Treatment Cycle 11 - Day 1

-
I'm getting my Perjeta as I write - 11 treatments down, 7 to go! Treatment has become so routine for me - it's funny to think back on my first treatment, when I packed my chemo bag as carefully as if I was going into battle. Now I hardly give it a second thought - we're in, we're out, and life goes on.


I got my favorite chair today, and it's crystal clear out, so the view is perfect (that's the ocean in the distance):


When I saw Dr. Hurvitz this morning, I asked her about a study that was published recently out of Sweden that found that increased coffee consumption is associated with significantly smaller invasive breast tumor sizes, a lower proportion of ER+ tumors, and improved disease-free survival among tamoxifen-treated women with ER+ breast cancer. Specifically, the study showed that caffeine (as well as caffeic acid) mimics the actions of antiestrogens and modifies major growth regulatory pathways, resulting in impaired cell-cycle progression and reduced cellular proliferation. 

Dr. Hurvitz hadn't seen the study, but I sent her the link and asked for her opinion. I only drink about three cups of coffee a week, but I could up my intake if she thought the study findings were legitimate. Fortunately, I love the taste of coffee, so it would be no hardship for me to drink more - but I'm really sensitive to the caffeine, so I would need to make sure to have it in the morning so that I could still sleep at night. It would make me feel good to be able to do something else (and something so easy) to try to  prevent recurrence.

Maddie and I talked about my period, which I haven't had since January. She said that between my Perjeta, Herceptin, and tamoxifen, it's not surprising that I would stop getting my period. However, if I go for a year without it, I will need to go to a gynecologist for an ultrasound of my uterus, and possibly get a biopsy of the uterine lining. This is because tamoxifen carries a higher risk of endometrial (uterine) cancer (approximately 2 out of 1000). Maddie assured me that there is no cause for concern, but it's just something to know could be out there.

~

Last week I saw Dr. Trott for my pre-op checkup, in preparation for my exchange procedure next Tuesday. Among other things, we selected my implants, which was a strange experience. Implants, it turns out, come in a dazzling variety of sizes and shapes. One determining factor in the selection is the size and shape of the "pocket" that has been created by the tissue expander. However, it's also a matter of taste, as with a cosmetic breast augmentation - how big you want to be, how natural you want to look. We selected what we thought would be the best one for me, but Dr. Trott will bring an array of different ones into the operating room. Bizarrely, she'll put them in and then the nurses sit me up, and then Dr. Trott will decide how they look and make a change if necessary. Thank God, I will be fully unconscious for all of that.

We also talked about fat grafting, which is the process of removing small amounts of fat from other parts of the body (in my case, the belly and thighs), processing it into a liquid, and reinserting it into the breast area. Because my chest is so thin (even before the mastectomy, I had a rather bony chest, and now it's really thin), fat grafting will help to soften the edges of the implants and make them less obviously fake. I don't have a whole lot of excess donor fat to use in the process, but Dr. Trott thought she could get enough. I told her that she's welcome to everything I've got!

Comments

Post a Comment

Popular posts from this blog

And So It Begins

-
On August 26th, I was diagnosed with breast cancer. Since then, I keep trying to say it out loud - "I have breast cancer" - so that I can start to believe it, but each time it sounds like something that couldn't possibly be true. About a month ago, I noticed some lumps in my left breast. I thought that my milk ducts were plugged, and I started trying the recommended home remedies - hot compresses, massage, extra nursing and pumping, lecithin supplements, hot showers. Nothing made a difference and I waited in dread for mastitis to set in. But no signs of infection appeared.  After almost two weeks, at the urging of Seth and my doula Cheryl, I consulted an OB. Dr. Yashari examined my breast and said that the lumps were fibroadenomas, benign breast tumors that are common in young women. He said they were nothing to worry about and would go away after I stopped breastfeeding. He also said that normally with fibroadenomas, they would just monitor them every few months, but jus...
Read more

Recovery - Day 4

-
It is Day 4 of my recovery and I am still in the hospital, an unexpected and frustrating situation since most mastectomy patients go home on Day 2. However, I have been having mysterious fevers and my doctors don't want to let me go until they have figured out the cause and/or the fevers have stopped. Possible causes could be an infection in my lower lungs, an infection in my chemo port, or an infection of one of the surgical incisions. I'm getting two kinds of antibiotics intravenously, a lung treatment administered through an inhaler, and a topical ointment on my incisions. My guess is that they never will be able to determine the cause, but that the fevers will stop through one of the treatments or on their own. My  last one was yesterday at noon, 100.5. Since I've now made it more than 24 hours without another one, everyone is starting to feel a lot more comfortable - but tomorrow is still the very earliest I might be discharged, and it sounds like it might not be until...
Read more

Dr. Armando Giuliano

-
Image
Dr. Yashari referred me to Dr. Giuliano, a former colleague from St. John's who is now at Cedars-Sinai. Dr. Giuliano is very renowned in the world of oncology; he pioneered the practice of sentinel lymph node biopsy as an alternative to removal of underarm lymph nodes, and we were later to hear from others who consider him to be the best surgical oncologist in LA. Perhaps through Dr. Yashari's influence, or maybe just the kindness of Dr. Giuliano's scheduler, Fernando, I was able to make an appointment to see him on Wednesday, August 27, less than 24 hours after receiving my diagnosis. The appointment has already become blurred in my memory, but certain things stand out. I remember Dr. Giuliano saying that my cancer is high-grade, which sounds like a good thing but isn't (it means the cancer cells are extremely different from my normal cells). He also said my cancer is HER2-positive, which used to be a bad thing but isn't anymore, because there are new therapie...
Read more