August 31, 2018:
I walk into Princess Margaret and take the elevator up to the 2nd floor … once again, convincing myself that it couldn’t possibly get any worse.
I sit down with the intent of letting Dr. W (my medical oncologist) know that I've decided to go with the every-two-week chemo regimen that we had discussed last week (here). Mostly because I want to know my hair will grow back (vain, I know), but also because it finishes two weeks earlier, which means that I will be able to have surgery, and get this fucking cancer out of me, two weeks earlier.
Only, that's not how it goes down.
Turns out, they found some spread in the scans. It has metastasized to my liver. Which means now, that I've been upgraded from stage 2, to 4. And because of that, and the triple positive (HER2+, ER+ and PR+) bullshit, we now have to be much more aggressive with treatment.
And by aggressive I mean two weeks on (once per week), one week off, and repeat ... for SIX MONTHS!!!
And let’s not forget the hormone blocker infusions. These will still be every three weeks. But instead of one to five years, we're talking for life now, because now that the cancer has spread, these bloody HER2 positive receptors will ALWAYS require suppression in order to (hopefully) avoid reoccurrence.
Talk about a gut-punch.
As for surgery, that’s off the table altogether now, as they don't want to "poke the bear" (so to speak) if it's not contained. Plus they need to keep me good and strong. It may potentially be something that we can consider later on down the road, but we won't know for sure until further into treatment.
I’m handed some papers, and we proceed to discuss my new cocktail: Paclitaxel (aka Taxol) + Pertuzumab (aka Perjeta) + Trastuzumab (aka Herceptin). The first one is chemo and the other two are immunotherapy (hormone blockers).
Similar to the previously discussed regimen, there are 4 pages of potential side effects. Side effects that range from hair loss, to neuropathy, to mouth sores, to bone pain, to losing my finger nails. However, Dr. W feels quite confident that because of my age and (otherwise) good health, that I should tolerate treatment quite well.
From his mouth to God’s ears!!
I ask if a liver transplant is an option.
Because I have breast cancer that has metastasized to my liver, and it got there via my bloodstream (not my lymph nodes).
It also means that I will never not have cancer! Or so says my oncologist. His goal is to shrink everything down as much as possible during my six months of chemo, and then let the hormone blockers maintain the situation.
Of course, there are cases where women (with the same diagnosis/prognosis as me) have responded so well to treatment that the scans show no evidence of disease (NED), which essentially means they no longer have cancer.
So while maintenance may be my oncologist’s end goal, NED is mine!!
I also ask what would happen if I don’t do any (traditional) treatment at all, and his answer is simply “that is not an option and we need to get started as soon as possible”.
I'm numb and in complete shock.
I don’t cry, but I do rock … back and forth, over and over again. I literally cannot sit still. One minute I’m dropping my head in between my legs, and the next I’m up and pacing around the room. Then I’m back in the chair again, rocking back and forth.
I feel like someone has pressed a fast forward button or something.
It’s a lot to take in, TO SAY THE LEAST. And man-oh-man, do I ever wish that I could go back to the good ole days of stage 2 with a lumpectomy and radiation. That all sounds so simple now.
But ultimately, it is what it is, and I’ve just gotta do what I’ve gotta do. What other choice is there, right?