Breast Cancer is this one-size-fits-all diagnosis. The title gives me a commonality with many others, but the diversity of what this diagnosis entails is pretty profound.
Imagine you’ve been invited to a buffet, which includes exactly zero of the foods you like.
We can all think of foods we can tolerate, and those which will cause us to gag or wretch.
There’s nothing good on this buffet, but there are some options that, with a condiment or some salt, you could tolerate.
When I was initially diagnosed with breast cancer after my biopsy, I had a diagnosis that was ideal.
ER+, PR-, HER2-, Luminal A.
Anticipated Stage 1.
Yeah. That’s common language and knowledge to me now.
To simplify: I could choose a right breast mastectomy and some Estrogen suppression, and I’d be back to my life within months, with a cure rate of over 95%.
Really, not bad at all when you look at this buffet of undesirable options.
The undesirable buffet includes things like:
Triple Negative Cancer
Triple Positive Cancer
BRCA1 Positive Gene
Invasive Breast Cancer
Non-Invasive Breast Cancer
Luminal A Tumor
Luminal B Tumor
Also, consider the nuclear and mitotic rate growth of your cancer cells – leading to a grade for your cancer
I’ve left some variables off of the buffet here, but as you can see, Breast Cancer is this many-layered, complex diagnosis for which one’s treatment choices are widely varied based on what gets thrown on your plate at this buffet you never intended to visit.
So, when my initial diagnosis seemed a relatively simple solution, I felt like I had at least one foot on the ground.
A full chest MRI showed no evidence of any further tumors.
Additional 3-D imaging and ultrasounds (torture) on my right breast seemed to confirm one location of cancerous tissue, and it seemed limited to the breast tissue. To be clear, you’re hoping to avoid spread to muscle tissue, lymph nodes, bones, and so on.
So finally, the surgery on October 15, 2018.
My mastectomy went well, and the initial pathology in the OR was that there was no spread to lymph nodes (they take your sentinel nodes during surgery & test them in the room to see if they need to take more lymph nodes).
The recovery from my right breast mastectomy was really smooth.
I was off of pain meds after 48 hours, and back in the kettlebell gym within 10 days – with some modifications. I was back in the gym coaching volleyball within 5 days.
The post-surgical appointment after my mastectomy was a different story.
At that appointment, the surgeon revealed that there were additional locations of cancerous tissue found in my breast, with different markers.
The buffet of Breast Cancer had dealt me a much different challenge.
I was now ER+, PR+, and HER2+.
There was also a macrometastasis of cancer deposit in one of my sentinel lodes.
The conversation changed dramatically.
Now, chemotherapy and radiation were needed.
Overall, that post-surgical appointment was like a nightmare. The sentiment oozing from the staff was pity. My outcomes were clearly different. My plan to get on with life with one less breast was no longer going to work.
Your own mortality. That’s nothing fun to wrestle.
So, here’s how we got to chemotherapy. So many chemicals. So much poison.
Doxorubicin. Cyclophosphamide. Herceptin. Perjeta.
But, after my chemical hell, I’ll be back at a 96% cure rate, so it was a no-brainer, but a treatment reality that is absolutely horrible.
There were some other steps along the way.
One important decision was transferring my care to UIHC. Talk about World Class.
The staff, the access to and knowledge of the most up-to-date and relevant research, and the facilities are all absolutely incredible.
Nobody looked at me with pity there. In fact, they challenged any assumption I had about not living into my 80s. They had a research-based confidence and treatment approach that conveyed an outstanding outcome.
The first time I felt good, truly good, after my change in diagnosis was after an opinion from UIHC.
Understanding Breast Cancer is really unique to the individual and her diagnosis. The buffet is an endless offering of nothing good. The buffet determines your treatment options and your outcomes.
So, next up, chemotherapy.