I was really hopeful that this blog would just live on as something to look back on from time to time. No such luck! On July 12 I was diagnosed with a recurrence of breast cancer.
Sometime around May/June I started to feel that my initial biopsy scar was changing. I've had the same scar for 4 years, so (once again) I knew what normal felt like...and this was not feeling normal. What I felt was another marble shaped, smooth lump - just like the first tumor but smaller.
My oncologist is now with UCLA, so I made an appointment with their SB-based breast surgeon, Dr. Haji, to establish and also have this lump checked out. In the appointment we talked through my history, got to know each other, and within 5 minutes of her asking, "Do you have any current concerns?" she had felt the lump and scheduled an ultrasound. She's incredibly proactive and on it - so happy to have her on my team.
It's been exhausting, but it's all necessary to figure out the plan:
1. Change medication. This tumor grew despite Tamoxifen, so I need to be on a more aggressive medication. I am now receiving monthly injections to shut down my ovaries. This is called ovarian suppression and it works by stopping the signal that the body sends to the ovaries to make estrogen, which causes temporary menopause. I'll also start taking an aromatase inhibitor that stops an enzyme in fat tissue (called aromatase) from changing other hormones into estrogen. These two medications (ovarian suppression and aromatase inhibitor) work together to make sure that there is as little estrogen floating around as possible - because apparently this cancer loooooves estrogen. Lots of potential side effects to contend with, but I'm really grateful to have an option to try now that we know Tamoxifen isn't enough.
2. Surgery. Surgery will happen on August 24 to remove the tumor, remove some surrounding skin, remove both implants, and replace them with flat-ish tissue spacers. Removing the implants will provide the best situation for radiation because it will allow for a shallower angle across my chest and less damage to the left side of my chest and internal stuff like my lungs. Not too worried about this step - we've got all the good stuff for recovery lined up!
3. Radiation. Radiation will start about 6 weeks after surgery once my skin is healed. I'll undergo treatment 5 days per week for 6.5 weeks - 33 sessions total. The radiation will be a pretty large area - the right side of my chest wall, all the way up to my collarbone, up into my armpit (regional nodal radiotherapy, including internal mammary lymph nodes). The idea is to radiate any and all of the potential areas where breast cancer likes to spread and kill any lingering cancer cells.
4. Reconstruction. And in the far distant future....sometime around 6 months after radiation ends, once my skin is healed, I'll be able to undergo reconstruction. There are a lot of variables in this situation, depending on how my skin does after radiation, so we won't know what's possible for reconstruction until we get closer.
All in all, it's looking like this plan will take at least the next 8 months, with everything going right.
