High Five

June 9, 2024. I’ve been thinking a lot about everything I’ve experienced since that day in September 2018 when a little voice in my head whispered, “I think the cancer might be back.”

It had been 19 years since my breast cancer diagnosis in 1999. After a lumpectomy, sentinel node biopsy followed by chemotherapy and radiation, the future looked bright. All my routine follow-up appointments were clean.

That was until October 2018 when my “little voice” suspicions were confirmed. The cancer was back. It was being called a recurrence even though the cancer was in a lymph node located inside my right pectoral muscle. It was triple-negative. In 1999 it was estrogen and progesterone positive. As it turned out, triple-negative is harder to treat. The fight began.

Because the cancer came back in an area that is very vascular, it was dangerous to try to remove. So, in January of 2019 I started chemo (Taxol and Carboplatin) to reduce the tumor to an operable size. In May I was finally able to have surgery which also involved removing several lymph nodes in my arm pit. Then in June of that year there was more chemo (Adriamycin) as adjuvant therapy to hopefully kill any stray cancer cells that might be floating around. Then it was time to heal and get my life back…or so I thought. But in January 2020 the cancer had returned, and in February there was another surgery. Adjuvant therapy this time around was an oral chemo (Xeloda) that I took through the end of November. I also had 8 weeks of radiation. Things were going along pretty good until October 2021 when, once again, the cancer returned. Only this time it was inoperable and had metastasized to my lungs and diagnosed as Stage 4, unresectable, metastatic triple-negative breast cancer (MTNBC). Again I was prescribed Xeloda only at a much higher dose. In October 2022 when the Xeloda stopped keeping the cancer in check, the oral chemo was switched to Bicalutamide. It didn’t work either. In January 2023 I began participating in a research study for “Patients with Unresectable, Locally Advanced or Metastatic Triple-Negative Breast Cancer.” I qualified in every category. Within a couple treatments my tumors were shrinking and tumor markers dropping. Within months the cancer in both my pectoral muscle and left lung was undetectable. It felt like a miracle. After 11 months in the trial, the cancerous nodules in my right lung continued to slowly increase in size. In mid-November I dropped out of the trial in order to receive focal radiation on the two largest lung nodules in December 2023.

After what has seemed like never-ending treatments in a battle it often felt like I was losing, I’ve not had any infusions for seven months. The most recent CT scan report from June 4 describe my condition as stable (such a pretty word).

Do I still have cancer? Yes, I do. It’s there, it’s just doesn’t seem to be active right now. Why no treatments? You know what they say about poking the hornets nest.

I have to confess my CEA (carcinoembriyonic antigen) tumor markers have been on the rise. As a matter of fact, on April 30th it was 49.6. The highest it has ever been. Normal is less than 5.1. However I was, and still am, recovering from a severe lung infection, which might be a contributing factor. The CEA on June 5 was 46.8 indicating a slight downward trend that I hope continues.

My next trip to UCSF is scheduled for the end of August when I’ll have a PET-CT (positron emission tomography) and another CEA test. The PET scan will let us know if the cancer has spread to other locations in my body or if it truly is stable.

When I met with Dr. Rugo on June 5 she had not yet read the Chest CT report. As I sat there, she pulled it up and began reading out loud the findings and impression. Once done she exclaimed, “Unbelievable! It gives me the chills.” And then she raised her hand in the air for a high five. It was a very emotional moment…for both of us.

A mother is she who can take the place of all others but whose place no one else can take. —Cardinal Mermillod (in honor of my mom who passed away two years ago today)