6 week) treatment option. I should know early next week if I was accepted in the study and which option the computer assigned me.

More about the HER-2 status(also called HER-2/neu) The following is from http://www.breastcancer.org/.

"HER-2 is a gene that helps control how cells grow, divide, and repair themselves. About one out of four breast cancers has too many copies of the HER-2 gene. The HER-2 gene directs the production of special proteins, called HER-2 receptors, in cancer cells.

"Cancers with too many copies of the HER-2 gene or too many HER-2 receptors tend to grow fast. They are also associated with an increased risk of spread. But they do respond very well to treatment that works against HER-2. This treatment is called anti-HER-2 antibody therapy.
There are two tests for HER-2:

  • IHC test (IHC stands for ImmunoHistoChemistry)
    The IHC test shows if there is too much HER-2 receptor protein in the cancer cells.
    The results of the IHC test can be 0 (negative), 1+ (negative), 2+ (borderline), or 3+ (positive). (My IHC test was a 2+)
  • FISH test (FISH stands for Fluorescence In Situ Hybridization)
    The FISH test shows if there are too many copies of the HER-2 gene in the cancer cells.
    The results of the FISH test can be "positive" (extra copies) or "negative" (normal number of copies). (I am still waiting on the results of the FISH test.)

There is an additional test, Oncotype DX. This test helps make chemo decisions for women with ER-Positive cancer. (Me!) Dr. Boyer is going to discuss ordering this test with Dr. Christian. The results typically come back in 10 - 14 days.

SO, I'm still in the hurry up and wait mode.

Many of you are asking how I'm doing emotionally. I'm sure this will come as a shock to most of you, but I'm a very pragmatic person. Crying, carrying on and wringing my hands will not change the fact that I have breast cancer. Am I happy that I have cancer? No, of course not. But I do and nothing will change that. However, I am very grateful that it was found early and I'm confident that by following the recommendations of my doctors, I will live a long and fruitful life. And having the support of such wonderful friends and family can't hurt either!