Nearly five years ago, shortly after I was diagnosed with Stage 1 breast cancer, a friend of mine who had already gone through treatment for breast cancer told me bluntly: "Amy, once you've been diagnosed with cancer, you're always waiting for the other shoe to drop."
And she was right, because after cancer every little ache and pain prompts a flurry of tests and scans to rule out spread of the disease. I've always kept those words in the back of my mind. I wouldn't say I was fearful of the other shoe "dropping," but I did keep it with me... a constant companion, an ever-looming possibility.
The other shoe dropped a few months ago when I noticed a suspicious lump on the right side of my chest, near the site of my original breast cancer. My physician didn't seem to think it was much to worry about, probably just "scar tissue" leftover from my mastectomy 4+ years ago. But due diligence dictates that these things must be followed up on, so an ultrasound was ordered. When the ultrasound left us with more questions than answers, we decided the lump had to go. The surgeon would take out the lump, we would get a read on what we were dealing with, and then we'd go from there. I wasn't worried.
But, as it turns out, it was cancer. Again. This time the tumor was bigger and enveloped in scar tissue, not breast tissue. It's personality was a little different too, the same in some ways but different in others, making it difficult to know if it was the same old cancer or a "new primary" cancer. Before I had even gathered all of my first opinions from the local team of doctors I work with, I hit the road for Boston, where I met with a multi-disciplinary team of breast cancer specialists at a well-known research hospital. I wanted to gather as much information as possible before my surgery. The team, made up of a medical oncologist, radiation oncologist, a surgeon, and a genetics expert, spent an afternoon reviewing my case. A week or so later they presented my particular situation to the "tumor board" to gain further insight into my latest predicament.
I learned from the team in Boston that my type of local regional recurrence is a bit of an uncharted territory. There aren't too many studies, not too much data to point us in any particular direction. They tell me that my best bet is to treat it aggressively again: surgery, radiation, chemotherapy, and another of year Herceptin. But didn't I do that already? Last time they gave me a 30 percent chance of recurrence if I chose surgery alone, a 15 percent chance of recurrence if I did the chemotherapy too, a 7.5 percent chance if I also took the drug Tamoxifen for five years. I did all that. But here I find myself in the dreaded 7.5 percent anyway. It's lonely here. Being here reminds me that this disease is tricky and that treatments aren't promises or guarantees.
My questions abound. If I hit my cancer with the proverbial sledgehammer last time, am I really supposed to do it again this time? I wonder to myself how much a body can take. My chemo-brain still lingers from the last go round. But the bottom line is this: I want to do everything I can do to be here to watch my kids grow up. So I will gather my opinions from the medical professionals and make the most informed decisions I can make.
Some days I talk myself into things being pretty okay: "It's just a local recurrence, so maybe I'm not worse off than I was the first time around and maybe I don't need that chemotherapy again after all." And then there is the more logical side of me, the researching side that performs searches on Google Scholar and comes up with slightly grimmer realities. Even breast cancer icon Dr. Susan Love's website tells me that: "Despite aggressive local treatment, up to 80-85 percent of women with an isolated local recurrence following mastectomy will eventually develop distant metastases." Maybe there is such a thing as too much information...
My medical oncologist asks me how I'm doing "psychologically." And the truth is that most days I'm fine. Although I wish -- of course -- that I didn't have cancer again. I am calm and methodical about my cancer and how I will go about treating it, because now it is just a part of my life. The first time around I felt, numb, panicked, and shocked during the first few months after my diagnosis. As many of us who have been through cancer know, some of the most frightening moments of the "journey" are when you find yourself in that state of not knowing. When you are wondering about everything: "I wonder if it's cancer? I wonder if it has spread? I wonder if I can beat it?"
This time around, the feelings are different: I find myself more accepting of the unknowns and possibilities -- both good and bad. I think more about the annoyance and inconvenience this latest round of treatments represents in my life. And at home we laugh a lot more this time around. My girls, now ages 8 and 13, have decided they will dub me "the bald eagle" when all my hair falls out again, and when I pull into the driveway after a long day at work they will chuckle and say "the bald eagle has returned to the nest." I laugh and tell them that I hope they will do just that.
So here I sit, another surgery and 34 radiation treatments behind me, and now I'm gearing up for eight more rounds of chemotherapy. On Monday, five years to the day from my original diagnosis, I'll have the surgery to put the chemotherapy port back in my chest. The irony in this is not lost on me. And then, if I can just get over this next chemotherapy hurdle, life will go back to normal...
Oh wait. This is normal.
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