Trixieland

words about words

Archive for the tag “CT scan”

Cancer is full of SCIENCE…and Spiderman.

Now that chemo and surgery are in the “done” pile, it’s time to move on to Phase 3 and plan for Phase 4 of this breast cancer “journey.” That’s so obnoxious, isn’t it? A fucking “journey.” A trip no one wants to take. It’s actually more like being an exile or refugee or something. I’ve been exiled from the land of health and forced to haul my cancery carcass up the Cliffs of Chemo and cross the Strait of Surgery in a leaky rowboat…

Eh, who am I kidding; I have health insurance and live in the Pacific Northwest which is where cancer goes to die. I haven’t done any of this on my own. I’ve been Sherpa’d up the slopes like an entitled heiress, and floated across the water Cleopatra-style.elizabeth-taylor-as-cleopatra-in-cleopatra

Phase 3

What happens in Phase 3 is radiation. For that, I need a radiation oncologist. I met mine last week and although he looks like a young Stephen King I’m going to stick to my theme and call him Dr. Spiderman (No, I won’t be hyphenating that, so get over it now).

Spider Man

Because radiation. Obvi.

We’re going to zap my breast and my lymph nodes with 33 days of high-energy x-rays. So I’ll show up at the hospital every weekday for about six weeks. Each beam of zap will last about 20 seconds and the entire procedure will take about 20 minutes. Spidey says since I have olive skin I may just tan and not burn the way many fair-skinned patients do. Next Tuesday I will go in for a “Radiation Simulation” which apparently includes one hour of “education” and an hour of CT scanning and such (not sure what), so that we zap the right bits. What Spidey and his team are going to do is use the map of my insides to program the big radiation machine (or linear particle accelerator) to zap from angles that don’t hit my heart or any other important junk.

breast_pet_CT_left_sah_radiation

Then shortly after that will be my first date with this bad boy.

linear accelorator

Phase 4 (and the continuation of Phase 1)

Okay, now my phases are getting all confused. Let me try to untangle this. Chemotherapy is over. I started that shit on May 5 and finished my sixth and final round on August 20. But simultaneously with the chemo, I started “targeted therapy” which is the drugs that specifically target the HER2+ aspect of my flavor of cancer. Those drugs are Herceptin and Perjeta. While Perjeta has dropped off the menu, I still get an infusion of Herceptin every 3 weeks, and will continue to get them until May (giving me a full year). This is to make sure the cancer doesn’t recur. The good part of this is that it only takes 30 minutes and I get to see my homies. Seriously, Overlake Oncology has become my Cheers.

Norm

I walk in and the front desk crew says “Christa!” I think that makes me Norm. I don’t see Dr. Captain America every visit, but I did see him last week. He’s not giving me so much crap about my anemia and I even managed to weasel out of a blood test (in exchange for getting a flu shot). This was the first time I’d seen Cap since surgery and it was the day after the Super Friends conference to discuss my case. Cap told me that with pre-menopausal womean (I am considered pre-menopausal because I was still having periods before chemo stopped them) usually get Tomoxifen for five years as their hormone therapy. But…aromatase inhibitors are just a smidge more effective (like 3-4%) in preventing a cancer comeback. But it won’t work if your ovaries are still producing estrogen. (Remember, my cancer was VERY Estrogen-reactive). So, given my age (I’ll be 47 in December) and the stubborn (there was still cancer in my lymph node after all that chemo) and aggressive (the aforementioned HER2+) qualities of my cancer, they think it would be best to go the aromatase inhibitor route. So there are two ways to make that happen. 1. Wait 8 -10 months to see if chemopause ends and Aunt Flo returns or if she’s gone for good. 2. Suppress my ovaries with drugs.

So, that is the plan for Phase 4: Some time after radiation has finished I’ll start getting monthly injections of drugs to suppress my ovaries. And then I’ll take a daily pill that is the aromatase inhibitor. That will go on for five years. FIVE. Side effects can include osteoporosis and joint pain. So before beginning this course of treatment, Cap is ordering a bone density test I guess to make sure my bones are good to start with.

It’s kinda awesome to not be on any drugs at all right now. Well, I mean I guess the Herceptin is inside my body, doing its thing, but I only have to go every three weeks, and I don’t have any side-effects. I don’t have to go to the hospital at all this week, which is refreshing.

Loki helping with the dishes

Loki helping with the dishes

And I feel good! I volunteered to help at my first-grader’s Halloween Party on Friday, and my chemo kitten, Loki, (we found out he was born on the day of my last chemo!) is filling our house with naughty kitten antics and soft kitten snuggles. And MY HAIR IS GROWING!

FullSizeRender (11)

I know it doesn’t look like much, but the hair is fine and fuzzy and my head looks just a smidge darker. I’ve still got this creeping dread/anxiety inside, but I’m functioning much better. Still haven’t resumed work on my book, but I made some really good soup the other day.

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Fear – The Real F-Bomb

Normally, I would wait until I know more before making this post. But, this–the waiting, the not-knowing–is a large portion of this cancer dance. So, today, I went to the radiologist to do ultrasound-guided biopsies of stuff that showed up on my breast MRI a couple weeks ago.lymph-nodes1

No biggie, I thought. I’ve done this before. I know what to expect. And I even had a prediction (left boob was a false alarm and lymph node in right armpit would probably be cancery). Here’s what I didn’t expect: it wasn’t one node they were looking at it was, according to two different techs “a handful” or “three or four.” Can you fucking count? I realize that techs usually can’t tell you anything because they aren’t supposed to make a diagnosis, but JEEZ. Is it five? Is it three?

Okay, so they’re looking at more than one node. I can deal with that. But here’s where it got freaky. One of the lymph nodes under my arm is GINORMOUS. It’s 4.4 cm. That is almost twice the size of Turdy the Tumor. Or at least his size when we did this ultrasound jazz back in early March.

Son of Turdy

Son of Turdy

Dr Movie Star comes in to do the biopsy. We talked about Burt Reynolds and that cheesy killer bees movie that culminated in the Super Dome.

Was he going to stick a needle in all the suspicious nodes?
No, just the big one.
If the biopsy comes back cancerous, is it a tumor in my lymph node?
No, it would be a malignant lymph node.
Since this blob is bigger than the one in my boob is it possible that the cancer started there and moved to my boob?
It’s not impossible, but it’s not probable. It usually starts in the breast and moves to the lymph nodes.

Okay, so he did the biopsy and I got to look at the little wormy core samples that he’ll send to the pathologist. They don’t look evil.

My left boob thing? Dr. Movie Star couldn’t find it. Hooray, said I. Well, that means we’ll need to do an MRI-guided biopsy instead. Boo, said I. He also mentions that if the biopsy comes back bad (and I am fairly confident that is the case, because it’s extremely common for cancer to spread to nearby nodes) they will probably do a PET scan or CT scan to see if cancer is anywhere else in my body. This is when I saw the Eternal Footman hold my coat and snicker. And in short, I was afraid.Prufrock

So yeah. I know I’m supposed to be all positive happy snappy blah blah bullshit, (and Oh! You should have seen my performance today. I was in full-on Trixie Mode. Cracking jokes, making small talk, calling everyone by name and telling Dr. Movie Star his techs should all get raises. Aren’t I a firecracker? Don’t I just have the BEST attitude, bless my little heart.)

Meanwhile, all I can think about is worst case scenarios. The cancer is everywhere. Every fucking where. I’m going to die. They’re going to do a bunch of scans and they’ll change my stage from 2A to 4, which as Dr. Boobcutter put it, is “game over.”

Bright side, bright side, bright side.

1. I’m starting chemo in six days. It’s going to work on killing cancer wherever it may be.
2. I don’t have any symptoms (but what about those headaches? Or how my back always hurts? Shut UP.)
3. I have an awesome medical team that is proactive and sympathetic.
4. I have health insurance. Yes, they may be slow, but Tricare has approved every single thing my doctors have ordered.
That’s all I can think of as far as the cancer. The other bright sides? It’s sunny today. I have two episodes of Mad Men waiting for me to watch. All three of my kids are healthy. I have amazing friends and family. I have this blog: a place to dump my fears and anxieties. The internet is forever and this blog may be my legacy.

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