Monday, February 21, 2011

Some Good News and Then Some...

Its been five days since I last posted a blog entry. I was in a bit of sadness for a few days. We went to see my case specialist at the hospital on Thursday to get an overview of the treatment plant and the results of recent tests done.

The good news: the bone scan, blood test for liver and chest X-ray all came out negative. Cancer has not spread to my bones, lungs and liver. These are the primary organs that breast cancer cells may spread into once it metastases (spreads). My heart scan also shows that I have 61% heart muscle function. My heart passed and can withstand chemotherapy because anything above 50%, they said, is acceptable for chemo.

Results for estrogen-receptor, progesterone-receptor and HER2 (protein) receptors also came back. My cancer is estrogen-receptor positive. It is 1-2% positive for progesterone-receptor and negative for HER2. It means that my cancer is sensitive to estrogen, which "feeds" it to grow. This is good because it means I can go on hormone therapy later on. I will be on Tamoxifen, which is a drug that blocks the action of estrogen for five years.

(It dawned to me that I was on an estrogen-based birth control pill for almost five years prior to having my baby. So I researched the pill, Necon 1/35. Their literature warns "avoid taking Necon 1/35 if you or someone in your family has ever had breast cancer or cancer of the reproductive system or liver problems". . I was not warned, informed or was aware of it. With two maternal aunts who succumbed to breast cancer, I should have taken other options.)

After the test results discussion, Melissa, my case specialist, talked to us about the next tests. I am being scheduled for genetic testing and genetic counseling. This test will show if I have BRCA gene mutation, which is crucial in my treatment. If shown positive, I would have to undergo double mastectomy and oophorectomy (ovarian removal) because the chances of getting cancer in the other breast and ovaries are much higher.

She also said that even when the test comes out negative, she recommends getting a double mastectomy because a Grade 2b has a 50% chance of recurrence in 5 years. With this decision, it will lessen the constant fear of "what if i have it in the other breast too?".

When I was pregnant, I was advised by a genetic counselor to have the breast cancer genetic testing. I didn't do it at that time, mostly because it was cost-prohibitive.  It was not covered by the insurance then yet.  If you have one of these "qualifications" in your health history, it would be good to get it done if you can.  
According to Mayo Clinic:
You might be at increased risk of having a BRCA gene mutation — and a candidate for BRCA gene testing — if you have:
  • A personal history of breast cancer diagnosed at a young age (premenopausal), breast cancer affecting both breasts (bilateral breast cancer), or both breast and ovarian cancers
  • A personal history of ovarian cancer and a close relative with ovarian cancer or premenopausal breast cancer or both
  • A history of breast cancer at a young age in two or more close relatives, such as your parents, siblings and children
  • A male relative with breast cancer
  • A family member who has both breast and ovarian cancers
  • A family member with bilateral breast cancer
  • Two or more relatives with ovarian cancer
  • A relative with a known BRCA1 or BRCA2 mutation
  • Ashkenazi (Eastern European) Jewish ancestry, with a close relative who has breast or ovarian cancer
  • Ashkenazi Jewish ancestry and a personal history of ovarian cancer
With these, being in Tamoxifen for five years and the possibility of double mastectomy, brought me into a few days of sadness and confusion. Being in Tamoxifen for five years, prevents us from having any children until the treatment is over. I will be 40 years old by the time it is done. With my biological clock and what the chemicals might do to my body, I feared the odds of having more children will be against me. We were thinking/hoping for a daughter when baby James is 3 or 4 years old.

Having a double mastectomy, I won't be able to breastfeed my future child anymore. Breastfeeding was one of the things that made my motherhood fulfilling. No matter what others think, I would have loved breastfeeding James till he's ready to wean. It has always been a special moment for us, each and every time. I love how I can stare at him and share a part of me that no amount of money can buy. I love how I can tell him I love him by cradling him in my arms as he feeds and falls down asleep. Its a bonding moment that I cannot explain. Not being able to do this again to my future child/children made me feel a little lonely.

I am lucky to have Jim beside me, through it all. He assured me it will all be okay. We can explore the option of freezing my eggs or adopting. Although those are options I know are possible, it still feels different for me having to carry my child to term. Maybe I'll feel differently later on.

A good friend Tetet told me to watch Christina Applegate on Oprah who is a breast cancer survivor. She had double mastectomy and I found out that she just had a baby at 39. That gives me hope.

I know some sadness will come and go through all these treatments. There will be a lot of realities that I have to face as I go though it. There will be times that I will still question, "why me and why now?" "Why not later in life when I have all my kids and grown up?" "Why not later when I would not care much about having both breasts intact?" "Why not later when I have already spent as much time as I can with my growing family?".

But all these questions will not be answered just yet. Only time will tell. I believe there's a reason for everything.

P.S. I will be presented to the Tumor Board for discussion of my case and treatments on Tuesday, February 22. Also on that day, we will be getting a second opinion at the UCLA-Revlon breast cancer center in Westwood,CA.

If you can , please help in raising funds for Krissy's Breast Cancer treatment:

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