Tag: DCIS

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Three Month Follow-up with My Oncologist

As I said in my previous blog post, I have had some struggles recently. I have been trying to write about what has been going on, but it has been challenging to put it into words. I am still not prepared, but there may never be a good time, so I may as well start to talk about it.

I had a check-up with my oncologist back on the 7th of January. I didn’t write about my appointment right away because it was an unusual appointment, not my usual, “Yes, I am doing fine on my medication. My sleep is improving, as I am averaging just one night a week, where I am still awake at 5 or 6 am, instead of several nights a week. I am still fighting fatigue…blah, blah, blah…”

My bloodwork has improved to where all of my levels are normal except for my red blood cell count, it’s still low, and unfortunately, it may be my regular reading from now on. It’s not terribly low at all, 4.18, where 4.20 to 5.40 is a normal range. But being even slightly low, I can feel it, so hearing that I might not ever be in the normal range makes me terribly sad as I hate feeling this way. I asked if there is anything I can do, that some cancer patients say that they take iron to fight the fatigue. My PA said that I could take iron, but she cautioned me that it could upset my stomach, so I should take it only every other day to start if I decide to try it. She also said that she had heard that there is a liquid version that might be easier to take, but she hasn’t seen it, so she wasn’t even sure where I could get it. I am on the fence about taking iron, so for now, I am not doing it.

My PA explained that one of the essential readings they are looking at when I come every three months is my Hgb or hemoglobin. Low hemoglobin levels usually indicate that a person has anemia. There are several kinds of anemia: Iron-deficiency anemia is the most common type. This form of anemia occurs when a person does not have enough iron in their body, and it cannot make the hemoglobin it needs. High Hgb is known as polycythemia. This means you have too many red blood cells. Polycythemia vera is a cancer of the blood in which your bone marrow overproduces red blood cells. With polycythemia, a blood test also shows a high red blood cell count and high hematocrit. So low or high Hgb would be bad for me, it would mean I am either anemic, which was also a concern during my chemo treatments, or I have cancer in my blood. My Hgb is a little low, only one point from the lowest acceptable level, but nothing to worry about for now.

Now for the tough part…for most of my appointment, I cried a lot. It was hard to talk about, even with my PA, whom I adore. I kept looking away from her while I was talking and crying; I was embarrassed. Why was I crying? It was a lot of things, but mainly the fact that I have had an overwhelming feeling of guilt recently. Why do I feel guilty? As it is, it’s hard being a cancer survivor, and for me, it is tough because I have always had a great deal of empathy for people, but now it includes other cancer patients. Recently quite a few people I know, through various ways, are dealing with having a cancer recurrence. I feel guilty because I am still doing well; I am OK for the most part. They are experiencing my greatest fear, and I am feeling guilty because it isn’t me. It is also a reminder that my breast cancer was incredibly aggressive, and it could return at any time.

It is easy for most to say, “don’t live in fear, don’t worry about it,” but honestly, someone who says that to me clearly doesn’t understand how horrifying it is to go from barely needing to see a doctor to countless scans, blood draws, chemotherapy, radiation and four surgeries in a matter of fourteen months. All three of my doctors, my cancer treatments, everything I went through saved my life without a doubt, but it also damaged me in every way. I don’t know if I will ever be myself again, many cancer patients tell me that I won’t be, but I am doing everything I can to defy that future.

At the end of February, I will reach the second anniversary of my first appointment with my surgeon when I was diagnosed with breast cancer. In many ways, I can’t believe that it has been that long already, and in other ways, it feels like it has been a lifetime.

Thank you for being here; it helps to know that people care enough to read my blog, that the information I am sharing helps other cancer patients and their caregivers, and it helps me in more ways than I can say.

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🎀 Breast Cancer Awareness Month 🎀

I can’t believe that it is already October 1st! Up until now, it seemed like 2020 was going by as slowly as possible, tormenting everyone with endless challenges and sacrifices. But it is finally October; Fall has begun, and the end of the year is around the corner.

I have to admit that October never really held any special significance for me in the past, but after going through my journey with breast cancer, it has a new meaning for me. October is a time to reflect on everything that I went through last year, to help newly diagnosed women in any way I can through a breast cancer app that I am active on, to support those going through treatments and surgeries, to chat with other survivors and see how they are coping, and to remember those that we have lost to this horrible disease.

I received a free eBook today that I want to share with everyone because, as I have learned over the last 19 months, knowledge is power! I share information that I trust with you, my readers, because I have been there. I know how scary the words “you have breast cancer” are and the thoughts that flood your brain after hearing it.

If you have any questions for me or if you just want someone to talk to, please contact me at any time. I have a Contact Me page on this website, or you can contact me through one of my Social Network links at the bottom of each page on this website.

Your free eBook, Breast Problems That Aren’t Breast Cancer, is here! We are thrilled to provide this helpful guide for you.

Click this link to get your free copy

Did you know National Breast Cancer Foundation is committed to helping people (including you!) with their breast health? NBCF is helping people at every step of the journey by providing breast health education, delivering access to vital early detection screenings and breast health services to those who could not otherwise afford them, and helping those diagnosed with breast cancer—and their families—navigate the complex cancer care system.

I hope you enjoy this free resource!

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Fatigue & Depression

I have been going through quite a bit of fatigue and depression lately. I am still experiencing fatigue almost every day, so when I do have a burst of energy, I make sure to take advantage of it. On days when my entire body is hurting, I try to remind myself that I had my 4th surgery not that long ago, so I don’t need to be so hard on myself when I just want to rest. Resting has become another problem in the form of not being able to sleep properly. It is not out of the realm of possibility for me to be awake until 2 or 3 in the morning, sometimes even later, at least a few nights a week. I realize that fatigue is linked directly with depression, so I am beginning to understand how everything I have been dealing with within the last few months is all part of the same problem.

Not all of my depression is linked to breast cancer, but most of it is. I was talking to a breast cancer patient the other day, and she was asking me how long it has been since I had finished each portion of my treatment. I hadn’t thought about the timing of everything in a while, so as I was answering her questions, I was surprised that time has passed much quicker than I thought. It has been 11 months since my last chemo treatment, 7 months since my last radiation treatment, and 4 months since my previous reconstruction surgery; at times, it feels like a lifetime ago, but when I am having a bad day, it all seems like it happened yesterday. Even with all of that time passing so quickly, my body and mind are still healing. I have been experiencing what I thought were some of the side effects that I had at the end of chemo again, but chemo ended almost a year ago, so I am beginning to realize that some of them are symptoms of depression, as described below. Luckily, we are going on vacation soon, and the timing couldn’t be more perfect. I need a break; I need time away from everything that has been hurting my heart and soul lately, and I need to get my mind and body back on track, and I will!

Depression may be a side effect of breast cancer and fatigue is often a symptom of depression. Some people may have a tendency to depression, which treatment can make worse. At the same time, fatigue itself can lead to depression. Not knowing why you feel drained week after week, and not knowing that this abnormal feeling is normal for many people going through treatment, can make you depressed.

Treatment for breast cancer may leave you feeling sad, tired, or depressed. These feelings are complex conditions, resulting from and affected by many factors: your cancer diagnosis and treatment, aging, hormonal changes, your life experiences, and your genetics.

If you’re abruptly going through menopause 10 years earlier than you naturally would, with a quick lowering of hormone levels, you may experience feelings similar to postpartum depression.

Sadness is a natural part of your breast cancer experience, something you need to express and move through. If you don’t allow yourself to feel sad and grieve, the unresolved grief gets in the way of feeling better and getting better. You may be having hot flashes and trouble sleeping. You may be feeling overwhelmed or even debilitated. All of these factors can lead to fatigue and depression.

How can you tell the difference between fatigue, sadness, and clinical depression? The symptoms of clinical depression include:

  • an inability to cope
  • an overwhelming feeling of helplessness and hopelessness
  • inertia
  • an inability to concentrate
  • memory problems
  • panic attacks
  • loss of pleasure in what used to make you happy
  • lack of interest in sex or food
  • sleep problems

If you think you’re depressed, talk to your doctor. If your doctor doesn’t have experience treating depression, ask for the name of an accredited psychotherapist. Together you can sort out if what you’re feeling is depression or extreme fatigue. Therapy can help you feel supported and allow you to talk about what’s bothering you. Antidepressant medicines can help ease feelings of sadness and anxiety and help you feel better. An accredited psychotherapist with experience treating depression can help.

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Breast Cancer Growth Rate

I came across this article recently and it was really shocking to me. I have always understood that breast cancer grows by cell division, but I had no idea of the timing from when it starts to when you can feel a lump in the breast like I did. I know that the information below is scary, but I am posting this to inform my readers because I truly believe that when it comes to breast cancer, early detection and information are key. If you won’t listen to me, listen to a doctor who makes it clear in the article below that a yearly mammogram is so incredibly important. As you know, I also believe that a monthly self-exam between mammograms is just as important. I don’t want anyone to go through what I have been through in the last 18 months, so if I can help just one reader understand the importance of mammograms then I have done my job.

Speaking of mammograms…my last mammogram was before my first surgery in April 2019. Now that I am over six months out from my last radiation treatment it is time to finally have a mammogram done to make sure that cancer has not come back. My surgeon explained that we couldn’t have a mammogram done any sooner than now because the radiation causes the images to look cloudy. So, next Monday I will have the mammogram done that my surgeon ordered back in February. I am scared, to say the least, but I am trying to have faith that all of the chemo and radiation treatments killed any tiny cancer cells that may have been too small to detect after my first surgery.

Ask an Expert: Breast cancer growth rate

From the expert staff of breast cancer research at the Robert W. Franz Cancer Research Center at Providence Portland Medical Center:

Like a lot of cancers, breast cancer grows by simple cell division. It begins as one malignant cell, which then divides and becomes two bad cells, which divide again and become four bad cells, and so on. Breast cancer has to divide 30 times before it can be felt. Up to the 28th cell division, neither you nor your doctor can detect it by hand.

With most breast cancers, each division takes one to two months, so by the time you can feel a cancerous lump, cancer has been in your body for two to five years. It can certainly seem like a lump appeared out of nowhere – especially if you or your doctor have recently examined your breasts and not felt anything suspicious – but in reality, cancer has simply doubled that one last time necessary to be noticeable. By the time you can feel it, a breast tumor is usually a little more than one-half inch in size – about a third the size of a golf ball. It has also been in your body long enough to have had a chance to spread.

This sounds scary, but what it really underscores is the importance of regular mammograms. These screening tests can usually detect breast cancer when it’s about one-quarter inch in size or smaller – a year or more before it would be detectable by hand. Mammograms also make possible the early diagnosis of some pre-cancerous conditions and early-stage cancers that appear as tiny calcifications (microcalcifications) on mammography but aren’t detectable by physical examination.

It’s important to realize that there are two types of mammograms:

A screeningmammogram is performed in cases where there isn’t any known problem. This type of mammogram is used for annual exams.

A diagnostic mammogram is performed when there is a known problem that requires careful evaluation. Diagnostic mammograms provide much more extensive images than screening mammograms, such as views from additional angles and compression, or blow-up, views. Often an ultrasound will be done in addition to the mammogram if there is a palpable lump. Make sure you receive a diagnostic mammogram if you’ve found a lump.

Once a breast cancer gets big, every doubling is significant. If you find a lump, see your doctor as soon as possible. Don’t settle for just a mammogram if the mammogram doesn’t find anything. The next step should be a screening ultrasound, and if those results are indeterminate you need to get a biopsy. Ask your doctor for these tests if he or she doesn’t schedule them.

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6 Tips to Support a Loved One After Breast Cancer Recovery

Very helpful information…Once a cancer patient is in recovery most people think that the worst is over, and it is as far as treatments and surgeries are concerned. But recovery involves not only dealing with and healing from the physical effects, but the mental effects as well. As the first sentence of this article states, “Even if your person appears strong on the outside, understand that their mind and body are still recovering from a trauma.”  Breast cancer and what a patient has to endure to survive it, is indeed a trauma, so it is very important that their support system is there for them more than ever when moving into the recovery phase.

Recovery from cancer is not easy, it takes time to navigate through all of the experiences and emotions that come up during what seems like endless chemotherapy and radiation treatments, blood draws, scans and surgeries. Coming to terms with the damage that everything I have been through has done to my body and mind is overwhelming at times. Every time I look in the mirror it is impossible to ignore my slowly growing hair, the scars on my breasts and the discolored skin under my left arm, from radiation treatments. I know that as time passes my hair will grow back and the scars and discoloration will fade, and maybe as I see those changes then I will feel like I am moving through my recovery instead of feeling like I do now, impatient and stuck.

I have to say that with Covid-19 limiting socialization and disrupting life as we know it, there is a stress that normally wouldn’t be an issue. I would be working on getting back to a normal life, life before breast cancer, and I am, but I am also dealing with the isolation and depression that the virus has brought to most of us at one time or another in the last few months. Normally, I would still be working at my job, and not laid off, which really helps keep me focused in all aspects of my life. I would also be making plans to spend much needed time with friends and family as I miss them terribly and being around them would help my recovery in so many ways. So in the meantime as I wait to find out when I will be going back to work and we finally get to a time when it is safe to get together again with those that we love; I am doing what I can each day to get through these uncertain times as best as I can.

Medically reviewed by Krystal Cascetta, MD — Written by Theodora Blanchfield on July 6, 2020

Even if your person appears strong on the outside, understand that their mind and body are still recovering from a trauma.

If you’ve ever lost a loved one, you may remember what it felt like immediately after your loss: friends checking in on you, bringing you food, and generally showing up for you. But as weeks fade into months and months into years, those check ins drop off — or disappear altogether.

This feeling is all too familiar to some breast cancer survivors who may suddenly feel alone as they struggle to adjust to their new normal.

Do you want to be there for your friend but have no idea where to start? We talked to mental health experts who work with cancer survivors to get the scoop on how you can continue to show up.

1. Respect their trauma and grief

“Loved ones should understand that a great deal of loss has occurred for the survivor,” says Renee Exelbert, PhD, CFT, a psycho-oncologist and breast cancer survivor.

This includes loss of safety in their body, loss of safety in the world, and sometimes, the loss of physical body parts, or the loss of prior functioning, she explains.

With that loss comes relearning how to relate in the world.

Even if your person appears strong on the outside, “understand that their mind and body are still recovering from a trauma,” says Gabriela Gutierrez, LMFT, clinical oncology therapist at Loma Linda University Cancer Center.

The physical loss associated with breast cancer can lead to a kind of identity rebuilding, she says.

“Women are learning how to still see themselves as women even after their breasts have been altered or removed all together,” Gutierrez says.

2. Understand fear of recurrence

You may be wondering why your friend isn’t being more celebratory. After all, they just got a clean bill of health and survived cancer.

Unfortunately, it’s not that simple.

According to the Cleveland Clinic, up to 50 percent of breast cancer survivors worry their cancer will come back.

“This fear of recurrence is a very common phenomenon that patients face as their bodies learn how to adjust back into the ‘normal world’ and as their bodies process the physical and emotional trauma they just endured.”

3. Ask what their needs are

It may be tempting to want to jump in and try to “fix” things or to try to take the burden off of them, but now is the time for your loved one to tell you what they need.

Because their process was so emotionally grueling, there are all kinds of things that may be innocuous to you but a trigger to them, such as a food they couldn’t eat while they were sick.

“Careful listening will demonstrate the desire to help the survivor feel connected to and understood,” says Exelbert. “Knowing that someone wants to help you is extremely meaningful.”

“But if they’re feeling stuck knowing what they need, you might want to offer to help them get back on track with exercise or other forms of self-care,” she says.

4. Continue showing up

More than anything, your person just needs to know that you’ll continue to be there for them.

“Remind them to be patient with themselves, and to have compassion for themselves,” says Gutierrez. “Remind them it is OK to bring up hard conversations with you, so long as you feel like you are a safe person to do so with.”

They may be afraid to bring up these heavy emotions with you, and they need to know they’re not a burden to you.

5. Understand their priorities may have shifted

You’ve been running with your friend for 10 years, and now that she’s healthy again you’re wondering why she’s not interested in running.

When someone has gone through a traumatic experience like an illness, perspectives and priorities will shift. Understand that it’s not personal.

“Loved ones need to be aware that the survivor may not place the same value or importance on previously shared values, relationships, or stressors,” says Exelbert. “What was at one time significant to the survivor, may no longer carry relevance at all.”

6. Take care of yourself

How can you take care of someone else if you’re not taking care of yourself?

“Many caregivers feel they do not deserve a voice as they were not the patient, but cancer is a relational illness, and your experience matters as well,” says Gutierrez.

You were also part of the emotional cancer journey, and your feelings are valid, too.

If processing your own grief and trauma around the experience is too much for you, consider finding a therapist to help you work through it.

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Anastrozole Check-up with My Oncologists PA

Today I had a check-up with the PA at my oncologists office to see how I am doing on Anastrozole. I have been taking it for about 5 1/2 months and I have been doing well. I was having problems with dizziness in the beginning so I changed the time of day that I take it from right before bedtime to when I wake up in the morning. I haven’t had a dizzy spell in a few weeks so it seems that my body has adjusted well.

First we went over my labs from the blood that they drew today. My white blood cell count is finally in the normal range, on the low end, but that was good to see as it means that my immune system is getting back to normal. My red blood cell count is still out of range, just a little low, so that goes along with me still fighting fatigue. I had one other value that was high but she said that it indicates that I have allergies to which I said “I don’t have allergies.” She laughed and said that as far as I know I don’t have allergies but I could be developing them….I hope not.

For the first time ever, she actually mentioned my weight but in a good way. She was happy to see that I have lost weight since the end of chemo, which was at the beginning of October last year, 27 lbs lost in total so far. She said that she knew it upset me to gain so much weight during chemo but she said that while going through chemo it is good to gain some weight because my body needed me to eat well. We agreed that my gaining weight helped me get through chemo as well as I did. She was also happy that I have been losing weight while taking Anastrozole because most women complain that they gain weight while  on it, which for me will be 10 years, so I will keep doing what I have been doing to get to my goal weight.

She also asked me how everything went with the second part of my reconstruction surgery that I had 11 weeks ago today. She was happy that my surgeon was able to get me on his schedule so quickly before my medical insurance ran out due to being laid off. She reminded me that it has only been 11 weeks since that surgery and since I have had so much surgery in the last year, it will still take some time for my body to recover from all of the trauma I have been through.

I asked her when the 5 year count starts as it is the main focus now that I am done with my treatments and surgeries. She said that in their office they start the count from when I completed all of my treatments, both chemotherapy and radiation, which was this year at the end of January. I then asked what the next steps are in their care for me as a cancer patient. I will continue to have check-ups every 3 months for the first 2 years after completing treatments, then every 6 months until I get to 5 years after treatments and after 5 years she said that most patients go back to seeing their regular doctor once a year. My chances of recurrence are at their highest until I get to 2 years, then it will drop a bit until I get to 5 years and then it will drop substantially after 5 years without recurrence.

We also talked about my next mammogram which is coming up in August. I am nervous about it and she assured me that especially with this being the first imaging done in over a year, it is completely normal for me to be worrying and nervous. I told her that am paranoid about the cancer coming back so I am checking my breasts often for anything that feels abnormal. But, I also told her that I am well aware that I have been through the maximum treatments for my type of cancer, having had both chemotherapy and radiation, plus having an excellent surgeon who removed all of the cancer; so keep reminding myself that there should not be anything visible in my mammogram.

So all in all I am doing well and getting healthier and stronger as I get further away from having ended chemotherapy, radiation and 4 surgeries. Here’s to another 3 months of continuing to improve! 🙂

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