Spooky

Sunday, October 31, 2021. I find it a bit creepy that this recurrence made itself known in October–the one month of the year highlighting Breast Cancer Awareness. It’s like a really bad joke. Seriously, if you are a breast cancer patient you are “aware” of cancer every minute of every day all year long. If you are the friend or relative of a breast cancer patient, you are painfully aware of it, too. Sadly, it’s nearly impossible to have a conversation with anyone who doesn’t know someone with or hasn’t lost someone to breast cancer. I liked it better when October was all about figuring out a cool costume for Halloween.

Monday, November 1, 2021

Be strong, go with your heart, and believe in miracles because anything…anything can happen. —Marlo Javidando

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A dear friend recently sent me a small book of quotes called Be Strong. This was the very first one. In that moment it felt like it was written just for me. I still feel that way.

I’ve been residing in “limboland” since my last appointment with Dr. Rugo. But I finally saw my surgeon Dr. Ewing on October 13. The long and the short of it is that because of the location of this newest recurrence (just below the right clavicle), I am not a good candidate for surgical removal. Too many veins, vessels and nerves. I was extremely disappointed with that news. Instead Ewing ordered a core biopsy which they were able to schedule for that same day. However, when the breast cancer center’s radiologists viewed the lesion with ultrasound, they concluded the procedure was too risky because of the nearby veins, vessels and nerves. Collectively, they decided it would be safer for me in the hands of Interventional Radiology and were going to make that recommendation to Dr. Ewing. So they had me get dressed, and I went home. I appreciated that my safety was their first concern. But I was disheartened to be making the long drive home not really knowing what was next for me.

About a week later there was a message in MyChart that another core biopsy was going to be attempted. This time I would go to the Department of Radiology and Biomedical Imaging at UCSF Parnassus. A couple days later I received a phone call from a nurse there who reassured me that I had been the topic of a lot of discussions about what to do next. After reviewing my FNA and ultrasound images, the team at Parnassus believed the biopsy could be done safely. On Friday, October 29, a core biopsy was successfully executed by Dr. Mongan and Dr. Keshav. Prior to prepping the area and shooting the site up with lidocaine, they gave me the usual pre-procedure “pop quiz.”

Q. What is your name? A. Lana Eberhard
Q. Your date of birth? A. 8/23/52
Q. What are we doing today? A. A core biopsy on a cancerous lesion or lymph node just below my right collar bone.
Q. Why are you getting this biopsy? I hesitated. A. Honestly, I don’t know why I’m getting it. We already know from the FNA (Fine Needle Aspiration) that it is triple negative. So, I’m really not sure.

It was then Dr. Mongan said that Dr. Rugo had ordered the biopsy to get cancerous tissue for genetic testing they weren’t able to do on the tiny amount of tissue from the FNA. I told him that’s what I was hoping, but until then no one had actually said it to me.

Keshav and Mongan were pleased with the amount of good tissue they were able to mine. I left feeling encouraged that some forward progress had been made. My next appointment is on 11/10 with Dr. Rugo.

From what I’ve read, there has been some success treating recurrent TNBC (triple negative breast cancer) with immunotherapy if the PD-L1 protein is present. Typically the protein is attached to healthy cells. If the protein attaches to cancer cells, T-cells see them as healthy. Immunotherapy works to unbind that protein from the cancer cells allowing them to be killed.

The beauty of this is that when I was diagnosed with TNBC in November 2018, immunotherapy was not a treatment option. I asked. Three “short” years later, immunotherapy is on the table, hopefully, for me. If not…

I haven’t a clue as to how my story will end. But that’s all right. When you set out on a journey and night covers the road, you don’t conclude that the road has vanished. And how else could we discover the stars? —Nancy Willard