TODAY I GO VISIT THE CHEMO DOCTOR!

Today is a BIG DAY.  I will get much more information today, including the MRI results and hopefully the Her2 test and the plan for chemo will be laid out for me.  Since learning of the possibility of having chemo first...I'm now wondering how soon!   I mean, if they are going to do it first, I could start chemo next week already!  I'm trying to get mentally ready for that, since I was expecting it more like a couple of months from now.  But, it really depends a lot, I think, on my own personal cancer.  I'm getting ahead of myself since I have no idea yet what the plan will be.  I'll find out today and I'm glad!  I think the unknown makes me more anxious than the known.  When you're waiting on test results your mind will wander around to places you don't want it to go.  You try to control it, but it still wants to go there.  Now, don't get me wrong, I'm still feeling very positive.  But, I have a lot of anxiety about the "unknown".  So, I'm glad today has finally arrived so I can find out these results and find out "what's next".  When you find out you have cancer, you want it out of your body....RIGHT AWAY!  And I have to remind myself that it was only last week when I was diagnosed, so in reality, things are moving along really fast.

One thing I really like about the Breast Center I go to is that they give you a copy of every lab report (maybe they all do....I don't know).  But, I like having those reports and seeing exactly what they say.  So, Monday when I was up there, they gave me the ER/PR (hormone receptor) lab report and I was just looking over it this morning.  Well, on this report the Estrogen Receptor was at 99% positive and the Progesterone Receptor is 71% positive.  So, that's good.  Then it shows a Ki-67 as "HIGH (36%).  Ok, I'm the type of person who wants to know what that means!  So, I turned to my friend "google" and  found that it is a way of telling how fast your cancer is growing. It is an antibody marker to a tumor antigen that can be found in breast cancer cells.  Anything above 20% means the cancer cells are growing and dividing at a rapid pace.  Honestly, this doesn't necessarily surprise me.  When you consider that I had a mammogram last August and they saw nothing and then I had another one in March and it was there and already at 2.5 cm, I figured out a long time ago that it evidently was growing fast.   

Now I don't necessarily find this particularly frightening, although I wish it was a slow growing cancer.  In one way I find it calming because it tells me it hasn't been there for years and just missed on my mammograms.  Yes, my mind has taken me there.  When you just had a mammogram six months ago and nothing was found, you wonder if they "missed it".  With this test showing it's growing rapidly, it gives me a peace that it hasn't been there for years and just missed.  So, it gives me peace that it's been found "early".    I already was graded at "2" which already told me it was faster growing....but not quite as fast as grade "3".  Now I can see where they got that information from.  I actually find this all fascinating.  The good thing about all of this information is that it tells them how agressively to treat the cancer.  They will know how better to treat me by what these lab tests are telling them.  So I thank God that there has been so much progress with breast cancer that they can now test for all of this.  I am finding that even with bad news you can find good!  I look at that 36% and think...."well, better than 75%, or 85%, or 99%!).  I will admit though, that the faster you feel like it's growing, the faster you want it out.  LOL!  I just want that thing out of me!  But, on the other hand, I'm glad to have had the time to think things through and decide what type of surgery to have, rather than being rushed with that decision.

One thing I do know.  I do not want this cancer to dictate my life.  While I know it's going to take over part of my life whether I want it to or not, I will do everything to keep my life "normal", going on with my "normal activities", as much as possible.  There may be some bumps in the road ....but this cancer does not rule!  I am not dying of cancer...I'm living with cancer!  Many women live years and years after being diagnosed and I expect to be around to watch my grandkids graduate, get married and make me a great mamaw!   And with all of the research that has been done, I know my chances of survival is so much better than it used to be.  I thank everyone who has ever donated or raised money for this research!  I am a life that is being helped by your donations!

Well, I need to start getting ready to roll up to Greenwood.  I've been keeping that road hot!  Erin (my youngest daugther) is going with me today.  She also went with me Monday.  Jennifer (my other daughter) is at work so she's been unable to go, but she is a school teacher and will soon be out for summer break, so she'll get her turn at going with me.  I'll be doing my chemo and radiation up there, so there will be plenty more trips for her to take with me!   And hubby (Larry) just found out he has to take some days off work because the earthquake is affecting the Toyota business, which affects the plant he works at.  This is not good for the paycheck, but maybe the timing is good and I can arrange appointments on the days he'll be off so he can go.  Like I said, I try to look at the "good side".  He's unexpectedly off Friday and Monday, so he'll be able to go with me to the Radiation Doctor on Friday.

Until later.....schedule your mammogram TODAY!

Cindy

HERCEPTIN

Well, I was wrong!  Herceptin is not a pill!  It's given intravenoulsy like chemo!  I just found this out today!  Actually, one of the caregivers today referred to it as a type of chemo that you take for a year. A year!!!  I'm still waiting on the HER2 test and thought surely it would be back today, but it wasn't.  It's making me a little nervous waiting on this test, but she said it's not unusual for it to take longer.  This is the test that I want to be negative so I don't have to take the herceptin.  But, I am thankful that they have found a treatment if it turns out to be positive.  Ok, just a little anxiety over this...I'm allowed that, right?  I just hate waiting on answers.  Maybe tomorrow.....

Ok, the MRI was today and I wasn't fond of it.  LOL!  But, it's over and done and I was able to hold still for 45 minutes in spite of the pain in my shouder and my arm turning numb.  Let's just say it's not something I'd want to do all the time, but I've been through much worse.  At least I was able to listen to Ray Boltz through the headphones as I lied there and that helped get my mind off my shoulder pain (a little), although Ray was hard to hear over the machine.  Man, that machine was louder than any I've ever been in!   I had hoped maybe I could nap to take my mind off it, but there was no chance of that!  But, it was very calming hearing Ray singing.....

the anchor holds
though the ship is battered
the anchor holds
though the sails are torn
i have fallen on my knees
as i faced the raging seas
the anchor holds
in spite of the storm

God is my anchor!  I don't want to ever lose sight of that.  I know He has not promised that I will not go through trials, but He has promised to be there with me.  And He always has been, so I know it will be no different this time.  With Him on my side, I can't lose!

Ok, the next appointment will be Wednesday....yay, I get a free day tomorrow and I have Stamp class tomorrow night, so double yay!  The appointment Wednesday is with the Chemo Doctor.  I found out today that he will actually have my chemo treatment mapped out for me and be able to tell me what/when/how long I'll be doing chemo.....and IF I'll be taking chemo before my surgery!  I hadn't even considered that, but she said many people do.  Wow, something else to have to think about!   I could be losing my hair sooner than I think!  And I just got me a cute haircut!  Crap!  I guess I'll know more about this Wednesday and will let you know.

Off to bed.......see you tomorrow!  :=)  Cindy

LUMPECTOMY OR MASECTOMY.....what to do????

http://www.webmd.com/breast-cancer/breast-reconstruction

This is the biggest decision looming ahead of me now. What surgery shall I choose?  At this point I can do either, but my decision weighs heavily on the rest of the test results.  If they all come back negative, I could feel comfortable to choose a lumpectomy and save my breast.  At first I had been leaning toward that if it's possible....who wouldn't?  But, then your mind goes to the "reoccurence thing" and you start to wonder if it would be better to have the masectomy and cut your chances of reoccurence.  If a reoccurence of cancer would happen down the road I would have no choice...it would be an automatic masectomy. 

But now I find myself leaning toward a masectomy when I think of reoccurence.  Reoccurence rate for a lumpectomy would be 8-15% while the masectomy reoccurence rate would be 5-8%.  So, as you can see, it can cut my chance of reoccurence in the future.  But, she did tell me that neither choice is a wrong choice.  It comes down to being a very personal choice and neither is a wrong choice.  The more tests I get back may lean me more toward the masectomy, but I'm asking myself....if they all come back negative, would I still want a masectomy?  I have decided at this point to get with my husband and children and let them help me make this decision.  It will still be MY decision, but I do want their feelings and input.

My reasons for leaning toward a masectomy would be my own medical history, as well as my family history.  I have heard 6 benign reports (combination of breast and ovary) in my life and had pre-cancerous cells (ovary) 6 years ago.  So, as you can see, this is not my first rodeo with waiting for results.....I just got better news the other times.   I've always joked that my body likes to grow stuff...LOL!  So, knowing my own body, I ask myself if the masectomy would be a better choice.  She also told me that I had very "active breasts".  I think she's talking about cell activity (I should have asked her to be sure and will...but I don't think she meant they were dancing...LOL!)  So, knowing that, also gives me a moment of pause when trying to make this very important decision.  I do know this...IF I end up choosing to have a masectomy, I WILL have immediate reconstruction (unless something changes my mind between now and then).  She is going to set me up with an appointnment with Dr. Jackson in Columbus, IN who is the plastic surgeon and I've always heard he's awesome.  So, I feel very comfortable with him as a choice.  I need to meet with him before my surgery so he can do what he needs to do right when I have the surgery...if I choose to go this way.   She said he can go through the whole process with me and show me "finished photos" of how natural they will look.  I think I'd love for my family to go with me so they can also see what the finished result will be.  I think that could calm their nerves and answer any of their questions if I choose to go this route.  Now, the thought of losing my breast doesn't bother me as much as I thought it would.  I think they're overrated anyway (well, except for feeding babies and I'm way past that)...LOL!   I have been doing some reading on the subject this weekend and have learned that I am probably not a candidate to have tissue from my abdomen used to reconstruct my breasts because of the 3 abdominal surgeries I've had in the past.  I hadn't even thought of that!  And man, it would have been like getting a bonus tummy tuck, which we all know I could use!  :=)  They can also take tissue and fat from my butt and I have plenty there to spare...LOL!  But, if the butt or abdomen ends up not being an option for me and I choose a masectomy....looks like silicone baby!  Now, keeping with my way of looking at the "bright side", I'm just thinking how nice it would be to have smaller, perky breasts again!  :=)  Hmm....what size should I get?  :=)  Of course I'm just joking around...this is not a deciding factor on what surgery to have!  But, you do have to admit it would be a nice little bonus!  LOL!  Like I've said, humor helps me get through things.

Ok, I go at 2:45 today for the MRI and the genetic testing.  And I hope my HER2 test result is back.  It won't be a hard day today, but I will have to lie perfectly still for 45 minutes- 1 hour inside that MRI machine (and I hate close places like that...that's why I hate elevators!)  She told me to bring headphones and I wondered why, but I've been reading that some breast MRI machines have music piped in to them and you can lisen with headphones.  So, I better go hunt me some up...surely have some around this house somewhere!  I can see where the music would be calming and take your mind away from the very loud clicking sounds I've read about!

Until next time....Winning!  :=)

Cindy

HER2 TESTING

The Her2 test....this is the result I am waiting on now.  When I was in the office on Friday they were still waiting for the biopsy results on the Her2 and the ER/PR  (estrogen or progesterone receptor). 

The ER/PR tells if the cancer is estrogen-fed.  If it comes back positive, then it means it is estrogen fed.  Your body produces estrogen and then this cancer pulls the estrogen from your body to feed on.  I'm actually surprised I'm still producing estrogen since I had an ovaian cancer scare about 6 years ago that resulted in a hysterectomy and pre-cancerous cells being found.  And to think that the doctor then put me on an estrogen pill!  I took it for about a year and just dropped it myself....I had heard too much about it being tied to breast cancer.  Now I understand why!  And did you know that ovarian and breast cancer are tied together?  Me either until I started researching!  The good thing about it being positive for being estrogen fed is that there are pills on the market that can treat it.  One of the pills is called Tamoxifen. 

• The drug tamoxifen, taken by some women for up to five years after initial treatment for breast cancer, helps prevent recurrence by blocking the estrogen receptors on breast cancer cells and preventing estrogen from binding to them.

This pill will block the estrogen in your body from the cancer cells, therefore they will not be fed (starve those suckers!).  They won't have the estrogen to feed on and this helps hold down the reoccurence rate.  It is harder to treat cancers that are not estrogen fed because these pills are not helpful since they don't feed on the estrogen anyway.  So, it is a good thing for this test to turn out to be positive (you usually want your tests to be negative but in this case positive is a good thing).  I got a phone call around 4:30 Friday that that result had come back as "positive".  That is a good thing!  :=) A huge weight was lifted from my shoulders!  Now I know I'm a candidate for this pill.  They actually talked with me about this pill last year and the possibility of taking it to help cut my chances of getting breast cancer and I got different opinions from two doctors, so I wasn't sure what to do.  Of course now I'm second-guessing myself on whether it would have made a difference if I had gone ahead and begun the pill.  Yes, you can take this pill even when you don't have cancer....if you're "high risk".  I was still considering it and thought I had time...and they were watching me closely (I had so many mammograms last year, with the last one in August.  They were all over my boob last year!).  Who would have guessed I'd get cancer so quickly!  I think it even surprised the doctor....she said,  "we were watching you closely and you still got it".  The only regret I may have is that I didn't start on that pill last year....then my body would have been blocking the estrogen that fed this cancer.  But, hindsight is 20/20 and I was getting mixed opinions and thought I had time to research some more and still decide to take it. You can't go back and have a re-do......and it looks like the decision has been made for me now. I'm sure I'll be on this pill after all of my treatment is done....Dr. Zusan already mentioned it.  We were just waiting to see if I was a candidate for it.

The HER2 is a protein that your body produces and if you are producing too much of this protein, then the breast cancer tends to be more aggressive and fast growing.  This is the test result I am still waiting on!  I'm sure I'll get this result tomorrow.  I WANT this result to be negative.  If it does come back positive, there is still another drug (Herceptin) that has been shown to dramatically reduce the risk of recurrence.  It is not without risks though, with the real risk of heart damage and possible lung damage.  I am soooo not a "pill person" (I'll put up with a headache before I reach for a tylenol...yeah, I know that's nuts!) and hate the thought of another pill...BUT, on the other hand, I'm thankful that so much research has been done that there is a pill available now to help reduce the chances of reoccurence.  I'm sure years ago women didn't even have these treatments available and that is why the survivor rate is so much higher these days.  So, I'll put aside my hate for pills and do what needs to be done.  But, the results aren't back yet....so I'm hoping for a negative report.  With a negative report, this is one pill I can do without!

Triple-Negative Breast Cancer - While I now know I do not have this type of cancer (because of my positive on my ER/PR test), I wanted to include a description of it because this is the type my sister, Sheila, was diagnosed with last year.  As you can see, it is a rarer kind and we're still scratching our heads on why she had to be so rare.  She IS a "rare breed" though...LOL...in a good way!

 Some breast cancers -- estimates range between 10% and 17% -- -are known as “triple negative” because they lack estrogen and progesterone receptors and do not overexpress the HER2 protein. The majority of breast cancers associated with the breast cancer gene known as BRCA1 are triple negative. I find this last little tidbit interesting and Sheila is working on getting the genetic testing done too.

The unfortunate part of the Triple Negative breast cancer is that it cannot be treated with the Tamoxifen or Herceptin drugs, making the possibility of reoccurence greater.  This is why my sister chose to do the double masectomy and I believe I would have chosen the same if mine had turned out to be this. So, you can see why this test result weighed heavy on my mind and it was a weight off my shoulders when they called with my positive report.  Although I don't know at this point what my decision will be, that is one deciding factor I can cross off my list.   In my opinion, a masectomy would give you the best chance to fight reoccurence in this particular cancer.  But, it's a hard choice to make and I applaud Sheila for having the faith and strength to make this decision.  She is also a fighter and has done well with her treatments.  My biggest prayer for her now is that there is no reoccurrence.  One thing I'm realizing is that once you are diagnosed with breast cancer, you celebrate every day, every month, every year that you are cancer free!  

And now you have "the rest of the story" (as Micky Rooney would say).  I want my blog to be educational as well as informative of my own journey.  I believe that "knowledge is power".  Before my mom and sister were diagnosed, I knew very little about breast cancer.  My father passed away from lung cancer and I wish I had researched it more when he was diagnosed.  After my mom and sister were diagnosed I found google to be one of my best friends and I learned so much!  I always just thought "cancer is cancer".  Not so!  There are so many other factors that decide the treatments and the prognosis and reoccurrence rate.  It's actually been fascinating to learn about it and I feel I understand so much more what is going on with my own body.  I understand the things that the doctor is telling me so I can make good decisions.  I remember last year when they told me I had 4 calcifications...I thought, "Well, what the hell-o is that? (sorry, but it's what I thought!) "  So I came home and reseached until I understood it better.  So many times doctors throw these words out and you have no clue what they are talking about....I think they just forget that it's a different vocabulary than we have...LOL!  So, I've learned to research, research,. research if I don't understand anything!  I will say this....Dr. Zusan (my doctor) was excellent in explaining things to me in a very understandable way!  I just love her and only met her last Monday.  I could not ask for a more compassionate, thorough doctor!  And besides that...she called me young!  That just endeared her to me even more!  LOL!  How can you not love a doctor that calls you "young"!?!  :=)  Now, on the other hand, she IS young and very pretty!

Here is a good link for information on these cancer types..,
http://www.webmd.com/breast-cancer/breast-cancer-types-er-positive-her2-positive

Ok, tomorrow is the MRI and genetic testing (which is done by a simple blood test).  I've had plenty of those in my life, so that's a piece of cake.  On the other hand....the MRI...well, I'm sorta kinda claustophobic and I think I'll be lying in some machine for like 45 minutes.  I'm not definite on this (I think I'll go research it now)....but they did tell me it would be 45 minutes.  Now here's a funny visual for you.  I will lie on my belly side and my boobs will fall through two holes that are cut out.  LOL, Linda!  She cracked up when she heard this at the doctor's office.  I was already familiar with this "special table" because I've seen it on...where else...google!  I'm wanting to hear a negative on the HER2, on the genetic testing, and on the MRI (for more spots).  So, from here on out...negative, negative, negative.  Who ever said "negative" is a bad thing?  :=)

My sister Sheila is on the right.  My sister Kim is on the left.

And that's me in the middle!  I've always been a "middle child" out of 6 of us!  So, these are only two of my siblings.  I'll introduce you to the others later, but wanted to introduce you to these two "cheerleaders" today and ask for you to also remember Sheila in your thoughts and prayers.  Like I said, she's in remission.  She went through so much last year and is my inspiration for what lies ahead.  My prayers for her is that there is no reoccurence and she can enjoy her kids and grandkids for many more years to come!

Ok, it's a beautiful day out, so I need to get off of here and go enjoy it!  I'll let you know what I find out tomorrow!  I know I might appear a little "windy", but have you ever met my sister, Sheila?  LOL!  She can talk circles around me (and anyone else) while I can write circles around her and others!  LOL!  Everyone loves Sheila!  She's a special lady! :=)

WINNING!

You have to say it in a "Charlie Sheen" voice...LOL! (yeah, I know he's crazy)  Those who know me well, know that my sense of humor gets me through a lot, as well as my faith.  And I woke up this morning with that voice running through my head saying "Duh...winning!"!  So, I have decided that is my theme of my journey!  WINNING!!!!!!!!

So, if you ask me how I'm doing, I'm liable to say "Winning!"!  :=)

On another note.....
Man I need to spruce up this blog.  It's boring!  It needs some cute little pink ribbons and a beautiful photo of me WITH HAIR (LOL) and some links!  I'll work on that this weekend!  :=)  I promise you...I'll pretty it up!

THE BEGINNING OF MY JOURNEY.....

 As many of you are aware, Breast Cancer has become personal for me with my mother and sister being diagnosed with breast cancer in the last 15 months.  Because we had never been touched with breast cancer in our immediate family, it came as a shock to us.  My mother passed away last February (2010) and my sister is in remission after a double masectomy, chemotherapy, and radiation.

Now I must travel that same road as I have just been diagnosed with breast cancer myself.  I have personally had several "cancer scares" in my life and have dodged the bullet....until now.  My mother was diagnosed in Dec 2009 and my sister was diagnosed in January 2010, and I followed in February 2010 with my mammogram showing 4 calcifications that had to be biopsied, which resulted in one surgery and a benign report on all 4.  Then I had a follow up mammogram in August 2010 and all was fine.  But, now just 8 months later I have breast cancer.  The first time I said "I have breast cancer" out loud, I felt numb.  When they first found the "dark spot" and I was asked to come back for more diagnostic imaging and an ultrasound and then a biopsy, I had a gut feeling by the way they were acting.  Then when they wanted to ultrasound my lymph nodes, I "knew".  But, I didn't get the official results until yesterday and today I had to go for a consultation.

The consultation went well and I left feeling upbeat and positive.  It wasn't the best news...but it wasn't the worst news either.  I have invasive ductal carcinoma.  What does that mean?  Well, my cancer began in the milk duct, but was not contained there.  It grew big enough to break through the duct wall into my breast tissue, making it invasive.  The treatment....a choice between a lumpectomy or masectomy, radiation and chemotherapy....followed with Tamoxifen (a pill taken for 5 years that will keep my body from producing estrogen, which in my case is feeding my cancer).  I had helped research my sister's cancer last year, so already was aware of a lot and have learned a lot.  I'm a firm believer in researching and learning as much as you can....to be able to make informed decisions.  All of this research helped me today to understand and remember what the doctor was telling me. 

Now, I do want to say something.  I'm not "all doom and gloom".  Much stride has been made in the treatment of breast cancer.  While there is some bad news, I prefer to look at the good news!

 THE GOOD NEWS!

#1 - the doctor believes it's been caught early

#2 - She doesn't believe it's in my lymph nodes,based on the ultrasound, but there is no certainty until she removes a couple of lymph nodes to biopsy them.  So, I will keep hope for my lymph nodes to be clear

#3 - I am being treated at a Breast Center, where they only deal in breasts!  I feel very good about that and today proved to me that I'm in the right place.  The doctor spent 2 hours with me and was so kind and compassionate and thorough, followed up with a hug. 

#4 - I found out that my breast cancer is ER/PR positive, which is a good thing.  It would be harder to treat if it was negative because it would not respond to the Tamoxifen pill.  I was particularly worried about this because my sister was diagnosed with Triple Negative in this area, which is rarer and harder to treat.

#5.  The tumor is 2.5 cm...so not the smallest, but certainly not the largest...a little larger than a peanut.

#6.  I'm Stage 2 and Grade 2....certainly not the worse.

#7 - I'm a fighter!  I've had battles before and they have just made me stronger!  I will fight to beat this!  I deal with things as they come and have a strong faith and know that God will be by my side every step of the way.  My faith and sense of humor will get me through whatever lies ahead. 

#8 - And my family and friends....they will be there for me and I can't thank them enough!  I feel so loved.  I promise them I will fight this with everything I've got and keep a positive, upbeat attitude.  I can do this!  Let's get 'er done!

Now, before I can make the decision between a lumpectomy or masectomy, I need to get a few more tests back.  I'm still waiting on a Her2 test (hoping it to be negative) and on Monday I will be going for an MRI, which can see any small growths that may have been missed with the mammogram and ultrasound.  I will also be having a blood test to be tested for a genetic mutation.  Once these tests come back, I will know more about what type of surgery to have.  Regardless of the surgery, I will be having the radiation and chemotherapy.  I wonder if I'll look good in those cute bandanas!  :=)

My message to you...PLEASE GET YOUR MAMMOGRAMS!  My mom's, my sister's, and now my breast cancer was caught by our mammograms.  I, nor my doctors, felt a lump and still don't.  I know how easy it can be to get "lax" about your mammograms...I have done it myself in the past.  But, I realize more than ever how important they are.  Had I not gone to my mammogram, the cancer would just keep growing until it would go into other parts of my body.  With my mammogram, I've caught it early.  If you have any questions or perhaps are going through your own "journey", please don't hesitate to email me.