I realise that up until now I’ve only written about my diagnosis. I haven’t yet written anything about the cancer itself, which means I’m not doing a very good job of keeping you updated. So here goes.
I have invasive breast cancer or, to give it its proper name, invasive ductal carcinoma. It’s Stage IIIa and Grade 3. In lay terms, that means it’s big and fast growing. I know that sounds bad but apparently it’s curable. It’s in the right breast and right axillary (armpit) lymph nodes, with no further spread detected. The cancer is also oestrogen receptor positive, which means it needs oestrogen to grow so I’ll take hormone therapy for years after surgery to try and stop it coming back or spreading.
We’re doing chemo first. Even if the chemo shrinks the tumour, however, a mastectomy is likely because of where the tumour is located in the breast. The main aim of the chemo is to stop any cancer cells that may be on the loose, as it were, on their way to a new site somewhere in the body but that can’t be detected using existing diagnostic tools.
The treatment plan as it stands after my first meeting with the oncologist two days ago is as follows.
We start with neoadjuvant (ie pre-operative) chemotherapy. This starts on August 19th, the day after my younger son’s 15th birthday and the day before my older son’s GCSE results. I’ll tell you afterwards whether my first chemo session was more or less stressful than GCSE results day! We’re currently looking at eight two-week cycles, which, assuming all goes well, takes us through to the end of November. The chemo drug regimen is known as “AC-T”; I’ll have four sessions of doxorubicin (trade name Adriamycin) and cyclophosphamide in combination then four sessions of paclitaxel (trade name Taxol). An MRI scan after the 2nd cycle will check to see whether the drugs are doing their job.
After the chemo, there’s a recovery period of around four weeks, after which they’ll do surgery: a mastectomy and total lymph node clearance. At the moment, the plan is to follow this with radiotherapy followed by five or ten (!) years of hormone therapy. So they’re throwing the works at it and we’re clearly in for the long haul.
At the moment, though, it’s one step at a time. I have an echocardiogram later this week, where they’ll check to see how my heart’s functioning. I won’t list all the potential side effects of the chemo drugs here but let’s hope I don’t get some of the more outlandish ones. It seems hair loss is more or less a given, although I may still give the “cold cap” treatment a go.
At this stage I haven’t asked for details of my prognosis. I guess it’s enough for the moment that it’s being treated “with curative intent”. In terms of the team that’s treating me, I know I’m in safe and expert hands.