Today was a challenging day. I met with the oncologist to discuss chemo as part of my treatment plan. The oncologist explained there were 3 additional invasions discovered during surgery, so there were actually 4 isolated invasions in the breast tissue. To review - my diagnosis is Ductal Carcinoma in situ (DCIS) with Invasive Ductal Carcinoma. All 4 of the invasions are HER2+ (aggressive) and hormone negative (recurrent). My oncologist walked us through the National Comprehensive Cancer Network (NCCM) guidelines for treatment of this type of aggressive, recurrent cancer - chemo and radiation. The good news is God had already moved the mountain in my heart opposing chemo, and rested me in a place of acceptance. While my initial prayers focused on not having to have chemo as part of my treatment, after hearing I had multiple invasions, He moved me to a place of understanding that chemo is a necessary part of my treatment. If there were 4 invasions in the sample they took, there could be more. I knew by the time I walked into her office today that a systemic approach like chemo needed to be part of my treatment plan to ensure any other micro invasions that have been missed are caught and that the cancer doesn't spread.
My chemo regimen will last one year, with Herceptin for the entire year and Taxol for 12 weeks. The worst side effects for Herceptin includes possible diminished heart function. Before they begin the chemo treatment they will do a baseline echocardiogram to determine my heart function. They will repeat the echo every 3 months to watch heart function. The Herceptin will be stopped if there is a 10% decrease in heart function. They will give my heart time to recover - if it does, I will resume chemo. If not, I will not be able to continue the medication due to the long term effects to my heart. The Taxol is a cytotoxin, so it carries the typical chemo symptoms - fatigue, nausea, muscle ache, flu-like symptoms. Taxol will also impact my white blood cell count, so I have to do my best to avoid being around germs. Unfortunately, all this means I will not be able to teach for the 12 weeks I will be on the Taxol. The radiation will follow the Taxol, so I will most likely be out of work for 16 weeks.
The biggest surprise today was the timing. I thought I would have some time to prepare for the chemo. Since I was originally told my radiation would begin in October, I was under the impression that chemo would begin after the radiation. I was wrong. Because of the aggressive nature of my cancer, they want to start on chemo immediately. I need to have a port surgically implanted for the chemo treatments, but they want that to happen fairly quickly. My oncologist suggested I begin chemo in 10 days. 10 days. Woah. My head is still spinning. I have the echocardiogram scheduled for October 5th; still waiting on the surgical date for the port. As soon as the port is placed, I will begin chemo.
This whole diagnosis has felt like I'm in a tailspin. I still wake up most days completely floored by the fact that I have cancer. It hits me over and over again, every morning I open my eyes. But I remain thankful that He is sovereign over everything. Though I continued to be surprised every time I walk into a doctor's office these days, none of this is a surprise to my God. He knew all of this was going to happen, and He already knows how it's all going to end. That brings me an incredible amount of peace and strength. And though I continue to receive difficult news, He continues to show up in the big and little details. I know He is in this diagnosis. Again, it was affirmed today that they caught this at the earliest possible moment, but the greatest praise today was that I was told the chance of recurrence for women who undergo this type of chemo as their treatment is only 2-3%.
I'm going to be okay. I have a difficult road to walk before I get there, but it was reassuring to hear today that I'm going to be okay. My heart is so sad to hear I only have a few more days with my students - they are such a delightful distraction from all that is difficult in this trial. But even in the transition, God has blessed me with the peace to know they will be well taken care of in my absence.
Thank you to all of you who have encouraged me in this journey. I have been blown away at the support I have received from dear friends and people I hardly know. You strengthen me. A special thank you to those of you who stand as my prayer warriors - I covet your prayers and thank you for the peace and strength you bring me through those prayers. It brings me such peace to know so many of you are walking this path with me.
Press on ~ you are loved
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