HOW TO LIVE YOUR BREAST LIFE WITH STAGE IV CANCER
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    My diagnosis

4/28/2014

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There are so many issues that run through my mind and sometimes I just want to sit at this computer typing nonstop until I get it all out.   Ill be on a breast cancer site, read a current struggle of a women who's about to start chemo or who is about to have surgery, and I want to jump right to that topic so I can help them cope.  I have to start somewhere though, and so I will start from the beginning. 

First and foremost: There will be a lot of information in this post but it's all very necessary in order for this blog to serve any purpose.  Ladies (and men too - because you are not immune to breast cancer), please make self exams a part of your monthly schedules.  Early detection is SO important.  My  survival based on my diagnosis is 95% according to my oncologist.  Follow your gut!  If you don't get the answers you are looking for, get a 2nd opinion.  I did, and it saved my life! 

Since I moved to Texas I had always been driving 45 minutes to go to my OBGYN.  June of 2013, I decided it was time to find one closer to home. A few people had recommended a doctor to me and so the appointment was made at a practice 5 minutes from my house.  I went for my appointment that day with concerns. I had a pain under my arm,  I had some funky things going on and I had a feeling something wasn't right.  I always chalked it up to the crazy hormones but I wanted to make sure.  I questioned them about it and this was the response..."There is no way you have breast cancer".  Yes my doctor told me that, in those exact words. So I had my exam and pranced out of that office happy that I wouldn't have to return for another year. 

Nearly 5 months later...

For the last few years I had done self exams regularly because I was told I had cystic breasts, and to keep an eye on them.  I knew what was normal for me because I was always aware of what my breasts felt like and where my cysts typically were.  So there I was, about 5 minutes from drifting off to sleep and I had my left arm above my head.  I guess I thought that was a good time to do a self exam.  I immediately felt a small lump in my left breast, lower left quadrant, close to my armpit area.  My stomach immediately dropped.  I knew it wasn't good, because it was much different, but I can't honestly say that I KNEW it was cancer.  I just knew it wasn't normal for me.  It was close to midnight and there wasn't much I could do at that point, and so I went to sleep knowing I would address it first thing in the morning. 

I woke up the next day explaining to my husband what was going on and called that same doctor close to my house.  I explained to them that I found a lump and they told me to call back in 3 weeks because they thought it was hormone related.  This was not acceptable to me.  When something like this happens, you want answers immediately and even though you rarely get answers immediately, you at least want to know your moving in that direction.  So I called my old OBGYN, they scheduled me the next day and the roller coaster began. 

Dr. Anca at Oak Hills Women Center, saved my life on this day.  Not only was she extremely aggressive in seeking out answers to my concerns, but she rushed everything along as quickly as she could so that I could have answers as quickly as possible.  She did a more thorough exam and the next day I was getting a mammogram.  That same week, I was called back in and was told my mammogram came back with BIRADS 4, meaning it's a suspicious abnormality.  November 4, our 2 year anniversary, I had a stereotactic core biopsy done on the mass.  During this procedure, they lie you on a table, numb you, and insert a vacuum assisted needle to "suck" parts of the suspicious mass.  This sample would be used to determine the diagnosis. 

On November 7, 2013 - My diagnosis

I walked in to my doctors office having no clue what I was going to feel like when I walked back out.  I had spent the time between my biopsy and this appointment focusing on my health, convincing myself this was some benign mass. My husband and I sat there squeezing each others hands as tightly as we could, waiting for what felt like an eternity for the doctor to come in. I kept telling myself I'm 33, Im too young, THERE IS NO WAY I HAVE BREAST CANCER.  That's what the other doctor told me and doctors know what they're talking about.  This was just a scare and life will move on as normal after this.  That was not the case. 

There is my life before this appointment, and there is my life after this appointment.  There is a very definitive, bold line that separates them from one another.  The doctor walked in and didn't waste any time telling me the results.  Dr. Anca was not there for this so I would see another doctor from the practice.  It was plain and simple.  "You have breast cancer". My face, my body, and my mind, all became completely numb in that moment.  I couldn't cry because I didn't believe it.  I remember shaking. In fact, I even asked the doctor if was really cancer or was it pre cancer.  "No, you have breast cancer", he assured me.  He apologized to me as if there was something he could do to change what that pathology report said.  He proceeded to tell me there was an excellent reconstructive practice next door should it become medically necessary to go that route.  "They are some of the best doctors in the country", he said.  His bedside manor wasn't the best but I can't imagine how awful it must be for a doctor to tell someone they have cancer.  But reconstruction?  I just found out I have breast cancer and we are already discussing the removal process? 

Before my diagnosis, I remember looking around and seeing women who had scarves on, and it was a pretty clear sign they had cancer.  In those moments, I always felt sad for them and then feared how I would ever deal with being told I had cancer, of any form.  I imagined my world would be turned upside down.   I was confident it wouldn't ever be something I had to face.  Then it happened.  Nothing around me seemed real anymore.  Nothing mattered except for the fact that I had cancer.  Suddenly, my fears of flying and tornadoes disappeared.    I was numb to everything.  I just wanted answers to every question I had.  I wanted to know what stage I was right away.  I wanted to know what my survival odds were.  Would I lose my hair?  Would I really need to consider breast reconstruction?  Was I going to die?  Really...was I going to die???  None of those answers come easy in those first few days and, in fact, would take several more tests before I would know anything. 

The truth is, cancer is not a death sentence.  Scary, yes...death sentence, no. It sure sounds like it is when you're told you have it.  At times, it can even feel like it when you're in the thick of chemo.   Anyone who has had to hear this unfortunate news understands that the waiting period between your initial diagnosis and getting any answers on what your prognosis might be is about as brutal as being told you have cancer.  It is one test after another and in between those tests all your doing is waiting and praying for good news.  Its hard to not let your mind wander and anticipating even worse news because lets face it...you were just told the worst news ever.  Now the fate falls within each and every one of those tests you have done...the MRI's, the PetScans, the ultrasounds, and the blood work.  All puzzle pieces that will help determine your stage, your prognosis, your treatment plan, and so on. 

So after all of these tests, this is what I was facing.  My tumor was determined to be 2.8 CM.  The crazy part is, most lumps aren't even palpable until its 2.5 CM and I felt mine just slightly over that.  My doctors all seemed amazed that I didn't have breast cancer in the family,  that I actually took the time to do a self exam at my age, and that I even felt this tumor. I was diagnosed with invasive ductal carcinoma, with surrounding ductal carcinoma in-situ, angiolymphatic invasion, grade 3  tumor.  My tumor was ER+ and I am BRCA2 positive. What does that all mean?

Invasive Ductal Carcinoma:  Makes for about 80% of all breast cancers and is a cancer that started in the milk ducts of the breast.  Invasive means it has spread beyond the ducts in to the surrounding tissue

Ductal Carcinoma In-Situ: This can eventually turn in to cancer but not always and is usually not palpable. Its typically diagnosed with a mammogram.  Its sometimes referred to as early cancer or pre-cancer

Angiolymphatic invasion: means that cancer was found in the blood vessels and lymph vessels and there is a possibility it may have traveled elsewhere in the body.

Grade 3:  Not to be confused with the "stage" of the cancer, grade refers to how quickly the cells are dividing and how aggressive the tumor itself actually is.  For me, grade 3 meant that the cells within my tumor were rapidly dividing and it was an aggressive tumor.

ER+:  My tumor is fueled by estrogen.

BCRA2:  Is an inherited gene mutation that is linked to breast cancer.  My chances of developing breast cancer were between 40-60% due to this gene.

All of these would help determine what my treatment plan would be and at the time I honestly didn't even know what that meant.  I don't remember ever really thinking chemo would be a part of that.  I am pretty sure I thought we could just cut this out and I would be done.  Looking back, I was so naïve to what cancer actually was.  I was naïve to what chemo was.  Who really believes that it will ever be a part of their lives?  

I strongly believe the first few weeks following your diagnosis can be the scariest, longest weeks of your life, but soon enough you will have your questions answered, your team of doctors selected, and a treatment plan in place.  A fellow survivor and friend (Jen Harman) told me time and time again..one day at a time.  It has become my mantra for life. Don't look back, don't look ahead, just focus on you in the moment and whatever feels right in that moment, do it. You have every right to feel scared and alone. You have every right to fear the unknown that lies ahead.  Try as hard as you can to just trust that your doctors want what's best for you.  Follow their lead, follow your heart,  and seek out the answers you feel you need in order to cope with the emotions your experiencing.  Don't be afraid to cling to your closest friends and family for support.  That's what they are there for.  They will be your rocks through out your journey, and they will carry you all the way to the end.  This will be a portion of your life when you absolutely need to let go, and allow others to help you.  Learn to be selfish. 

Be strong, fight like crazy, but know when to give in and allow others to help you.  Its okay not to be okay but I promise you, you will be okay.  You will get past this and each day you will get more answers and find just a little more comfort in knowing that your time to kick cancers ass is about to come. 


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