Choices

Did you have an Ultrasound to see if the tumor shrank? My Oncologist and surgeon had one done mid-way through chemo to see if it was working and tumor had shrunk. Tumor shrank by 1cm. My surgeon indicated that it needs to shrink to 2cm or less for me to have a lumpectomy. It's at 2.3cm now. My last chemo is next week. 6 cycles of docetaxel with Herceptin and Perjeta targeted drugs for HER2+ protein. They dropped the Carboplatin after 1st round due to severe side effects.

FWIW, I've read that only about 30-40% of tumors shrink enough to be considered pathologically complete response where no cancer is found in tissue removed during surgery. If cancer is found, or found in lymph node samples then it's considered residual cancer and requires additional treatment via chemo and/or targeted drugs. I'm hoping no residual cancer is found in mine when I have surgery mid March, but I don't think it will have shrunk this much by then. Essentially no tumor.

@LifeInBloom100 I'm thrilled to hear you're done with radiation!! And thank you for you kind words and encouragement on this and other threads.

@marlakeeth Likewise, I'm thrilled you are done with chemo! Such an accomplishment! And I'm so glad @claoh and @RocDocVic are seeing tumor reduction with their chemo!

@Sadiej You're doing a little better each day was exactly what I was hoping for for you. I pray that it continues!

@claoh I'm not really doing any art projects as I'm not leaving the house much, except for appointments. I had signed up for a virtual Art Museum tour this morning but woke up too late. They do them every Friday morning, so I will try to set an alarm and make it next week.

You also asked about my "intellectual pursuits". My work is very intellectually demanding and my difficulty with concentration, attention span, and "brain fog" has been anxiety-producing and frequently distressing. I'm trying to be gentle and patient with myself. I started a couple weeks ago with some word searches and sudoku puzzles. Then a former co-worker gifted me with a very unique type of logic puzzle book and I've been working (very slowly) my way through that. Before my disability leave, my technical mentor had recommended some physics type courses (both to refresh and to learn some new content). That's what I'm trying to add into the mix now. I wasn't able to start on Monday because the Coursera courses I had picked out are free through my employer but I needed some info from work before enrolling and I can't access my work email while on disability. I got it all sorted out now and I've finished the first few lessons. I had hoped to be able to whip right through the first course as it is mostly review but only managed about 75 minutes so far. Again, I know I need to be patient and 3 weeks (until I go back to work) can see a huge difference.

This week has had both challenges and blessings. (Don't they all?) I did get my last drain out Tuesday. @Sadiej It's hard to explain my feelings about the drains. I can't say they hurt OR didn't hurt. They were uncomfortable ALL THE TIME, frustrating to deal with just with clothes and going to the bathroom multiple times a day, easy to accidentally hit or yank a little, which did hurt, sometimes terribly so. And the drain sites on my skin, though closing, look terrible. Hoping to not have an infection at the site of the most recent removal. I'm very, very glad to be done with them. I also finally heard back from the TPA with approval for my disability leave. Yep, the 8-week leave that ends in 3 weeks. It was an absurdly long process that added additional stress.

I am straightening up more and doing some walking in the house without my walker. I easily overdo things so I'm trying to pace myself. This weekend, I might try to sleep in bed for at least a few hours (instead of the recliner). Don't want to try on a work night for my husband and risk keeping him from getting any sleep. I remember it was a process transitioning from recliner to bed after my mastectomy too.

We are borrowing a wheelchair from a friend and going to try to get out of the house, get some fresh air, and just do something different tomorrow, which will likely mean a trip to Disney just for a few hours since we have annual passes and it doesn't cost us anything (unless we get food, which we always do, lol!).

What will you all be up to this weekend?

I'm sorry for not posting for a while. I'm so very glad to hear your chemo continues to go well, @claoh , and for the tumor to be shrinking.

I'm getting around a lot better but I easily overdo it. And I continue to have multiple areas that are not healed up but the surgeon's PA feels like they are coming along and she changed the treatment under the left side. I'm driving again but mostly just dropping off or picking up our daughter from the fast food restaurant she works at or places I can drive through. I've been getting around the house primarily without the walker and just take it if I'm going to an appointment or something, for stability. I'm still very anxious about the possibility of falling.

For the first time in my life, I saw a psychiatrist this week. I left with feelings both of shame and relief with my diagnoses. I'm praying especially that I can get my anxiety under more control before resuming work soon.

RocDocVic

when is your surgery, you mentioned in February. How is your chemo going?

RocDocVic

In regards to your pre-op testing, usually within 20-30 days before surgery. Radiation usually starts 3-4 weeks after surgery. Not to feel bad, but I had to ask my oncologist about radiation as well. It seems like they only give minimal, need-to-know information. I asked what happens after my post-op appt, any more chemo or what? Then she said would wait to see what the pathology report says, maybe oral chemo. What about my port? When can it be removed? "I like my pts. to keep it for a year or two, just in case we need it again, but need to flush it every 3 months or so"

so don't feel to irritated with your doctor!

I had chemo until my tumor shrunk enough for surgery, and had a lumpectomy two years ago and have been cancer free since then. But I did end up with neuropathy in my fingers and that is why he stopped giving me chemo one treatment early. Don't be afraid of a lumpectomy...my dr. told me when I was considering mastectomy that lumpectomy had just as good and outcome and there are complications with mastectomy, so I went with the lumpectomy and glad I did. But keeping in mind that everyone is different, you have to make your own decision. Best of luck and prayers to you!! Sunny

I found it odd that there is no pre-op tests. I've had them before for other surgery, but perhaps they feel they have enough info for anesthesiologist. However it will be general not just sedation anesthesia and they usually like to have it for general anesthesia. I agree, they only like to provide the bare minimum information. This is unacceptable to me. I don't appreciate it having last minute information sprung on me where I have to scramble to change my schedule and research the information. As for starting radiation I've read upto 6 weeks max, and I should be back in time for that. However, if it's going to be scheduled I'd like to know now rather than later. If I can go to appointments to do the pre-rad setup before my trip we can get it done then and I can meet/discuss the proposed treatment schedule and options for radiation amount then with Rad Oncologist. Lots of questions too about a proposed drug, T-DM1 that was briefly mentioned back in late December when I found out tumor was shrinking and I mentioned good chance of clear margins with lumpectomy. Onco then said if residual cancer is found this drug would be used. No discussion on differences between this or continuing with Herceptin and Perjeta which is used for my cancer type - HER2+ No discussion on odds of cancer returning or survival rates for each treatment option. T-DM1 is a very toxic chemo drug that can damage the liver, lungs and heart, not to mention continuing neuropathy. It's a Trojan Horse type drug that is inserted into cancer cells, and sometimes your good cells, and delivers the toxic payload. Also, 14 cycles typically done so I would not be finished until next January or February vs October with Herceptin and Perjeta. No discussion on how they would monitor residual cancer or use of liquid biopsies- blood tests that look for cancer cells and your specific tumor DNA. Tumor needs to be tested for genetics and DNA. FDA just approved a test for this. Medicare covers it if you're stage 2b or higher. I have been initially staged as 2a but sentinel lymph node test results could change this to 2b from what I understand. Sadly, I've had to do a lot of extensive research/reading since Oncologist is not providing any information. If I'm going to have to make decisions on my treatment I want the information up front, not dropped at the last minute because they're afraid we'll walk away from treatment. This was actually told to me by sister - her daughter is an Oncologist at Sloan Kettering who specializes in ovarian and uterine cancer. They prefer to hold their cards close because they're afraid they'll scare us off. So much for open honesty!

Welcome to a new week, my friends. I am struggling with anxiety about returning to work next Monday. Thankfully, I'll be able to work from home at first but even being able to sit at a desk for several hours seems daunting right now. When I try to sit upright (versus recliner) for more than a couple hours, my back and my knees hurt so badly, I could cry. Same with getting around. I have hardly used the walker the past few days and it's hard for me to untangle how much the knees/back issues are because of that versus non-reclining sitting. (We did use a wheelchair for me at Sam's Club though - I knew I wouldn't survive walking very far there!) I'm trying to show myself grace in advance. I'm going to "show up" and do what I can for as long as I can and hopefully that will increase as each day and week goes by.

I will be seeing my cancer support counselor tomorrow and need to discuss my psychiatrist visit this past week and her diagnoses. Not cancer related, but I'm also in the midst of worrying about how much taxes we will owe this year and securing new home insurance, hopefully not at an outrageous cost. (I know this applies to more than FL, but here, lots of homeowners have been put in this terrible spot, having our home insurance provider leave FL, requiring us to find a new insurer with not a lot of options.)

This week, I just have the counseling appointment and my weekly OT. What do you all have on the calendar this week?