Yesterday I was off to see my surgeon to schedule my surgery, and I'm due to go in on the 5th January, which means I should have a fairly healthy few weeks over Christmas and New Year.
I've decided to go for an implant based reconstruction, which means that I should only be in hospital overnight and be mostly recovered within a month. In the initial op a temporary saline implant will go in, and be replaced later with silicone. The reason for this is that radiotherapy can distort the skin and damage an implant, so a better cosmetic result is achieved by going back after all the treatment is complete, but means that most of the skin is preserved. During the gap, I can change my mind and go for a flesh based reconstruction.
When I spoke to the surgeon (who is based in Essex rather than Berkshire) he was very surprised that the plan was to give more chemo after surgery. He rang his oncologist colleague who gave the opinion that it wouldn't be necessary, especially if I'd had a good response to the previous treatment. I don't need to take a decision on further chemo for a while yet, and I suppose it will be informed by the result of the tumour analysis, but it's very confusing to have 2 such contradictory opinions. Hopefully once the 2 sets of doctors have spoken after these results they will come to a mutual opinion.
I drove myself over to Essex yesterday and have stayed today. Glad I decided to have a rest day before heading home as for some reason I'm especially tired today. I may have been over doing it again!
Wednesday, 14 December 2011
Monday, 12 December 2011
All Change
I'm now just about recovered from the last treatment, and it has been noticably harder this time around. More tiredness, more achiness, more sore feet and hands. It's also taken longer to start feeling better. I have at least managed to make it out to the office Christmas party and a leaving do, although I was only able to stay a little while at each. It was nice to get out of the house and dress up though.
Last Wednesday I was back to the hospital to meet the oncologist to discuss the biopsy findings. Not unexpectedly, the biopsies were not able to yield enough cancer cells to be able to do an HER2 test. In fact, they didn't get any cancer cells, only pre-cancerous ones. This means that my treatment regime is being changed, and by quite a lot more than I expected. So here is the new plan of action:
I'm also starting to get worried about the surgery, it being moved up and the fact that time seems to have flown by means that its snuck up on me. It's not just a physically tough experience, but a psychologically tough one, and I'm starting to get anxious about it. I also have a fear of general anaesthetic, I find the concept of being chemically knocked out quite terrifying. Still, I've had 2 so far and woken up from both...
Last Wednesday I was back to the hospital to meet the oncologist to discuss the biopsy findings. Not unexpectedly, the biopsies were not able to yield enough cancer cells to be able to do an HER2 test. In fact, they didn't get any cancer cells, only pre-cancerous ones. This means that my treatment regime is being changed, and by quite a lot more than I expected. So here is the new plan of action:
- Surgery will be next, probably within a few weeks - most likely straight after the New Year, but earlier is also a possibility. I'm going to see my surgeon tomorrow evening to get it set up, so I'll know then when I'll be going in.
- After I'm recovered from surgery, the plan is to give me another 3 chemotherapy treatments, Taxotere only. The reason being that the FEC had no effect, and 3 effective chemos is not really enough. As they know that the Taxotere is effective, and given my age, it is better to over treat than under treat.
- After the 3 chemos is still a bit vague, and will depend on the outcome of surgery. If the HER2 test is positive, then I'll have herceptin (some of which may be given in cobmination with the chemo). Herceptin is usally a 6 or 12 month long treatment - given as an injection once a month. My understanding is that the side effects are not too bad, so wouldn't stop me from working.
- Radiotherapy is still likely to happen, after the second round of chemo. Again this will be decided on based on what happens when I have surgery.
I'm also starting to get worried about the surgery, it being moved up and the fact that time seems to have flown by means that its snuck up on me. It's not just a physically tough experience, but a psychologically tough one, and I'm starting to get anxious about it. I also have a fear of general anaesthetic, I find the concept of being chemically knocked out quite terrifying. Still, I've had 2 so far and woken up from both...
Friday, 2 December 2011
More Hospital Time
The blood tests I had for blood clotting came back before I'd even finished receiveing my chemo treatemtn, despite the fact that they had to be sent over to a different hospital. The results were borderling, so it was decided to send me for a CT scan in case of a pulmonary embolism. Apparently there was some debate on whether to send me over to Slough immeadiatly, or if it could wait until morning, but in the end it was decided to be OK to wait, and I was given an appointment for 10:30am yesterday.
I was a little worried about this, but the oncologist reassured me that it was most likely nothing, they just wanted to be certain. I was also worried about spending another day in hospital, but as it turned out I was in and out of Heatherwood hospital in just over half an hour. And within an hour, I had my result - no indication of any blood clots. The tightness in my chest is most likely a low level infection or a result of lower heamoglobin levels, so just something to keep an eye on.
So rather than a day in hospital, I spent the day in Reading with Kate having a girly afternoon, we went to see Twlight - not exaclty the greatest movie ever, but a nice few hours of escapism.
I was a little worried about this, but the oncologist reassured me that it was most likely nothing, they just wanted to be certain. I was also worried about spending another day in hospital, but as it turned out I was in and out of Heatherwood hospital in just over half an hour. And within an hour, I had my result - no indication of any blood clots. The tightness in my chest is most likely a low level infection or a result of lower heamoglobin levels, so just something to keep an eye on.
So rather than a day in hospital, I spent the day in Reading with Kate having a girly afternoon, we went to see Twlight - not exaclty the greatest movie ever, but a nice few hours of escapism.
Wednesday, 30 November 2011
Penultimate One
Long day in the hospital today, in part because of strikes but mostly because I've had a lot done.
First up was meeting with oncologist to discuss my latest MRI results. The word used was delighted at the change to the tumour. Also discussed the biopsies- I said I was happy to go ahead if the pain could be controlled. Doctor said no problem to have some sedation, but chat to the radiographer first.
There was a bit of a wait to arrange this, as it was pretty busy, but I went for another mammogram and to see the head radiographer who explained that she has a new technique of getting samples that is much less likely to cause pain- its faster and goes through less tissue. I also had another ultrasound, which is the first time I've been able to see the change to the lump and it really is quite striking. It's obviously a lot smaller and a lot less dense.
Next I was back in the mammogram machine but rather than sitting up, I was laid down on my side and given a big dose of anaesthetic. I barely felt the biopsies this time and they managed to take 10 (vs 4 last time before being in too much pain to carry on) and I only felt the last 2, and that only mildly, which was a big relief as I was really nervous.
Given the change in the lump, the chances of getting enough cells is pretty low, but probably worth it. The oncologist mentioned that they may bring forward surgery if they can't get anything from the biopsy, and then have some more chemo after.
Next it was back to the chemo suite to go back to the oncologist for a quick check of my side effects. I mentioned that I've been getting breathless and have had a little chest pain, and the next thing I knew I was being whisked off for a chest X-ray. Thankfully I didn't have to wait more than a few minutes, and then I was back again to have my blood pressure taken and prepped for chemo. After a pause to confirm that the X-ray was clear, I was set up with my needle which went in first time, thankfully. They took a blood test as well to confirm that I don't have a blood clot on my lung, unlikely but they have to check. I should get the results this evening.
Then it was back into the oncologist to set up an appointment for next week when they should know if they have enough cells for the HER2 test and if not to discuss bringing forward surgery.
So now it's 10 past 3 and the Taxotere has just started going in. Considering I got here at 10am, it's been a long day. It's been a pretty good day as far as treatment days go as things are looking up. Glad I've had Kate with me for company. Going to pop into town to pick up dinner and then I'll vegetate on the sofa for the rest of the day- I think I've earned it.
First up was meeting with oncologist to discuss my latest MRI results. The word used was delighted at the change to the tumour. Also discussed the biopsies- I said I was happy to go ahead if the pain could be controlled. Doctor said no problem to have some sedation, but chat to the radiographer first.
There was a bit of a wait to arrange this, as it was pretty busy, but I went for another mammogram and to see the head radiographer who explained that she has a new technique of getting samples that is much less likely to cause pain- its faster and goes through less tissue. I also had another ultrasound, which is the first time I've been able to see the change to the lump and it really is quite striking. It's obviously a lot smaller and a lot less dense.
Next I was back in the mammogram machine but rather than sitting up, I was laid down on my side and given a big dose of anaesthetic. I barely felt the biopsies this time and they managed to take 10 (vs 4 last time before being in too much pain to carry on) and I only felt the last 2, and that only mildly, which was a big relief as I was really nervous.
Given the change in the lump, the chances of getting enough cells is pretty low, but probably worth it. The oncologist mentioned that they may bring forward surgery if they can't get anything from the biopsy, and then have some more chemo after.
Next it was back to the chemo suite to go back to the oncologist for a quick check of my side effects. I mentioned that I've been getting breathless and have had a little chest pain, and the next thing I knew I was being whisked off for a chest X-ray. Thankfully I didn't have to wait more than a few minutes, and then I was back again to have my blood pressure taken and prepped for chemo. After a pause to confirm that the X-ray was clear, I was set up with my needle which went in first time, thankfully. They took a blood test as well to confirm that I don't have a blood clot on my lung, unlikely but they have to check. I should get the results this evening.
Then it was back into the oncologist to set up an appointment for next week when they should know if they have enough cells for the HER2 test and if not to discuss bringing forward surgery.
So now it's 10 past 3 and the Taxotere has just started going in. Considering I got here at 10am, it's been a long day. It's been a pretty good day as far as treatment days go as things are looking up. Glad I've had Kate with me for company. Going to pop into town to pick up dinner and then I'll vegetate on the sofa for the rest of the day- I think I've earned it.
Tuesday, 29 November 2011
Some Good News at Last
I received a phone call this morning from my breast care nurse. Initially I panicked slightly, as they usually ring to impart bad news, but today was different.
My MRI results were reviewed this morning at the weekly meeting to discuss all the breast cancer patients, and apparently my response to the new treatment has been described as excellent. So the improvement in the lump that I felt wasn't just in my imagination and it appears that the lump is shrinking well. Better response = better prognosis, so I'm very happy.
On the other hand, my response has been so good that there's a concern that by the time I get to surgery there'll be no cancer cells left to test. As its not yet clear if I have an HER2+ cancer, this could cause an issue as they can't give Herceptin without a positive test. There is some debate as to how effective Herceptin is for my stage of cancer, but frankly I'll take any small statistical advantage that I can.
This means I have to go and speak to the head oncologist before my chemo tomorrow to discuss having a further biopsy. There were so few cancer cells (as opposed to pre-cancerous cells, of which there were a lot) that they simply weren't able to test. Now the chances of getting more cells are still pretty low, but it could be the only chance of getting the information. I'm quite happy to have another set of biospies provided that they can manage the pain for me - which most likely means being sedated rather than a local anasthetic. I'm not sure if I can cope with having it done like last time - especially as I know up front how painful it is. Something to discuss tomorrow...
My MRI results were reviewed this morning at the weekly meeting to discuss all the breast cancer patients, and apparently my response to the new treatment has been described as excellent. So the improvement in the lump that I felt wasn't just in my imagination and it appears that the lump is shrinking well. Better response = better prognosis, so I'm very happy.
On the other hand, my response has been so good that there's a concern that by the time I get to surgery there'll be no cancer cells left to test. As its not yet clear if I have an HER2+ cancer, this could cause an issue as they can't give Herceptin without a positive test. There is some debate as to how effective Herceptin is for my stage of cancer, but frankly I'll take any small statistical advantage that I can.
This means I have to go and speak to the head oncologist before my chemo tomorrow to discuss having a further biopsy. There were so few cancer cells (as opposed to pre-cancerous cells, of which there were a lot) that they simply weren't able to test. Now the chances of getting more cells are still pretty low, but it could be the only chance of getting the information. I'm quite happy to have another set of biospies provided that they can manage the pain for me - which most likely means being sedated rather than a local anasthetic. I'm not sure if I can cope with having it done like last time - especially as I know up front how painful it is. Something to discuss tomorrow...
Monday, 28 November 2011
More Scanning
I've been back at the hospital today for another MRI scan to check how the lump is responding to the new Taxotere treatment. I will get the results when I go in for chemo (penultimate one...nearly there!) on Wednesday morning, but from having a feel this morning, I'm glad to report that when I went to check the lump, I couldn't find it. I've noticed that it seems to have been getting both softer and smaller over the last few weeks, and the tissue is still more dense than the other side, but it feels like I've had a lot of improvement over this treatment, which is a great relief.
However, I think I said that it was smaller before the last scan, and it wasn't, so I'm just tentatively pleased until I get the scan results. The more it shrinks, the better my long term prospects are, so fingers crossed.
I've also been for my blood tests today, which will be used to determine if I need a blood transfusion before my next treatment, as last time my haemoglobin levels were low. I guess that they'll either plan that for tomorrow, or perhaps Wednesday morning, but I think it takes quite a long time to transfuse. I may also be affected by the strikes on Wednesday - they're saying all urgent treatments will go ahead, but I'm not sure where chemo falls within the definition of urgent.
However, I think I said that it was smaller before the last scan, and it wasn't, so I'm just tentatively pleased until I get the scan results. The more it shrinks, the better my long term prospects are, so fingers crossed.
I've also been for my blood tests today, which will be used to determine if I need a blood transfusion before my next treatment, as last time my haemoglobin levels were low. I guess that they'll either plan that for tomorrow, or perhaps Wednesday morning, but I think it takes quite a long time to transfuse. I may also be affected by the strikes on Wednesday - they're saying all urgent treatments will go ahead, but I'm not sure where chemo falls within the definition of urgent.
Friday, 25 November 2011
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