Tag Archives: breast cancer

When Will You be Done?

This is the question I hear most frequently from people.  They see my hair growing back and assume either I’m done with treatment, or must not be going through treatment at the moment.  The answer is, I will never be done treating for metastatic breast cancer.  If I am “done” with treatment, it will mean that I’ve decided the disease has progressed so far and fast that treatment will do nothing but further diminish the quality of my life.  At that point, I’ve decided I won’t put myself through the side effects and will spend the time I have left with my family.  I’m already considered an “exceptional responder” in that I’ve survived more than 5 years with mbc.  The odds of that are only 1 in 4.

I am still actively treating.  Currently, I’m on an IV drug called Gemzar or gemcitabane. The side effects include flu-like symptoms, fever, nausea, fatigue, and lowered platelet counts. Hair loss is minimal and mostly consists of hair thinning.  I have treatment once a week for 3 weeks and then have one week off.

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Treatment starts

The off week happens because usually, after 3 rounds my blood counts have lowered to the point that it would be dangerous for me to have another treatment.  The off week gives my body a chance to recover and get ready to do it all over again.  My last scans showed that this treatment is holding things steady.  It doesn’t mean that the cancer is gone or has gotten less severe. It means that the chemo is keeping things in check and more or less, nothing new has grown.  I have a few new spots, but they are small and some other spots have gotten a bit better.  So, the fire wall is holding and we are keeping things at a nice, slow, contained burn.

 

In the meantime, I do what I can to support my body and me.  There is no magic or nutritional cure for cancer.  You can support your body and immune system, and I do. But eventually, the cancer will outsmart your immune system and spread.  This doesn’t mean I give up and don’t do what I can to help myself.  I like to say I’m a “realistic optimist” and I do all kinds of things nutritionally and otherwise to support my mind and body.

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How I look a few hours later. Blaghh.

I’m fully aware of reality and what can happen.  I’m just hoping it doesn’t happen for a long time. That’s one of the scariest parts of living with the unpredictability of this disease. Things can happen so quickly.  Even though my scans look stable there is a tiny part of me still nervous.  This is because I have lobular breast cancer and my tumor markers are at one of their highest points ever. Usually, when a chemo is really working, my markers will go down. Lobular bc is notoriously hard to see on scans.  It grows in sheets, or fingers instead of compact tumors.  Which makes organ involvement harder to spot.  But for today, I’m good and I’ll stay with that!

 

Despite being on Gemzar I’ve been busy.  I’m not sure how chemo side effects and timing have worked out so well, but they have.  We’re gearing up for Ladies Midsummer Wine Night, our annual fundraiser for mbc research.  This year we hope to break the $100,000 mark!  I also gained a greater understanding for why supporting small research grants is so important.  In my enthused, energetic chemo break last winter I applied to be a consumer advocate for the DOD Breast Cancer Research Program.  I was accepted and served on a committee looking at incoming research grants.  I’ve never been in a room with so many MD/PhD labels! IMG_2492 Before research grants can apply for certain funding levels, they have to support their proposal with preliminary data.  Many researchers have fantastic ideas, but don’t have the funding to gather this preliminary data and take their ideas to the next funding level.  This is what Team Judy helps to support with our mbc grants.  We choose a researcher to support at the Masonic Cancer Center, University of Minnesota, so they can gather their preliminary data in order to apply for the larger DOD and NIH grants.  It’s disheartening when you realize how few research dollars goes towards metastatic research.  Over 1600 Americans die every day from metastatic cancer.  We must find a way to figure this out.  It’s also why I was happy to participate on a panel at the University of Minnesota Cancer Moonshot event on June 29.

IMG_2470Too many Americans are dying from cancer. We need to collaborate and share the data that comes out of publicly funded research grants.  Often times, large institutions delay in sharing their data.  That’s not cool, so to speak. We also need to look at all sides of the problem.  We can’t just focus on prevention and treatment of curable cancers.  If we don’t understand how cancer metastasizes then we are missing vital pieces of the puzzle and won’t have a clear picture on how to control metastatic disease.  If you’d like to help Team Judy support metastatic breast cancer research grants you can donate to our crowdfund page.  100% of what we raise goes directly to the labs of researchers at the Masonic Cancer Center, University of Minnesota.

 

Colors

I’ve been thinking a lot about the book ” My Many Colored Days” by Dr. Seuss.  It’s been an apt descriptor of what life has felt like recently.

“Some days are yellow, some are blue.  On Different days I’m different too. You’d be surprised how many ways I change on different colored days.”

My last scan showed some cancer growth, with new lesions on my spine and one of my left rib.  The pain in my spine has been tolerable and well controlled with pain meds and by managing what I do physically.  I have been surprised by how much I’ve felt my rib pain.  Last month after my scan results my doctor and I discussed what to do next.  Both of us felt that given the new lesions it was unlikely the Ibrance was working anymore. However, since my next treatment option was IV chemo I wanted to wait another month to see what would happen next.  Moving to the next drug would have a significant impact on my quality of life.  Unfortunately, during this last month the pain in my ribs has increased quite a bit.  I’ve learned that I really do have to stay on top of my pain meds and not try to martyr through it.

“Some days, of course feel sort of brown.  Then I feel slow and low, low down.”

I like to think I’m pretty tough, but this has taught me that sometimes I’m just not.  Pain is exhausting.  It makes me crabby and  lowers my patience.  Steve is much happier when I stay on top of the pain meds, and so am I.  I’ve learned that the importance of sleep continues to be underrated in this country and it’s tough to sleep when you can’t roll over without groaning and letting out an expletive;  tough for both of us.  I met with my doctor again last week and was truly surprised at how much the pain had increased.  This of course bought me another set of bone and CT scans to make sure nothing else has grown.  Bone and CT scans aren’t the best way to look at lobular breast cancer, but it was too soon for insurance to pay for another PET scan.  Based on these most recent scans it looks like my rib met has increased a little bit and so has one spot on my spine.  Nothing really huge, but enough to know that the treatment I’m on is no longer working.

“On purple days I’m sad.  I groan. I drag my tail.  I walk alone.”

Monday I went into Abbott and had a port placed.  I’ve been lucky and unlucky that I haven’t had this yet in 9 years of treatment.  A port is a device placed under your skin.  It is connected directly to your vein and makes it easier to have labs, chemo and contrasts for scans and other tests.  I have pretty terrible veins and sometimes it’s an event in itself to get an IV in me.  This will make things much easier, but on the not really important, but still kind of stinks side of things; it means I have another scar and another “thing” in my body that just shouldn’t be there.  Next Thursday I’ll start IV chemo.  There are no other oral chemo pills for me to take at this time.  Cancer will now get to run a little bit more of my life.  I’ll head down to the oncology office one day a week for three weeks and then have one week off.  Treatment should be fairly quick, about 2-2.5 hours.  I asked my doctor how long I’ll have to do this.  Here’s what he said ” Until this works like a charm and kicks back the active metastatic lesions, ( MY first choice), or until the cancer grows and we know it’s not working and have to switch to something else, (another IV chemo) or until we figure out you are not tolerating it well and we have to switch.”  In other words, welcome to the new reality.  It also means I’ll be “outed” as a cancer patient. I’m going to lose my hair again.  As annoying as it can be sometimes to feel really crappy and still have people say how great you look, I have enjoyed being able to be incognito as a cancer patient.  I can still wear a wig, but it won’t be the same as having hair no matter how great the wig is. So, how do I feel?  I’ve felt just like Dr. Seuss describes.  I’ve had all kinds of emotions.  Anger, fear, sadness, loneliness and then round about back to acceptance.

Green days. Deep deep in the sea.  Cool and quiet fish.  That’s me.”

People say they admire my bravery, courage and strength.  I want everyone to know that I don’t always feel that way.  Sometimes I’m not brave and I don’t have a lot of strength.  I cry, I get scared and I lose faith.  This cancer is not a gift.  It can teach me things, but I have to choose how and what I’m willing to learn.  I have to make a choice some days to get up off the floor and to act like I have faith even when I’m not feeling it.  There are nights I go to bed and will wake up with a panic attack; scared and wondering how I’m going to make it through this.  How much will it hurt?  How long will it go on?  How much can I really handle before I fall apart?  It’s then I have to remember to grab on to the tiniest of things to be grateful for and hold on for dear life.  I whisper to God that I’m losing it and need help.  I don’t always feel calm right away, but I keep remembering that I need to quit thrashing and start floating.  So I take long, slow deep breaths.  I keep telling myself it’s going to be ok until at least my heart and my body start believing the words and i can go back to sleep. And basically, that’s how I manage cancer.  One day at a time, one moment at a time.  I practice gratitude, because I know there is always someone out there going through something harder than I am.  I leap blindly with faith and hang on to the belief that somehow this will be manageable and I’ll make it through until the end.  I cry and despair and then I get up and live another day.  Some days with more grace then others.

“Then comes a Mixed-Up Day. And WHAM!  I don’t know who or what I am. But it all turns out all right you see. And I go back to being…me.”

108 Every Day

Yesterday I celebrated my 53rd birthday, my fourth birthday since being diagnosed with metastatic breast cancer (mbc). While I was able to celebrate another year of life, 108 others with mbc in the United States died. Today, another 108 people will be robbed of their next birthday and tomorrow 108 more.  Each and every day 108 mothers, sisters, friends, cousins, husbands, brothers and sons with metastatic breast cancer die. It has to stop.

This past weekend I attended the Living Beyond Breast Cancer conference in Philadelphia with over 300 others with mbc. The conference began by asking those in attendance to stand up according to the number of years they have been living with mbc.  First, those diagnosed 2 years and less stand, then those diagnosed 2-5 years ago and then 10 years or more.  The largest number stand for 2 years or less.  By the time we get to 10 or more years there are only a handful standing.  We clap and applaud these exceptional outliers, each of us secretly hoping that will be us some day, but knowing the reality is unlikely. From 2000-2013, 15 billion dollars was raised for breast cancer research,  but of that 15 billion less than 7% was spent on research for metastatic breast cancer.  You can read the study in its entirety on the MBC Alliance website. This year the LBBC conference trained its first group of Hear My Voice advocates, but advocacy takes time and time is one thing people with mbc don’t have, so out of frustration a die-in was organized, Why I Organized a Die-In, and Philadelphia Story.  108 of us gathered together and got down on the floor. We closed our eyes; some of us holding hands, and recognized our greatest fear. It was hard, really hard, lying there and knowing that one day I would most likely be one of the 108.  I lay there thinking about all of the things I was probably going to miss, my son’s graduation from med school, grandchildren, vacations, all of the milestones and memories that make life so precious. I thought of the increasing number of young women being diagnosed with mbc and what was going to be taken from them. The picture of us is dramatic, uncomfortable, but mbc is not pretty. It’s hard to visualize the reality of living and dying with mbc when others look at me. I don’t look sick.  There is a lack of congruence when you see me and think of the 108 who die each day.  But when I was on the floor with those other 107 the reality became evident.  My hope is that someday mbc will become a chronic illness, similar to what we’ve been able to do for AIDs.  People with mbc are starting to develop their voice, I hope the world starts listening.

One Week

It’s been a crazy week.  Last Wednesday we meet with my oncologist to go over my blood work and scans.  My scans didn’t show any major progression, but my tumor markers were almost as high as they’ve ever been.  There are many different kinds of breast cancer.  I have lobular breast cancer and one of the characteristics of lobular breast cancer is that it tends to grow in a more diffuse pattern and it can be much harder to detect its spread in ct/bone scans.  Tumor markers don’t tell the whole story either.  For some people they are totally unreliable.  However, in my case we have 9 years of data on my markers and know that they are a pretty good indicator of what’s happening in my body.  I’ve also been having some more pain in my back and other areas.  All of this information put together lead my oncologist to determine that the current drug I’m on is not working.  I agree. Problem is, the next course of action is IV chemo. There is one new drug that was just approved this month called Ibrance or pablociclib, but the chances of it being available and approved by insurance were very, very slim.   So, I was scheduled to have a port placed in my chest this morning and to begin my first round of Abraxane.  I’d receive an infusion once a week for 3 weeks and then have one week off.  This would continue indefinitely.  One of the major side effects of Abraxane is hair loss.  Darn!  I was ready for moving to IV chemo, I knew that was the next line of treatment,  but I hadn’t quite prepared myself for being bald again.  I didn’t wear a wig last time, but this time I went to the wig store on Saturday and was fitted for a wig, then I called my hair stylist and scheduled an appointment for this Friday to have my hair cut short.  You usually lose your hair within 3 weeks or so on Abraxane and having it cut short now would make it easier for me when it started to fall out.   On Monday my doctor called me back.  He had been talking about my case with other doctors in the oncology clinic and one of them had just been able to obtain Ibrance for a patient in the clinic.  Hold everything!  So, we decided to cancel the surgery for this morning and see if we could obtain the drug.  Ibrance is a new oral drug that works differently from other aromatase inhibitors I’ve been taking.   Most drugs currently available for er/pr+, Her2- breast cancer target the hormone receptor pathways and try to disrupt those pathways.  Ibrance takes a different approach and targets a family of cell proteins (CDK4/6)  that are responsible for cell growth and stops those cells from dividing.   Well, I just received the call today that insurance has approved my trying this drug.  Whew!!!  Talk about in the nick of time! Need I say more about the importance of additional research for metastatic breast cancer and treatments?  It’s unlikely that when this drug stops working there will be another newly approved drug to take its place and I will have to start IV chemo.  But for now I’ve been given a period of grace.  There will still be side effects and I’m hoping I handle them well.  I’m heading to Europe in April and for me this is all about quality of life and being able to have a great trip with my friends and my son.  We’ve talked about this trip for years.  We had always said that when he was accepted into med school we’d go to Europe together.  It was making me pretty sad to think that the pictures he would have for memories would be ones of me in a hat or scarf and looking like a cancer patient.  I’m pretty happy with flying under the radar sometimes.   It’s funny how having your hair allows you to look normal and healthy even though you are far from it.  So today I was grateful that I was at the club exercising instead of waking up in the recovery room and then heading over to oncology for my first infusion!

Waiting

Here I sit.  Waiting for scan results.  It’s not much fun.  Somedays I handle it better than others.  I keep trying to look inward and make a guess as to what’s going on in my body.  Has it spread?  Gotten better, stayed the same?  All the while trying to live a normal life and keep things in perspective.  I seem to live out my life in 30 day increments now.  If my markers are looking good I let out a sigh of relief and push things down for another 30 days until the next doctor’s appointment and treatment.  It’s a different way to live.  I’ve been making travel plans, but my markers are going up and I start to wonder how I’m going to feel in 2 or 3 months.  I don’t know for certain.  I bought travel insurance for the first time.  Seemed like a prudent thing to do.  Yep, for me having cancer is like doing Tree Pose.  Some days my balance is better then others.  When I’m wobbly I have to just accept it and feel what there is to feel.  Emotions are ok.  There are no good or bad ones.  I can be scared, angry, sad, and irritated and it’s all right.  There is no “right way” to do cancer.  There is only “my way” and I can’t get it wrong.  When I’m ready, I’ll push myself up off the floor and choose to be grateful for the little things.  I’ll try balancing again and it may be easier, it may not.  But I’ll accept myself where I am.Pet Scan

 

Finding Equilibrium

“How do you do it?”  I hear it over and over again.  How do you live with a diagnosis of metastatic breast cancer and continue to live your life in a positive and productive way?   We all have hard things in our lives.  All of us.  No one has it easy all of the time, but some people do seem to be able to weather the rough water, bumps, obstacles and tough spots better then others.  What’s the difference?  Sometimes I look at having cancer as trying to learn Tree Pose. In yoga, Tree Pose is when you balance on one foot and lift your other foot and place it somewhere on your opposite leg.  As you get stronger and find your center of balance you’re able to place one leg higher, lift your arms higher over your head and find yourself feeling grounded and strong, just like a tree that’s been there forever.    The trick is to ground yourself and to not condemn yourself when you loose your balance.  If you start to fall you have to let the self-judgement go.  The more you talk down at yourself for not finding your balance, the less balanced you’ll be.  If you just let it happen, accept where you are that day then you’ll find your center again.  It’s curious how this pose can be easier or more difficult from one day to the next.  Some days it’s just hard to find that balance, that sense of calm and grounding. Living with a terminal, chronic illness is the same.  Some days it’s easy, others it’s hard.  There is no magic answer.  I have found that the more I choose to be grateful and ground myself in the present moment, the better the day will be.  If I’m in pain, I’m tired or I’m frustrated because I’m just not getting everything done that I thought I should be getting done or even wanted to, I need to let it go.  Refocus on where I am at and think about what’s good about that very moment.  Having gratitude and finding balance isn’t always pretty.  Sometimes you just do it because you’ve made a choice to.  Somedays I can’t do Tree Pose as well as I used to before cancer.  I let that go too. I do the best I can.  I forgive myself when I fall and I choose to try again.  Sometimes, I let myself stay on the floor for a bit and study where I’m at.  Sometimes I pull myself up, other times I have help and a friend reaches out.

Gotta Start Somewhere….

I’m going to break the rules right off the bat and admit that this blog isn’t going to be about cancer all of the time.  I like to cook, so I might share some food porn and a recipe here and there.  I’m also a licensed Parent Educator and I may feel the need to occasionally hop on that soap box  and talk about early childhood development.  I’ve followed the rules most of my life and I’m spending the last of them trying to be much less compliant.  Guess I’m a rebel with a blog.

A Rebel with a Blog
A Rebel with a Blog

Here’s the shortened back story.  8 years ago I had a mammogram in December.  I was 43 years old.  All was clear.  About a month later I started having the same  dream repeatedly.  I’d awaken each night at the same time,  agitated and afraid. I would tell myself to remember the dream in the morning.  The next day, I’d remember that I’d had a dream, but could never recall any of the details.  A few months later in March of 2006,  I found a lump in my right breast.  Turns out I had invasive, lobular carcinoma.  The night after the nurse called with my biopsy results I had the dream one last time and finally remembered it the next morning.  I haven’t had the dream since.  I dreamt that I was lying in my bed looking up at the ceiling.  There was a large, swirling black cloud that was gaining speed and intensity.  With a force I could feel, it swooped down and hit me right in the chest.  Actually, it hit me right where I found my lump.  How weird is that?  I’ve learned to trust my intuition and I’ve come to believe that somehow I knew something was going on with my body, but I just wasn’t paying close enough attention.  My dog also knew something was up.  He started following me everywhere.  Like glue.  I just couldn’t shake him.  It felt like I had a stalker with four paws.

I started out by having a lumpectomy, and then a mastectomy when the doctors had a hard time getting clean margins.  I decided on a single mastectomy.  There was no lymph node involvement.  I was a stage 1 and felt very lucky to have caught things early.  I had 4 rounds of A/C chemo and then went on Tamoxifen for 5 years.  The hot flashes were hell! A month or two before my 5 year check up I remember noticing that my dog was stalking me again. A little warning bell went off in my head, but I ignored it.  I saw my doctor for my five year check up.  We did the normal labs, he gave me the all clear and I floated out of the office.  I was so HAPPY to think I would never have to see that place again.  Two days later the nurse called to let me know that labs were back and my tumor markers were elevated.  Que the tragic movie score. Rounds of needles, scans, and phone calls later I learned that the breast cancer had metastasized, or spread to the bones in my spine. I’d gone from a simple stage 1 to stage IV just like that.

This is where you learn that Pink is Complicated.  It’s been 3.5 years and I’m still learning. It’s just not as simple, easy and happy as the color sounds.  There are many different kinds of breast cancer and all of them have different treatment options.  30% of all women ( and men get breast cancer too) who are diagnosed with breast cancer will go on to develop metastatic breast cancer.  Cancer that stays in your breast doesn’t kill you.  It’s when the cancer travels to other areas of your body that you’ve pretty much lost the war.  You’ll win battles for awhile, but the reality is that metastatic breast cancer is stage IV and there is no stage V.