No Bad News 😁
First and foremost - can you see my hair? Well, my five o'clock shadow anyway?! It's coming back slowly, but surely and like an old man with just the sides and back. I even have a little comb over section on top. 🤣
I mentioned in my last blog post that I was going to ask Dr. Khanal about Xeloda and if I could benefit from it, so when he said he was recommending 6-12 months, I wasn't surprised. He said there wasn't a benefit to doing radiation and oral chemo in any particular order and would get with Dr. Eaton (radiation oncologist) to see if he had a preference, but that I just couldn't do them concurrently. He scheduled me for an echocardiogram so we can get another baseline and I have a regular mammogram scheduled on the 24th. My labs were status quo; my white and red blood cell counts and platelets are still low, but starting to rebound and I'm still anemic. I also picked up my genetic kit so they can run an expanded panel to see if there's anything else I or the boys need to keep an eye on in the future. They originally ran a stat panel back in January with nine genes and then recommended an expanded panel, but I was doing AC chemo (aka red devil) and too sick to worry about it then so I'm circling back.
The oncology pharmacist called this morning to discuss side effects of Xeloda, where to pick up since it has to come from a specialty pharmacy, and how to take the pills. The Xeloda is done in conjunction with immunotherapy and my next infusion is on September 23rd. I'll take two pills each day for two weeks, rest for one week, and then start another cycle. I talked to the radiology team right after and will start 20 rounds tomorrow, finishing September 13th.
I've had a couple people ask why the oncologist is recommending more chemo since they removed the mass during surgery. The standard of care for triple negative breast cancer is systemic chemo then either mastectomy OR lumpectomy plus radiation. Until very recently, these two were interchangeable and had the same outcomes for survival and recurrence. My knee jerk reaction at the beginning was a double mastectomy so this would never happen again. Then I started researching and looking at recent studies showing that a mastectomy wasn't necessary to achieve the same outcome. I could have a lesser surgery with less recovery time with the same result so I opted for a lumpectomy. In May, a study was released showing better outcomes for lumpectomy plus radiation. I actually sat in on a webinar Saturday afternoon where the doctor talked about these findings. Once I found that study, I knew I had made the right decision for me.
When chemo is complete, the surgeon removes the mass and it's sent to pathology. If they determine there's no cancer left, then you are said to have achieved PCR (pathological complete response). I'm told that triple negative patients have a 50% chance of that. If the pathology determines there's cancer present, then there was not a complete response to the chemo. My mass was removed and the surgeon got clear margins, but it only shrank by about half and there was cancer present in the pathology. That means I have a 50% chance of recurrence.🙁 Now I've been having a blast with all my nurse friends for the last several months and I love playing Skip-Bo with my entertainers, but once I say goodbye to that cancer center, I don't really want to go back. We can just as easily play cards at my house.🤣 By taking Xeloda, I can reduce my chance of recurrence to 30-35%. I'll take what I can get!
The radiation is to "mop up" the microscopic cancer cells that are still in the breast. I don't need those crazy things acting up and coming right back. The immunotherapy that I'll still be taking into next year is to teach my immune system not to kill me. ☠️ Everyone has cancer cells in their body. Typically, cells multiply, divide, and die off so there's never a mass. When cancer cells don't follow the rules, this is what happens. The immunotherapy is supposed to help keep them in line. I'm just throwing everything at this, including the kitchen sink!
I've been trying to stay busy when I'm not tired, which is getting better and better. 😁 I got to design some menus for an awesome new ice cream shop (yay Autumn and Frank!), work on a couple websites including one for my amazing aesthetician/massage therapist (shout out to my girl Krystal!), and even scrapbook with the girls yesterday. All things considered, I've been pretty productive the last couple weeks so I'm feeling more normal. Cade got his driver's license recently and he's back to school and busy with cross country this year. Christian, my eternal student, is chomping at the bit to get back on campus, but working on video editing projects in the meantime. Bre and Corey are enjoying the Iowa life and adopting the Hawkeyes as their favorite team. Rhys has been busy bringing on new clients and servicing the existing. We really can't complain ❤️
TODAY'S SILVER LINING: I'm going to start chemo right after radiation so I guess I'm going to be tired for the foreseeable future. The fatigue is something I need to learn to live with so after talking to my boss today, I decided to go back to work, part-time and remotely, during radiation. This way, I can start to get back in the swing of things, but still be at home to rest when I need to. I'm out of Netflix shows to watch anyway. 😉