Sunday, April 17, 2011

The "Results Show": All Clear!

Well, as the title of this blog post suggests, my scans were ALL CLEAR!  This means there is currently no evidence of cancer in my body - WOOHOO!

This moment has been a long time coming.  It's the first time since my diagnosis 15 months ago that I've been able to say - with documented medical tests to back me up - that there is no active cancer!

And while these results were what we expected and I tried not to worry too much about my test results, it obviously came as a huge relief nevertheless.

The tests themselves went fine on Tuesday - I know the drill by now so it was the same low-carb diet on Monday, then I got to the testing place bright and early at 8:45am on Tuesday morning.  First up was three spine MRIs - thoracic, cervical and lumbar.  They were all separate tests - about 20 minutes each - and luckily they wheeled me out of the machine in between so I could move around a little before going back in.

Then I moved on to the PET/CT scan.  I had dutifully followed my low-carb diet the day before, and as usual they put in an IV first (this had to go in my arm because the contrast is made of glucose so can clog the port), then gave me my oral contrast "milkshake" (I chose vanilla this time), then I sat in a little room for about an hour.  I snapped this pic of the sign on the door:

Inviting, isn't it?

Then I was called in to the scanning room where I was belted on to the table, injected with the CT contrast, and then into the scan machine for about 30 minutes.  I think I dozed off at one point - again!  There's something about that PET/CT machine that makes me sleepy.   I guess I would feel the same about the MRI machine if there wasn't all that loud clanging going on during that test.

I was done around 1:30pm and then had to head over to the hospital to get blood drawn in advance of my radiation planning session on Friday.  A busy day, but it was relatively uneventful and smooth.

On Wednesday, I went to see Dr. Sara for my test results.  He told me they were all clear - there was nothing in the breast, nothing in the liver, nothing in the spine (the two healed spots we already knew about were unchanged).  He said there was really not much to talk about since it was all clear!  My next set of tests will be in about 4 months - in August.

It's important to note that although a clear scan is amazing news, it doesn't necessarily mean that every last cancer cell has been eradicated from my body.  There is no way of knowing that - well, I guess unless the cancer either comes back or it doesn't.  I will always be at risk of a recurrence for the rest of my life and no one will ever be able to tell me that I never have to worry about the cancer coming back, becuase there is always that risk.  But, that is why I will have scans every four months or so at least to start, so that if there ever is evidence of a recurrence it can hopefully be caught early and nipped in the bud.

Here's a picture of Dr. Sara and me right after he told me the good news:

Treatment has not changed - Herceptin every three weeks and of course radiation will be starting soon.  I also saw Dr. Rosenbaum Smith this week for my regular follow-up and everything was AOK there too!  My next breast checkup will be in July.

On Friday I went to my radiation "planning" session.  I have been through this before with my spine radiation so I pretty much knew what to expect.  My friend Kim was able to come with me to this appointment and they even let her come back to the CT room while they got things started, so she served as resident photographer.

Here's a picture of the CT machine:

And here's a pic of my feet on the scanning table.  Aren't my shoes cute?  I try to go to my cancer treatments in style!

First the tech explained what would happen - first they would get me into the right position and make a mold (that blue thing in the first pic is what eventually became the mold) that I would lie in each time to be sure I'm in the same exact position for each session.  I wondered if they could use the mold I had last time but the answer was no - and in fact they use a different kind of mold for the breast radiation than they did for the spine radiation for some reason.

After the mold was made and I was in position, they would do the CT scan, and then they would do some planning and finally I would get my new tattoos and be on my way.

It all went as planned and took a little over an hour all together - not too bad.  I had to lie with my right arm above my head and it started to hurt after awhile.  When I was finally able to move it my arm had totally fallen asleep and I couldn't feel it at all - it kind of flopped off to the side.  Such a weird feeling!  But then it quickly came back to life.

I also saw Dr. Evans who told me again how all my scans were clear and the results were the "best possible outcome".  Even though I already knew the results, I never get tired of hearing them!

They were able to use some of my existing tattoos so I only had to get four new ones, which was nice.  Now I have a total of 11 tiny blue dot tattoos.  Or as I say, they are all of the "world as seen from space" (a reference to an old Friends episode)!

Radiation should start in 1-2 weeks - they will call me when the planning is done and they're ready for me to come in.  I will have to go every day, but it will be a short treatment - just a few minutes hopefully.  I will see Dr. Evans once a week - on Mondays.

I know the radiation drill already because Mom is still going through her radiation treatment, but should finish on Friday!

Now, I have a week "off" from treatment before my next Herceptin on April 27th and as I wait for radiation to start.  I think I'll just revel in my clear scan results until then!

Sunday, April 10, 2011


This blog post starts off on a somber note.  On March 29th, my Uncle Bob passed away of cancer at the age of 59.  He was diagnosed with cancer of the bile ducts in late January.  A mere two months later, he was gone.  He is missed by his many friends and family.

Besides being yet another blow - the worst one yet over the last year - to my family, it was also a stark reminder of how cruel, ruthless and unforgiving this disease can be.

Besides being sad for the loss of my uncle, and for my Dad, who lost his younger brother, inevitably it also makes me think about my own cancer diagnosis.  And while there may have been a shred of comfort in the fact that my uncle had a very rare kind of cancer that I do not have; cancer is still cancer. 

And then two days later I found out that the woman who runs the community programs at my breast surgeon's office passed away of breast cancer.  So there goes that shred of comfort.

As evidenced by my last few blog posts, I've been doing fine over the last few months with no side effects to speak of.  In a lot of ways, I live my normal life, with just a few more doctor's appointments and treatments than my fellow 32-year-olds.  And while the fact that I have cancer is always with me - always there when I wake up in the morning and constantly in my thoughts - I've learned to live with it.

But then something like two cancer deaths in one week kind of throws you for a loop and reminds you that this cancer thing is SERIOUS BUSINESS.  It really sucks, to put it bluntly.

In other news, on March 23rd I had my last chemo treatment, i.e. my last Navelbine treatment.  I didn't even know until I showed up that day that it would be my last Navelbine, but Dr. Sara said that it had been six months, and so he was taking me off the chemo drug.

However, I will stay on Herceptin for another 6 months, maybe more.  As he's said before, my case does not fit into any of the "neat categories" of cancer diagnoses.  Typically, when someone is diagnosed with Her-2 positive cancer, they are on Herceptin for one year.  The reason for the "one year" is simply because that's the length of time they have research on.  It could be that less than one year provides the same effectiveness; it could be that more than 1 year provides longer-term effectiveness.  We simply don't know because the drug hasn't been around 25, 30 years to know the long-term benefits.

Now, in cases where patients have active metastatic disease (i.e. the cancer has spread to other parts of the body and is still active in those other parts), their Herceptin treatment is determined by how the active tumors are responding.  If they keep shrinking on the Herceptin, they stay on it; if not, they may be taken off the drug.

Of course, MUGA scans are the other determining factor in treatment length, as someone whose heart muscle is being weakened by the drug will be taken off it, at least temporarily until heart strength is regained.

However, I don't fit into any of these categories.  Yes, I have metastatic disease, but it's not active (at least we don't think it is... more on that later).  So what to do?

Well, Dr. Sara says that there is really no reason to take me off the Herceptin.  It's a relatively quick treatment and doesn't have any side effects (except for the heart muscle thing which has not affected me), so why not keep me on it?

My response to this is:  Fine by me!  I will gladly get Herceptin for the rest of my life if there's even a shred of a chance it's keeping me from a recurrence.

So, now that my chemo is complete, this means it's time for another PET/CT scan.  Although all evidence of "active cancer" has presumably been eradicated from my body - the active cancer in my breast, lymph nodes and liver removed by surgery; the active cancer in my spine already showing as healed when it was discovered, and then also treated with some "insurance" radiation - we won't really know how things look until my next scan.

It's not my liver or spine that Dr. Sara is necessarily worried about... it's the fact that I had 8 out of 11 lymph nodes still affected after surgery.  This tells him that my cancer is a cancer that likes to move.  So the danger is not necessarily that it will start growing again in places where it's already "landed," but that it will show up in new places.

My scans are set for this Tuesday, and I will get the results the next day, on Wednesday.

I am pretty optimistic that my scans will be clear, but I also remember that last time my results suprised us all when those two little spots on my spine were discovered.  So you never know.

Now, besides getting scanned again, the end of chemo also means the beginning of radiation.  This Friday, I will be going for my radiation "planning" session, where I will be getting more tattoos and will find out more about this next stage of treatment.

As part of my "day of tests" on Tuesday, I will also be getting an MRI of my spine as a follow-up to my spine radiation last fall, so hopefully it will show what we expect - that the combination of chemo and spine radiation has fully healed those two little spots on my backbone.

On top of all of this, it's also time for my 3-month checkup with Dr. Rosenbaum Smith, which is also set for Wednesday, just before my "results show" appointment with Dr. Sara.

Whew - it will be a busy week!

OK, time for some comic relief.  First, as you may remember my friend Amanda's comment over a year ago about how many Mardi Gras beads she will need to give me thanks to all of my "boob flashes" inspired my little sidebar tallying both the boob flashes and needle sticks.

Well, true to her word, sure enough a couple weeks ago she presented me with a string of beads for every boob flash I've had over the last year - 112.  In case you're wondering, here's what 112 Mardi Gras beads look like!

Haha - thank you Amanda!

Now, secondly, while this is totally not cancer-related in the least, last Saturday, April 2nd was my niece Claire's 1st birthday!

Here is a picture of Claire and me on her big day:

And here's another picture of Claire in her party dress:

I think my sister Sara put it perfectly when she said that Claire is "our sunbeam in this cloudy, cloudy world." 

Happy Birthday to sweet Claire!