B12 Shots


When I saw my regular doctor last Wednesday, we had some time to sit and chat, which was nice. This doctor prescribes my diabetes meds and keeps track of my general health. Today he took some blood to check my A1c and to run a panel for cholesterol, liver, kidneys, etc., things that my oncologist doesn’t look at every month.

We discussed my fatigue and depression, and he suggested I get B12 shots. He told me to look it up online when I got home, and if it is something that I want to do, to call my oncologist and ask if I can have B12 shots while on iBrance and Faslodex. I have been suffering for months, so I am willing to try anything to feel better and not so disconnected from myself.

There is an overwhelming amount of information about B12 online. Some of the data is favorable, and some is not, depending on your general health and reason for taking B12. My doctor has had very positive results with his patients who are suffering from both fatigue and depression like I am. B12 shots will not interfere with iBrance or Faslodex, so I decided to go ahead and try them, hoping to improve my overall well-being. Today I had my first shot, and I will have four more over the next month.

A healthy intake of B-12, whether in a normal diet, through a supplement, or via injection, can help a cancer patient recover. It can also help reduce the risk of cancers in healthy people. In most cases, the body only absorbs the amount of B-12 it needs and naturally discards the rest.

I will keep you updated on my results over the next few weeks.

PET Scan Results and Oncologist Appointment on November 7th

 

My husband and I met with my oncologist to get the results from my PET scan, run my blood panels, and get my Faslodex injections. My blood panels came back with several low levels, which seems to be my typical result month to month. Still, as my oncologist explained to me again, my blood looks good for someone on chemotherapy medication.

As far as my PET scan results are concerned, I am happy to say I have good news! The two tumors in my neck are gone; there was no sign of them still being there other than some excess tissue. Cancer on my rib in my back had no change compared to my PET scan in July. I have no other signs of metastatic disease, so no new tumors have been detected. 🙂 So, the meds are still working, so we are staying on the current plan.

I am hoping that when I have my next PET scan in 4 to 6 months, the remaining tumor will either be smaller or still have no change. From what I understand, once the tumor is stabilized or killed off, I will be in remission, which is the end goal of stage 4 metastatic cancer since there is no cure.

2nd PET Scan and Information About PET Scans

I had my second PET scan on Friday since starting iBrance and Faslodex. I wasn’t nervous about the scan; that part is relatively easy; it’s the uncertainty and having to wait to see my oncologist for the results that is the most difficult part. I also deal with pain during my scan because ever since my first surgery in April 2019, I have had pain when raising my arms over my head, which can become very uncomfortable when I have to stay still in that position for more than a few minutes.

Unfortunately, PET Scans are not as quick and easy as getting X-rays. From checking in to registering, going through the scan process to leaving, I was there for 3 hours. I go alone to the appointments because my husband can’t go back with me while I am being scanned, so it doesn’t make sense for him to be there. He goes with me to my oncologist appointment after my scan, so he will be with me when I get my results. I never know what to expect, so it is comforting to have him with me, no matter what the results turn out to be.

Until I faced breast cancer in 2019, I had never had surgery, a biopsy, a CT Scan, a Bone Scan – Nuclear Medicine, or a PET Scan. I have learned so much in the last three years and eight months about things I wish I had never had to experience. I share as much information as I can with my readers because I want you to not only understand what I have been through and what I am going through now as a stage 4 metastatic breast cancer patient but also to help those who are going through the same journey. It is terrifying when you don’t know what to expect, and you are overwhelmed with information. I try to make it a little easier for those interested in getting the information needed to help themselves through whatever they may be facing or helping a friend or loved one through a difficult time.

What is a PET Scan?

A positron emission tomography (PET) scan is an imaging test that can help reveal the metabolic or biochemical function of your tissues and organs. The PET scan uses a radioactive drug (tracer) to show both normal and abnormal metabolic activity. A PET scan can often detect the abnormal metabolism of the tracer in diseases before the disease shows up on other imaging tests, such as computerized tomography (CT) and magnetic resonance imaging (MRI).

The tracer is most often injected into a vein within your hand or arm. The tracer will then collect into areas of your body that have higher levels of metabolic or biochemical activity, which often pinpoints the location of the disease.

Why it’s done

A PET scan is an effective way to help identify a variety of conditions, including cancer, heart disease and brain disorders. Your doctor can use this information to help diagnose, monitor or treat your condition.

Cancer

PET scan combined with CT scan

Cancer cells show up as bright spots on PET scans because they have a higher metabolic rate than do normal cells. PET scans may be useful in:

  • Detecting cancer
  • Revealing whether your cancer has spread
  • Checking whether a cancer treatment is working
  • Finding a cancer recurrence

PET scans must be interpreted carefully because noncancerous conditions can look like cancer, and some cancers do not appear on PET scans. Many types of solid tumors can be detected by PET-CT and PET-MRI scans, including:

  • Brain
  • Breast
  • Cervical
  • Colorectal
  • Esophageal
  • Head and neck
  • Lung
  • Lymphatic system
  • Pancreatic
  • Prostate
  • Skin
  • Thyroid

Heart disease

PET scan image of the heart

PET scans can reveal areas of decreased blood flow in the heart. This information can help you and your doctor decide, for example, whether you might benefit from a procedure to open clogged heart arteries (angioplasty) or coronary artery bypass surgery.

Brain disorders

PET scans of the brain for Alzheimer's disease

PET scans can be used to evaluate certain brain disorders, such as tumors, Alzheimer’s disease and seizures.

Risks

For your PET scan, a radioactive drug (tracer) will be injected into a vein. Because the amount of radiation you’re exposed to in the tracer is small, the risk of negative effects from the radiation is low. But the tracer might:

  • Expose your unborn baby to radiation if you are pregnant
  • Expose your child to radiation if you are breastfeeding
  • Cause an allergic reaction, although this is rare

Talk with your doctor about the benefits and risks of a PET scan.

How you prepare

Tell your doctor:

  • If you’ve ever had a bad allergic reaction
  • If you’ve been sick recently or you have another medical condition, such as diabetes
  • If you’re taking any medications, vitamins or herbal supplements
  • If you’re pregnant or you think you might be pregnant
  • If you’re breastfeeding
  • If you’re afraid of enclosed spaces (claustrophobic)

Your doctor will give you detailed instructions on how to prepare for your scan. A general rule is to avoid strenuous exercise for a couple of days before the scan and to only drink water after midnight before the day of the scan.

What you can expect

The PET-CT or PET-MRI scanner is a large machine that looks a little like a giant doughnut standing upright, similar to CT or MRI scanners.

From start to finish, the procedure takes about two hours to complete and typically does not require an overnight hospital stay. When you arrive for your scan, you may be asked to:

  • Change into a hospital gown
  • Empty your bladder

A member of your health care team injects the radioactive drug (tracer) into a vein in your arm or hand. You may briefly feel a cold sensation moving up your arm. You rest and remain silent in a reclining chair for 30 to 60 minutes while the tracer is absorbed by your body.

During the procedure

When you are ready, you lie on a narrow, padded table that slides into the part of the scanner that looks like a doughnut hole. During the scan you must be very still so that the images aren’t blurred. It takes about 30 minutes to complete a PET-CT scan and 45 minutes for a PET-MRI scan. The machine makes buzzing and clicking sounds.

The test is painless. If you’re afraid of enclosed spaces, you may feel some anxiety while in the scanner. Be sure to tell the nurse or technologist about any anxiety causing you discomfort. He or she may give you a drug to help you relax.

After the procedure

After the test you can carry on with your day as usual, unless your doctor tells you otherwise. You’ll need to drink plenty of fluids to help flush the tracer from your body.

Results

A doctor specially trained to interpret scan images (radiologist) will report the findings to your doctor.

The radiologist may compare your PET images with images from other tests you’ve undergone recently, such as MRI or CT. Or the PET images may be combined to provide more detail about your condition.

I hope this explanation of PET scans helps you to understand what is involved and what cancer patients go through as a regular part of their care. Depending on the type of cancer and the treatment plan, most cancer patients are scanned every three to six months. I am scanned every four months because my cancer, in both 2019 and currently, has proven to be aggressive, so my oncologist feels that every three months is too often, but every six months is too long between scans, making both him and me nervous.

I will post again once I have my results, but in the meantime, if you have any questions, don’t hesitate to get in touch with me. Thank you for being here! 💕

What is Metastatic Breast Cancer?

Many people have asked me to explain what Metastatic Breast Cancer is and what it means for my future. There are a lot of misconceptions out there as to what a stage 4 MBC diagnosis means. The information below is an excellent explanation, that is clear and easy to understand. I previously posted an article specifically about the Myths and Misconceptions About Metastatic Breast Cancer which highlighted many of the questions that I have been asked since being diagnosed back in March.

Metastatic breast cancer {also called stage IV} is breast cancer that has spread beyond the breast and nearby lymph nodes to other parts of the body. Although metastatic breast cancer has spread to another part of the body, it’s still breast cancer and treated as breast cancer.

The most common breast cancer metastasis sites are the bones, the lungs, the brain, and the liver. The symptoms of metastatic breast cancer can be very different depending on the location of the cancer cells.

Bone Metastasis: Symptoms and Diagnosis
The most common symptom of breast cancer that has spread to the bone is a sudden, noticeable new pain. Breast cancer can spread to any bone, but most often spreads to the ribs, spine, pelvis, or the long bones in the arms and legs.

Lung Metastasis: Symptoms and Diagnosis
When breast cancer moves into the lung, it often doesn’t cause symptoms. If a lung metastasis does cause symptoms, they may include pain or discomfort in the lung, shortness of breath, persistent cough, and others.

Brain Metastasis: Symptoms and Diagnosis
Symptoms of breast cancer that has spread to the brain can include headache, changes in speech or vision, memory problems, and others.

Liver Metastasis: Symptoms and Diagnosis
When breast cancer spreads to the liver, it often doesn’t cause symptoms. If a liver metastasis does cause symptoms, they can include pain or discomfort in the mid-section, fatigue, and weakness, weight loss or poor appetite, fever, and others.

Cancer cells can break away from the original tumor in the breast and travel to other parts of the body through the bloodstream or the lymphatic system, which is a large network of nodes and vessels that works to remove bacteria, viruses, and cellular waste products.

Breast cancer can come back in another part of the body months or years after the original diagnosis and treatment. Nearly 30% of women diagnosed with early-stage breast cancer will develop metastatic disease.

Some people have metastatic breast cancer when they are first diagnosed with breast cancer (called “de novo metastatic”). This means that the cancer in the breast wasn’t detected before it spread to another part of the body.

A metastatic tumor in a different part of the body is made up of cells from the breast cancer. So if breast cancer spreads to the bone, the metastatic tumor in the bone is made up of breast cancer cells, not bone cells.

Being diagnosed with metastatic breast cancer can be overwhelming. You may feel angry, scared, stressed, outraged, and depressed. Some people may question the treatments they had or may be mad at their doctors or themselves for not being able to beat the disease. Others may deal with the diagnosis of metastatic breast cancer in a matter-of-fact way. There is no right or wrong way to come to terms with the diagnosis. You need to do and feel what is best for you and your situation.

Keep in mind that metastatic disease is NOT hopeless. Many people continue to live long, productive lives with breast cancer in this stage. There are a wide variety of treatment options for metastatic breast cancer, and new medicines are being tested every day. More and more people are living life to the fullest while being treated for metastatic breast cancer.

While metastatic breast cancer may not go away completely, treatment may control it for a number of years. If one treatment stops working, there usually is another one you can try. Cancer can be active sometimes and then go into remission at other times. Many different treatments alone, in combination, or in sequence are often used. Taking breaks in treatment when the disease is under control and you are feeling good can make a big difference in your quality of life.

September & October Doctor’s Appointments

I have had several doctor’s appointments over the last two months, seeing my oncologist twice, my surgeon, and having my annual mammogram done.

On Monday, September 12th, I had my monthly oncologist appointment to chat with my doctor, check my blood, and get my Faslodex injections. As far as my bloodwork is concerned, it is a little better. My white blood cell count went up a little bit from last month, so my ANC went up as well, which is good. My PA explained that my white blood cell count, red blood cell count, and ANC levels would go up and down from month to month, but it is normal, and as long as I am not too far off from a normal range, there is no reason to worry.

Friday, September 16th: I had my annual mammogram appointment. This appointment is made along with my annual check-up with my surgeon, so he orders the mammogram and then follows up to do my annual exam and go over my results. My mammogram appointments are not routine, mainly because of the scar tissue I have from my surgeries. As usual, they had to do extra imaging, but at least this time, I didn’t have to go through an ultrasound as well as a mammogram. The hospital has a 3D mammogram machine now so that they can get amazingly clear images. The tech I had was the same one I saw back in 2019, and she was very open about showing me the side-by-side pictures from 2019 and now. It was both sad and a relief to see the comparison because my tumors were very easy to see in 2019, just as it is easy to see that there is nothing in my imaging now to be concerned about. My appointment took 3 hours; as I said, not routine, but when I leave, I had my results in my hand, which was a relief because I didn’t have to wait until the following week when I saw my surgeon. All of my imaging was clear, with no sign of cancer.

Wednesday, September 21st: I went to see my surgeon for my annual check-up and to discuss my mammogram results. As soon as he walked into the exam room, he asked me about having a biopsy done on one of the ribs on my back, so I explained the imaging I had that led up to my getting the biopsy. Once we discussed what I had been through since I last saw him in February, he went through my annual exam. He said that I might have some slight capsular contracture developing in both breasts. I was alarmed by this news, but at this time, I am not overly concerned as I am not in any pain, and I can’t physically feel anything myself. But my surgeon is the expert. So if he feels something, then I believe him; he certainly knows better than I do. He mentioned a few times that I don’t have to limit my visits to once a year, so I agreed and said I would feel better if he kept a closer eye on things, so we decided to do a checkup every six months. I love that my surgeon genuinely cares about his patients and that I can fully trust him.

My oncologist appointment on October 11th was pretty routine. My white blood cell count dropped by .1, but again, it will fluctuate a little from month to month, so there is no reason to be worried. This time my Faslodex injection on the right side hurt for days. I do have some discomfort, usually in the evening after I have had my injections, but this time the pain lasted for days. I can’t explain why it hurt so much this time, but I am sure the thickness of the medicine is part of it. Unfortunately, I now dread the injection part of my appointments, but I must have them because the treatment will help keep my cancer from spreading more than it already has.

I’m sorry for the late update. I have been struggling with several things but mainly with depression. I might write about it in the future, but for now, I need to keep the details to myself. All I can say is that having stage 4 cancer is hard, especially mentally and emotionally. People compliment me on how good I look, and I appreciate that because I try my best not to look as ill as I feel on any given day. On the bad days, I stay at home because I can’t face people, and on the good days, especially days when I have little to no fatigue, I get out of the house or do a workout; anything I can do to take advantage of feeling better on that particular day.

Take care and remember, tomorrow is never promised, so live your life as best as you can. Be kind to people, treat people the way you want to be treated, and don’t judge people; you have no idea what someone else is going through, so always be kind and keep hate out of your heart. 💕

Oncologist Appointment on Monday June 20th

I was pretty wiped out when I got home from my appointment on Monday, so that’s why I am just now updating you. Each appointment is usually about 2 hours long, from checking in to leaving, and depending on how I am feeling on that particular day, it can take a lot out of me. Below is an explanation of what happened during those two hours. 

When I check in, I fill out a short form with my name, arrival time, if I have been recently hospitalized and if I have changed my insurance. I give the staff my name, birth date, and the short form. The staff person goes into a drawer and pulls a file with two more forms for me to fill out, hands me a clipboard, and they put a hospital bracelet on me. I sit in the waiting room, which is almost always pretty full, so about 16 to 18 people, both patients, and caregivers. The first form is a general form asking about any recent side effects, hospital stays, surgeries, medications, allergies, and what questions I have for my doctor. The second form is a suicide form with a few questions about self-harm and caregiver abuse. It is sad that such a form exists, but it is a reality for cancer patients, especially older patients. I fill out both forms, keep the forms with me and return the clipboard to the check-in area. This process is done every time I have an appointment.

Next, I am called back to the lab area, where I hand the tech my completed and signed forms. They weigh me, take my temperature, blood pressure, and oxygen. The tech then asks me about my pain level and if I am constipated, both common issues while undergoing cancer treatment. Last, the tech draws two vials of blood, puts them in the machine for processing, and walks me to the exam room. To give you an idea of how big this office is, there are eight doctors and twelve exam rooms.

Everything is very efficient, so I rarely have to wait longer than five minutes before my Oncologist’s PA comes in and hands me the results of my blood panels. I see his PA almost every time I have an appointment, and every other time I am there, I see both my Oncologist and his PA. On Monday, the PA said that everything looks good considering the treatment plan I am on. My white and red blood cell counts are a little low, but nothing to be overly concerned about. My ANC is low again but not too low, so hopefully, it will stabilize as I continue my treatment.

The last part of my appointment is when I go back to the chemo treatment room to get my injections. This is generally the longest part of my appointment because the medicine for my injections isn’t ordered from the pharmacy (which is in-house) until my Oncologist or PA has seen me and approved for me to get my injections, which is determined by my blood panel results. Once my nurse gets the injections from the pharmacy, she warms them because the medication is so thick, so this adds on extra time for me to wait, but it is an important step. Once the injections are sufficiently warmed, I am taken into “The Shot Room,” and I am given my injections which take several minutes due to the amount of medication. I mentioned on Monday that I have a lot less pain and discomfort after my injections if they massage the area after taking the needle out. By massaging the site of the injection, they help the medication disperse quicker. My nurse thanked me for letting her know that info and said she would pass the word on to the other nurses. Patients are often scared to speak up about even a minor issue, and it doesn’t need to be that way. I have learned to be very open no matter how embarrassed I might be because I know that after coming to see my oncologist and his staff for over three years, they want me to be open, honest, and, most importantly, not to suffer in silence if something is causing me issues. So please remember, you are your best advocate when it comes to our healthcare system!

So what is next? I started back on iBrance on Monday after having a much easier time on the lower dose. On July 11th, I will have my PET scan to check the size of my tumors. Hopefully, they will be smaller, which means that the medications are working. On July 18th, I will go back to my oncologist’s office for my monthly appointment and get the results of my PET scan. My husband will go with me on the 18th but not on the 11th. Unfortunately, I am used to PET scans now, so he does not need to go with me.

Take care, everyone!

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