Going Through Changes
Hey everyone!
The last few weeks of treatment have gone smoothly and as I’m typing this I just completed my 11th out of 16 treatments. It finally seems like the end is in sight!
With the end in sight, it’s time to start planning for a few things:
The Next Phase of My Drug Regimen: Ever since diagnosis I have been warned about this phase, other survivors and doctors really chalk it up to be pretty rough. The drug protocol I will be on is called “AC”. As part of this protocol, I will get a drug that is nicknamed the “red devil” as it’s a syringe filled with red liquid. The side effects of this drug protocol are expected to be much more intense than the previous 12 infusions I received - more fatigue, more nausea, and diarrhea to name a few. These drugs are also tougher on hair, so this will likely be the point where I lose any remaining eyelashes and eyebrow hairs. I will also have to cold cap for an extra hour each treatment to try and prevent as much head hair loss as possible. Since this drug protocol is more intense, I will get more downtime between treatments - which will be nice, I will either have infusions once every two or three weeks, depending on a few variables we are sorting out currently.
Hey, maybe being at the hospital several times a week won’t be part of my personality anymore!
Surgery: Ahhh the inevitable surgery at the end of this journey. The surgery portion is hard for me to talk about. It’s emotional thinking about permanently losing a part of your identity. I know you can make new breasts, but it’s still a very painful and timely process and still ultimately a big change. At this point, I’m not sure if I will be able to keep my nipples, so I may or may not have functioning breasts in the future. This all depends on the location of the “thing” and if the surgeons think they can spare my nipples. Either way, I will be left with scars that last a lifetime and have weeks of recovery with lots of restrictions ahead. All I know at this point is that I will do a double mastectomy. You really have three choices when it comes to surgery:
Lumpectomy - This just takes the portion of the area where the tumor is/was. Lumpectmies require weeks of radiation afterward to ensure all bad cells are gone and the chance of recurrence is lower.
Single Mastectomy - This is the full removal of the breast where the “thing” is/was.
Double Mastectomy - This is the full removal of both breasts
I’ve opted for the double mastectomy for a few reasons. One of them being I am trying to avoid radiation as much as possible. A double mastectomy gives me a 95% chance that I won’t need radiation, so let’s hope that’s the case. Also, there were a few other suspicious-looking spots in my breast when I got my MRI done back in August. They were very tiny, and couldn’t even be found on ultrasound. But per protocols, they would individually need to be biopsied to ensure they weren’t made of bad cells. My doctor said if I want to have the mastectomy, we don’t need to bother with the biopsy because everything will be removed. I thought on that and decided to go with it. It will bring me the most peace of mind to have everything removed and tested.
So yes, I have a few upcoming appointments filled with breast surgeon consultations, scans (to check in on the thing), and an echocardiogram to get a baseline for my heart as the new drug protocol can cause heart issues.
Other than that, I’ve just been dealing with a lot of physical changes and working through some uncomfortableness. The steroids I’m on have made me gain back the weight I had lost, give me a jittery feeling, make me wake up in the middle of the night, and also have caused something called “moon face” which essentially has made my face puffy and round. As someone who has always struggled with self-image and confidence, these are hard things to navigate. These physical changes are outside of my control right now, but they are the part of me that everyone sees. I have been working with my endocrinologist on my steroid dosing and we are hoping that helps to alleviate some of the puffiness. I’m sure we can also blame some of the physical changes on the chemo as well, and the immunotherapy drug, and my hypothyroidism, okay there are lots of drugs circulating in my body right now - so please give me some grace if you see me and my puffy cheekies.
The other night we went to Tim’s boss’s house to play cards and have dinner, and I cried beforehand because I was nervous about other people seeing my cheeks and judging them. These are the things that you usually don’t see, the things that happen behind closed doors. I have also been so tired lately that I try to wake myself up by jumping on a rebounder, and I was so tired the other day I couldn’t help but cry again (in the middle of a workout). Whose body am I living in right now? It feels a little surreal - but I take these changes and symptoms day by day and just try to be grateful for the little things that really are the big things. I can walk, I can see, I have an appetite, I have a warm, cozy home, there are SO many blessings all around you if you just take the time to notice what you do have vs. what you don’t.
My tattooed eyebrows - don’t worry they will heal and fade!
On a more positive note, after three weeks of being off of treatment, I had very good labs and I got my doctor’s blessing to go back and get my eyebrows tattooed again a few weeks back. I originally got them tattooed back in August but wasn’t able to get them touched up when I was scheduled to because I was admitted to the hospital and very high risk for infection. So, I was SO happy when I asked and got the approval, it’s seriously the little things.
I love the result and am waiting to see if I need to go back one more time to seal in the results. But overall it’s giving a nice shadow of where my eyebrows should be, which will help me feel more confident when my brows go completely. They will at least give the illusion of having eyebrows or serve as a good baseline for where I can pencil some in. These things may not seem important to the normal person - but when you’re going through so many physical changes and experiencing so many side effects, it’s nice to still look like yourself - even if you don’t feel like it. It’s crazy, during the three weeks of time I was off treatment I got to see my armpit, leg, and eyebrow hairs grow back. It’s cool to see the body bounce back to “normal” processes so quickly. Not so much fun to have to shave again, but I’ll take it!
In other news, I met with one of my oncologists on December 20th. It was a conversation I was very nervous going into because I knew we would be discussing one main thing, rechallenging me with the immunotherapy drug. I’ve had two oncologists now say that they don’t think it’s in the cards for me. Mainly, because I have already experienced multiple ICI toxicities, or Immune Checkpoint Inhibitor toxicities. I only received this drug two times back in September, but in October I had hepatitis of the liver which had to be resolved with a high dose of steroids and close monitoring. Then in November, I was diagnosed with the hypothyroidism and the Addison’s Disease, both of which have been correlated to the immunotherapy drug.
It’s kinda, a three strikes and you’re out game - right!?
Since I seem to be very sensitive to this drug, we aren’t sure if it’s the best idea to reintroduce the drug. If we do, we will do it at a smaller dose and be extremely careful. My oncologist is mainly concerned about it attacking my liver again or my kidneys. At this point, my endocrinologist has given us her blessing to continue with immunotherapy, because she says that my thyroid and adrenal glands aren’t coming back, the damage has been done and no further damage can be done. So whether that’s a good thing or bad thing, not sure
In our discussion we looked at a large study, which shows that the use of immunotherapy can help the “5 year event free” rate by 6%. Meaning, that people who used the immunotherapy drug vs. those who didn’t had a 6% better chance of not having a cancer recurrence in their breast or anywhere else in their body within 5 years. I know 6% doesn’t sound like a lot, but to doctors, I guess it is substantial. To me, percentages and stats aren’t very helpful to know. I don’t like to inquire about a lot of them, because I feel that it’s not good for my mental health. Knowing myself I dwell on those numbers instead of just “living” and focusing on being the most healthy version of myself. So I’ve kinda gotta separate myself from these percentages and remind myself, it’s just a study and studies are flawed too.
Tim and I decided that we would like to go ahead and have another ultrasound on my breast and see what changes have occurred since continuing with just one of out the three drugs I was originally prescribed. Prayers are that this single drug is still doing a great job and we can see more progress! I can still feel a tiny little bump if I search really hard, but that can also just be leftover tissue as well. But we will see what the scans show and make a more informed decision on the immunotherapy drug soon, more updates to come there! I’m glad I have some time to weigh the pros and cons and come to a decision that feels well with my soul.
Let’s take a second to highlight some of my answered prayers in this journey so far:
My auxiliary right lymph nodes looked suspicious, but the biopsy came back negative for bad cells. This was huge because this would have changed the staging for my diagnosis.
I was able to drop the drug Carboplatin after having two severe drug reactions
The mass on my ovary was benign and I was able to keep my right ovary and fallopian tube
I have been able to keep almost all of my hair throughout the first 11 treatments so far due to cold capping
The “thing” in my breast has shrunk by 70% last time we checked, hoping for even more progress in the next scans
I have been able to do my healing sessions in Austin which is very close and convenient
I am able to tolerate the one drug in my current protocol very well and don’t deal with nausea and vomiting
I have been able to take this time off from work to really focus on healing and my health
I have so much love and support from family and friends
Many of these things wouldn’t be possible without the power of prayer, so thank you for sharing your love through prayer as I navigate this journey.
Remember - you can still sign up for a time to connect with me in the upcoming weeks! The link below redirects you to a virtual calendar to sign up for time slots where we can chat and catch up:
Wishing you a wonderful Christmas and a Happy New Year!
Xo, Breanna
