- They call it pathological complete response - pCR - this means that the tumour has completely disappeared or pretty much disappeared with chemo. There is no standard definition for pCR so some doctors say its when a tumour completely disappears while others say its when its reduced in size significantly (whatever that means). Regardless of this, the research has shown that people with tumours that have a pCR have a significantly better outlook in terms of recurrence rates. With two more chemos to go I'm aiming for pCR!
- The smaller the tumour, the easier the surgery - this was the whole point of having chemo before surgery - the technical term is neo-adjuvant treatment - the goal of this is to get the tumour to shrink as much as possible so that the surgery is the least invasive as possible. With the negative results of my genetic test, I am hoping even more that the tumour will shrink because that ups my chances of having a lumpectomy (removal of tumour and surrounding tissue) rather than something extreme like a mastectomy. I also need to have at least one lymph node removed because we already know that the cancer spread to my lymph node so that one has to go. I can no longer feel my lymph node and Dr. Dent hasn't examined it in while but back in August it was 3 cm (that's way bigger than a normal size lymph node) and my armpit was sore - I'm sure its way smaller than it was...
I have an appointment with the breast surgeon on December 17th which is five days after my last chemo treatment. I haven't seen Dr. Beaulieu since August so this appointment is for us to chat about the surgery options. Most likely, she will order an MRI of my chest so that she has an up-to-date picture of where things are at. I cannot have surgery until about 3-4 weeks after my last chemo treatment (my body needs time to recover) so that takes me to early January for the possibility of surgery. I have to say I'm a bit anxious about stopping chemo and waiting for surgery especially if by then I can still feel the tumour but I know this is the usual course of action so I shouldn't stress about it...
I have an appointment with Dr. Craig on the same day as I see Dr. Beaulieu which is very convenient. This will be to change my vitamins and supplements in anticipation of surgery. Kudos to Dr. Craig because he was really the one that encouraged me to research surgery options to make sure that I fully understood every option - by research surgery options, I am referring to breast reconstruction. The thing is, is that there are a limited number of surgeons in Ottawa that do breast surgeries and guess what, just like breast cancers - there are about 8 different kinds of surgeries. Of course, not every surgeon in Ottawa does every kind of surgery - they are crazy complicated. Anyway, there was a doctor in Ottawa who got so sick of seeing patients that had no idea what their options were (not that he was sick of seeing his patients but he was frustrated that there wasn't a resource for these women) so he created a website. Here is it: http://www.breastreconstructioncanada.ca/ If you know anyone who is facing this decision send them this website - it explains each surgery in detail and also has a database of which surgeons in Ontario do what surgery.
So, you are probably wondering why I am researching reconstruction options if I am getting more confident that I'll be having a lumpectomy...well its because triple negative breast cancer is very aggressive and has the worst survival rate of all of the breast cancers (when I say worst, I mean 77% as opposed to 89% - its not that bad). And most likely after this is all done and dusted, I will still have follow up appointments with my family doctor and oncologist for probably the next five years since with triple negative your highest recurrence rate is in the first five years (some research says three years, others say five). This means most likely MRIs and mammograms every year which can be stressful if they find something - and most likely they will find something if they are looking that hard - like cysts or benign tumours which you have to get tested, then wait for the results. So, I have still been thinking of mastectomy which would completely eliminate my risk, forever. You are probably wondering why I wouldn't do that in January - but you can't have reconstruction surgery right after a mastectomy if you are then going to have radiation. And if you are having a mastectomy and then nothing for a while afterwards, reconstruction is more limited - you can't have any surgery until six months after radiation. So, you are limited in options unless you are like me and hoping for a lumpectomy then want to take some time to think about things afterwards...
After surgery I will have radiation. I met with Dr. Caudrelier (my radiologist) briefly back in August when I first met Dr. Dent - we didn't chat too long as it my first appointment and if you remember, things moved quickly, I was back at the Cancer Centre having my first chemo treatment the day after I met Dr. Dent and Dr. Caudrelier. Anyway, radiation is very specific - pinpointed to where the tumour was - and its every day for a number of weeks. I think Dr. Caudrelier said it will be everyday for five weeks but don't quote me on that. I have an appointment with Dr. Caudrelier on January 28th so I'll know more details then.
Okay, breast cancer lesson over.
This week was a good week - I continue to feel good - I think its more because my chemo brain isn't as bad - yes that's a real thing. Sometimes chemo makes you feel sort of out of it and you can't remember things. For example, one night a few months ago Lesley was at my house to pick me up and it took me three tries to put Fat May in her cage. The first time I went downstairs to the basement and just fed her - I forgot to put her in her cage and up she walks to the back door as I'm putting on my coat. The second time, I put her in her cage but forgot to close to the door, so up she walks to the back door as I'm putting on my coat. The third time I repeated in my head as I walked downstairs "put May in her cage, put May in her cage" and I did it! That's what I mean by chemo-brain. I still am forgetful but overall I feel much better.
My co-worker Amy came over on Tuesday last week for a visit and brought me some snacks. Amy also inspired me to seriously start to get physical - can you say Participaction!
Remember these two? If you do, you are old.
At my last appointment with Dr. Craig, I mentioned that I bought a pedometer. He said I should aim for about 7500 steps a day. Dom has unfolded by treadmill (which hasn't been unfolded since I moved to Ottawa) and off I went! So I tried to use it a few times this week depending on what I am doing - the first day I did 8000 steps. I've also started to get back into some strength training too - oh and I've been curling Monday nights for two hours. Take that Hal and Joanne!
Other than that it was a quiet week - Ann and Mike came over for a visit and brought a delicious Indian dish for dinner. I had my usual appointments for massage and PICC cleaning and then on Friday Dom had the day off so we went out for breakfast with his parents then looked for a new freezer. Did I mention that we are getting a freezer from Dom's parents for Christmas? I am so excited! This also means that I'm old - since when does someone get excited about getting a large appliance for Christmas? This old gal does.
On Friday night we met some friends for drinks and dinner and then Lesley and I headed to see Amelia Curran - great concert and good times with Lesley. Oh and I got the most unique cancer present yet - not that there's a competition - but if there was one, this would win for most unique (and quite possibly the one that took the most time to create). This is from my friend Matt who widdled this by hand!! Amazing!
On Saturday, Ann and I went out for breakfast (two days in a row!) then hit up some craft sales. The craft sales were really good and I was able to scope out some local people who make homemade, natural products like deodorant, face wash, soap etc. which is my new thing - trying to de-chemicalise (this isn't a word, I know) my life as much as possible. For anyone who is interested, my favourite one was Zoe's Corner https://www.facebook.com/zoescornerottawa
I also picked up other business cards so if anyone is interested, let me know and I'll email you the websites for them.
I also picked up other business cards so if anyone is interested, let me know and I'll email you the websites for them.
On Saturday night we went over to Lesley and Brian's for a turkey dinner - it was great - all the fixings. If you know Lesley, you know she's a good cook. She also made us some shepherd's pie earlier this week. Its good to be friends with Lesley.
On Sunday we got a special package from Uncle Rick and Sharon - Uncle Rick's famous Christmas pudding and two little critters to hang out in our living room over Christmas.
Dom put them on the record player then said, 'just what we need, more mice'. Not that we aren't grateful - but if you've been reading my blog or know anything about our summer, we've had a huge battle with mice in our shed as well as hanging out and partying in our walls and ceilings. Anyway, after this summer it somehow seems appropriate to celebrate Christmas with a few mice - I wonder if Uncle Rick and Sharon bought them on purpose? If they did, good joke - well played Uncle Rick and Sharon, well played.
On Monday I had acupuncture - Tran told me that he is away from December 8 until the end of January! WTF! I am not impressed but I cannot hold a grudge - he goes with a team of other people (don't ask me who) who go somewhere (don't ask me where) and treat people - sort of like a medical mission, I guess that's what you'd call it. I've been having some weird hot flashes lately and the first thing that came to mind is that I am going through menopause! But no, Tran assured me its completely normal with the chemo to have these hot flashes so he worked on that and so far, its made a big difference.
On the hair loss front, I am disappointed to say that my Fryer Tuck-like hair is falling out. Every day a bit more falls out - I even found some on my pillow this morning which I haven't seen for at least a month or so. But if the trade off is my hair falls out but my tumour shrinks, I'll take it. My left eyebrow has also managed to develop its own bald spot but I've been doing really well with pencilling on the eyebrows - even Ann complimented me on my handiwork on Saturday. I haven't been wearing my wigs yet for two reasons, one reason is that I'm lazy and haven't practiced wearing them at home so I'm not yet comfortable going out in public with them on - especially in this weather, have you noticed the wind lately? No way I'm risking having a wig blowing around! The other reason is that I know that once I'm back to work I'm going to have a lot of time wearing these wigs so there's no rush.
And...of course we have to talk about Joan Lunden - her blog says that she's having a hard time with mouth sores - I did too when I was on the Red Devil chemo - but I don't anymore which is great. I don't know why they call them "mouth sores" it sounds gross - they are basically canker sores - not nearly as gross, right?
So here's to the miraculously shrinking tumour (I stole this line from Pete) and guess what? Its only one month to Christmas - yay! And I have my second last chemo on Friday morning - double yay!
On the hair loss front, I am disappointed to say that my Fryer Tuck-like hair is falling out. Every day a bit more falls out - I even found some on my pillow this morning which I haven't seen for at least a month or so. But if the trade off is my hair falls out but my tumour shrinks, I'll take it. My left eyebrow has also managed to develop its own bald spot but I've been doing really well with pencilling on the eyebrows - even Ann complimented me on my handiwork on Saturday. I haven't been wearing my wigs yet for two reasons, one reason is that I'm lazy and haven't practiced wearing them at home so I'm not yet comfortable going out in public with them on - especially in this weather, have you noticed the wind lately? No way I'm risking having a wig blowing around! The other reason is that I know that once I'm back to work I'm going to have a lot of time wearing these wigs so there's no rush.
And...of course we have to talk about Joan Lunden - her blog says that she's having a hard time with mouth sores - I did too when I was on the Red Devil chemo - but I don't anymore which is great. I don't know why they call them "mouth sores" it sounds gross - they are basically canker sores - not nearly as gross, right?
So here's to the miraculously shrinking tumour (I stole this line from Pete) and guess what? Its only one month to Christmas - yay! And I have my second last chemo on Friday morning - double yay!
