An Unexpected Encounter

This week, I met an amazing person in such an unexpected way.  I have been taking advantage of the free shuttle service the hospital offers.  They come to my place of work to pick me up … drive me to my radiation appointment every weekday … and then drive me back to work.  How neat, huh?  I’ve had a couple of different drivers, and this week one of my drivers was Sherman.  He is a very friendly gentleman, and we hit it off right away.  As we were talking, he shared with me different things, and when he found out I was having radiation treatments, he asked how many.  When I told him 30, he shared he had 40+ himself.  WOW!  I told him I had been informed that the fatigue will start at around the 3 week mark.  What he said next had a profound impact on me.  He said he never had any fatigue when he was undergoing radiation, and then told me that I wouldn’t either.  That comment was really encouraging to me, and I’ve held onto it ever since he said it.

As we continued to talk, he also shared that he has been singing for all of his life, knew he’d sing since the age of 5, and has traveled all around the world.  How exciting!!!  I once had a dream to be a singer.  He happened to also mention that if I googled him, a lot of stuff would come up.  So, as he dropped me off at work, following my appointment, I promised him I’d google him and we’d chat about it on Friday, when he was scheduled to drive me again.

Well Sherman, it turns out, is a Grammy winning famous contemporary Christian gospel singer.  This is Sherman Andrus from Andrae Crouch and the Disciples, the lead singer of The Imperials, co-founder of the contemporary Christian group Andrus, Blackwood & Company, and more.  You can read more information about Sherman from wikipedia.  We took this ‘selifie’ when he dropped me off back at work on Friday.

sherman-andrus-and-debi-2017

I was treated to hearing some of his beautiful music on Friday, as well as a simply amazing song he wrote for his wife, titled “I’m Yours”.  He told me it was written many years ago, but only released in 2014 and even nominated for “song of the year”.  Sit back, relax and enjoy his velvety smooth voice … as he sings this beautiful love-song written for his wife.

Here’s another amazing song he sang while on the Gaither’s show.

What a blessing for God to have our paths cross in such an unexpected way.  I thank God for bringing Sherman into my life – in the midst of my illness.  Thank you for being an inspiration to me as I walk this journey, Sherman.

2 down … 28 to go!

I had my first two radiation treatments this week, and thankfully get the weekend off before I get fully into the swing.  I will have a total of 30 treatments, where I go 5 days a week (Monday – Friday) for 6 weeks.  The timing is interesting, as my final radiation treatment will actually fall on my birthday.

My radiology oncologist informed me that of the three simulations that were done, he had treatment plans prepared for all three of them.  My heart sits back a bit from my ribcage, so that is a good thing.  Amazingly, all three positions provided about the same protection (negligible differences) for my heart and lung.  So then the focus went to how much of the breast can be treated in each of the different positions.  In the end, the supine position (on my back) is the best position for treatment … with normal breathing throughout the treatment.

The treatment itself is very short in duration.  I believe I’m radiated for 2-4 minutes tops.  The longest part of the process is getting into the proper position, ensuring I’m aligned with the laser beams properly.  (This is where those tattoo’s they gave me come in.)  The machine moves around me, even moving under the table, to get to the other side of me for proper angles.  I feel kind-of like I’m on an alien planet or something.  I have to turn my head to face toward the right, to ensure my chin is not in the path of the radiation beams.  Since my head is facing right, I watched the radiation machine as it was making the noise like when you get an x-ray at the doctor’s office.  There are ‘fingers’ (for lack of a better word) that constantly move while the radiation dose is being given.  When I asked, I was told it was part of the programming for my treatment … and part of that ‘blocking’ that occurs is the heart block to protect my heart from the radiation.  There is a small sliver of my lung and heart that will receive a small dose of radiation, but I was assured that it is very little – and is well within the accepted margins.  So … both times, so far, as the technicians leave the room – before the machine starts the treatment, I say a prayer “I’m in your hands Lord, please keep me safe”.  I fully trust that God is keeping me safe.

Following treatment, before I go back to my office at work, I apply vitamin E oil (a tip from a fellow breast cancer survivor — thanks MaryJo!) and then Miaderm radiation relief lotion (thanks for telling me about this Jo!).  Thanks to another friend, I have enough of this to make it through my 6 weeks of treatment … and she even threw in one tube with Lidocaine in it that I’m saving for the last week, when I think I’ll need it most.  (Thanks so much, Pauline!)

I’ve been told that I’ll start noticing a difference in the skin after the first couple of weeks, and then at about week 3, the fatigue will start coming on.  This fatigue will remain throughout the duration of the treatment extending for 2-3 weeks beyond when it’s finished.  After then, I’ll start to regain my strength again.

That’s all I have to report for now.

Radiation begins…

I heard from my radiation oncologist this afternoon, and my radiation will begin tomorrow.  I know that I’ll be in the supine position (on my back) for my treatments, and was told I’ll also have a heart block of some sort, to protect my heart from the radiation.  I will know more tomorrow.

Please keep me in your thoughts and prayers, as this is the phase of treatment that I’m really not looking forward to.  I’ll write to share how I’m doing as I progress through this phase, and as I have more to report and feel up to it.

Thank you for all of your caring emails, comments and ‘snail mail’ cards.  ((HUGS))

2/8/17 Update: Wanted to let everyone know that I had a last-minute cancellation of my appt today because of an insurance glitch. Now we’re just waiting for authorization before I can proceed forward.

Radiation Simulation

This week I went to see my Radiation Oncologist for the 2nd time.  It has been ~3 weeks since I last saw him.  I really didn’t know what to expect at this visit, but since my last one was 2 1/2 hours, I figured this one would be no more than 1 hour-long.  Boy was I wrong!  It was another 2 hours, 45 minute appointment.

What they did was conduct three different ‘simulations’ of my radiation treatment.  I was in 3 different positions, and they utilized a CT scan to take pictures of where my heart and lungs are located, in relation to the area that needs to be radiated.  In order to see precisely where those lines were, they used stickers that had small metal “bb’s” so it would show up on the CT scan, so they could do their measurements and calculations.  I also received 6 tattoos (yes, tattoos) – that look like black freckles.  Three would be used to guide them for proper alignment of the beams for radiation for two of the simulations we did, and the other three are for the third simulation.  I will only be using one of the positions during my treatment.

Now the hard part for the doctor starts.  He, and his treatment plan team, will all study these three scenarios, CT scans, as well as the pathology and reports from surgery … to develop the plan of treatment that will be best for me, while at the same time minimizing the harm done to healthy tissue/organs.  So, until they have completed that, I am in a holding pattern again.  That can be the hard part when you’re just wanting to get the treatment done … and move on with life.

Here’s a video that better explains what my treatment will be like, if you’d like to watch it.  it’s just over 17 minutes long, but is very informative.

 

I’ll be sure to post an update when I know more…

Status Update

I’ve had several people reach out asking how I am feeling, so I thought it was an opportune time to write a quick post to share with everyone.  I am feeling just fine … I have not yet started my radiation treatments.  My doctor wanted me to heal a little more from my surgery before we start that.  I meet with the radiologist next week, and will likely find out when my radiation treatments will start at that appointment.

I also started taking my chemo pill 2 weeks ago.  This is the pill I’ll be on for 5 years.  So far … I’ve not experienced any negative side effects, and pray this continues.

Thank you for continuing to keep me in your prayers … and for caring so much about how I’m doing.  You are all very special to me and mean the world to me.

Meeting with the Radiologist

Yesterday, I had a very long and emotionally draining meeting with the Radiologist Oncologist who will be treating me with radiation.  He was a very nice, informative doctor who took the time (2 1/2 hours actually) to fully and completely explain the different options, positions as well as the pros/cons involved with this very important decision.  I will attempt to share some of that in this post.  For those who don’t really want to read all the details, I will share here that I will need to endure 6 weeks of radiation, 5 days a week.  This will not start for another month or so … giving me time to heal from my surgery 2 weeks ago.  Also, my cancer has been staged as a 1A breast cancer.

First he went over the details of my particular diagnosis.  The fact that I had microscopic evidence of the invasive cancer (even though none was found in the tissue that was removed during surgery) changes the way I will be treated.  He must treat me for the more aggressive form, to ensure the optimum results going forward (i.e. a long, healthy life with the least risk of developing a new breast cancer or having a cancer recurrence).  There are several regimens that are practiced, that on the surface give the same outcome.  I don’t understand all the terminology he used, but was able to understand that the shorter radiation treatment (4 weeks) would be with a higher concentrated radiation beam or voltage.  (As I said, I don’t understand the terms used … but the shorter treatment is with a higher concentration of radiation or something like that.)  He used “267” in the shorter treatment along with a hypofractionation term; and then “200” in the longer treatment with a conventionally fractionated three-dimensional external-beam radiotherapy.  Basically the end result is that he believes the longer, 6 week radiation program, with the lower “200” conventional beam would be better for my case, given the microscopic invasive cancer found in the biopsy.  The invasive cancer being present, even if only from the biopsy, dramatically changes the way one is treated, as it’s recurrence risk is much higher than the DCIS only would have been.

Then he spent time explaining how the 6 weeks will start to affect me.  For the first 3 – 3 1/2 weeks, I will likely not have any change in how I’m feeling.  At around the 3 1/2 – 4 week mark, fatigue will start setting in.  He explained this to be more like going to bed an hour earlier than normal, or taking a nap in the middle of the day (if i didn’t work).  This would be something I experience every day during my treatment phase.  Around week 4, I’ll start to notice skin dryness; week 5 I’ll notice the skin becoming pink and starting to itch, then week 6 some patients will have some small peeling – similar to the peeling when you get a bad sunburn.

For the first 5 weeks, I’ll have radiation of the entire breast; then for the final week, they change and focus a more concentrated beam at the tumor area … which will minimize some of the skin symptoms experienced the first 5 weeks.  This includes at the 7-10 day mark, following week 5, I will start bouncing back a bit from the fatigue and a lot of the other affected skin changes will start looking and feeling better.  During the final week of treatment, however, I may also notice a ‘tan’ appear on the breast.  This is typically only a shade or two darker than the rest of my skin … and will hopefully lighten over time (meaning years).

Next we went over the typical chronic concerns involved with radiation:

  1. Skin changes
  2. Heart impact
  3. Lung impact
  4. 2nd cancer diagnosis over lifetime

As you can imagine, this was a long in-depth discussion that involved how different body positioning during radiation treatment impacts items 2-4 above.

There are two different positions that can be used for breast cancer radiation treatment.

  • There is the “supine” position, where you are on your back with a wedge under your back/head at a 10-15 degree incline, as well as a round pillow roll under the knees and your arms are above your head.  In this position, they are able to radiate the entire breast (including the nodal area under the armpits).  They also perform x-ray / CT scanning to know the exact position of the heart and lungs.  They will put a ‘heart block’ to shield the beam from the heart, and will minimize the amount of the lung in the range of the radiation beam.  (For some people, their lungs are set further back from their breastbone, so none of the lung is in the beam … but some other people’s lung is right up against the breastbone, so a small amount is in the range of the beam.  They can utilize a technique called “DIBH” — basically an intermittent breath hold, that can further protect the lung during treatment.  This position also allows better consistency in ensuring they radiate the same area every day for the duration of treatment.
  • There is a “prone” position, where you are on a table (similar to the one where my breast biopsy was performed) on your stomach and your breast hangs through a hole.  The radiation beams are shot under the table.  I had incorrectly thought that this position would protect my heart and lungs from the radiation, but that is not the case … it provides no protection that way.  Additionally, they are unable to radiate the entire breast in this position … as the nodal area under the armpits and center area, closest to the breastbone, would be blocked by the table.  Additionally, they do not have the ability for exacting precision in consistently radiating the same exact area, as one can never always be in the same exact position / angle / tilt on the table every day for 6 weeks.  Finally, they are not able to do the x-ray / CT scanning to perform the heart block in this position the same way either.

Another radiation technique is proton therapy.  While that also sounded like a great option, for my case, he does not recommend it.  Those beams are aimed straight on, as opposed to angular across the breast (i.e. left to right) and there would not be the same protection for the heart/lung, as they can use for the supine positioning.

Finally, he explained that the lifetime increased risk of a new cancer differs based on chemotherapy treatment and radiation treatment.  Your increased risk of new or recurring cancer is largest with chemotherapy in the first 10 years following diagnosis.  With radiation, your increased risk of a new or recurring cancer is largest at the 30 year mark, however, that increased risk is small, only 0-2%.  Still – good information to know and be aware of.

WHEW!  That’s a lot of information!!  I have time to think about all of this and come up with a choice on which I’d like to pursue, as I still have another month or so before the radiation will start, so I can heal from my surgery.  I’ll be praying for God’s guidance so I make the best decision.

Thank you for your continued prayers, cards, email messages, and gifts.  I love and appreciate all of you so very much.  Until next time … Happy New Year!!!

Meeting with the Oncologist

Today I had my ‘new patient’ meeting with my new oncologist.  He is a very, very nice doctor who is full of compassion and just an all around great doctor you’d want as yours if you had a cancer diagnosis.  I feel lucky that he is my new doctor.

God is answering all of your prayers!  Based on the results of the pathology (that I blogged about earlier) as well as all the other scans/MRI’s etc. that I’ve had – I do NOT need to endure traditional chemotherapy.  YIPPEE!!!!  I am, however, going to have to take a pill for 5 years.  I’ll be placed on an estrogen inhibitor called “Femara“.  There are some side effects that may be hard to deal with over the long-haul, however, it is the best medication to treat my case, so if I can endure – it would be best for me.  If not, I can be switched to one of two other medications, but they are not as good as this one, and also have a long list of side effects.

Some of those side effects are:

  • arthritic/joint-like pain and fatigue
  • menopause symptoms (hot flashes, night sweats, etc.)
  • weight gain (yah, like I need that)  <sigh>
  • bone density loss
  • blood clots (less than 1%)

I am requesting prayers that my side effects will be minimal, at best, or totally non-existent.  Our God is great … and he’s already performing a miracle right in front of us with what He has done already in my case.  He CAN do this too, if it is His will.  I pray it is.

I will be meeting w/ my radiation doctor tomorrow … so I’ll post more information tomorrow or Saturday — when I know more.  ((HUGS)) to you all!

Verbal preliminary pathology report

I just got off the phone with the surgeon who performed my surgery last week.  She called to see how I was recovering from surgery last week, and to tell me that she had good news to share with me.  Obviously, I’ll receive this information in more detail and in written form when I see her next week, but she wanted to give me a call personally to see how I’m healing and to also share some information with me.

She shared that she took a rather large specimen from me (10cm x 7 cm x 3 cm) and there was a 5mm area they had concern about when the surgery was performed.  {I googled a comparison size of the dimensions above and the results were approximately the diameter of a soup can or the size of a baseball.  WOW!  That is a large specimen!}  In all of the tissue that was removed, they found absolutely NONE of the Invasive Carcinoma.  She said that she believes that I only had a very tiny amount, that was removed when the biopsy was performed — also meaning that I was in the very early stages of the Invasive cancer.  THANK GOD!!!  Of the lower grade cancer (DCIS) they obtained clear margins on the entire specimen.  Praise the Lord!!!

Now, for the node incision that they had issues with.  Of the tissue removed – they were unable to find even one lymph node in the tissue that was removed.  (Personally, I’m not surprised, as I’ve been told – from former surgeries I’ve had – that I am one of those people who doesn’t have a lot of lymph nodes.  They’ve had to go ‘hunting’ for them previously.)  The Dr. told me that since the MRI showed it had not spread, combined with the large sample of tissue removed with the tumor – AND that all of that tissue came back with clear margins … as well as no sign of the invasive cancer anywhere — that she is confident that she got it all.  WOOHOO!!!

Now, as a precautionary measure, since no lymph nodes were removed, she gave me a heads up that the oncologist and/or radiation oncologist may want to also radiate the lymph area at the armpit to be extra sure – but that would be their call.  Additionally, she felt is was unnecessary for me to have to endure traditional chemotherapy.  I would likely be put on an oral medicine regimen for a period of time (likely 5-10 years) but that her recommendation, based on the surgery and results from that surgery – is that chemotherapy is not recommended.  Can I get an Amen!?!  🙂

So … that’s what I know for now.  I will have more information after my appointment with her next Tuesday and with the oncologist next Thursday.  I will also need to see a radiation oncologist specialist – but that has not yet been set up.  (Whenever you get a cancer diagnosis, you go from one or two doctors to an army of doctors overnight.)

I wanted to wish you all a very Happy New Year!  Lets make 2017 a FANTASTIC year …. as we kick this cancer to the curb!

The Day of Surgery

Yesterday, the day had finally arrived.  The first ‘real’ step in beating this breast cancer — the removal of the tumor.  My husband and I arrived at the hospital at 7:45 a.m. – 30 minutes earlier than we were asked to arrive.  I didn’t want to be late, now did I?  LOL.  Upon pulling into the hospital parking lot, I saw my brothers truck pulling into a parking space.  He had just arrived too.  So, we all walked in together.  My parents arrived a bit later and joined us as I was already prepped, in my gown, the trendy ‘no slip’ socks they give you and IV already put in – ready to go.  After signing a plethora of paperwork, and meeting the surgical team (my surgeon Doctor, the surgery nurse and anesthesiologist) it was just a waiting game until ‘showtime’.

When the time arrived, I said my ‘goodbyes’ to everyone, and headed to the operating room with the surgery nurse.  As anyone who has gone through surgery knows, you get in the OR, are put under … and then magically awaken in recovery.  That was my experience as well.  In recovery, I was assured that all went well, although it took longer than expected.  In fact – it took 2 hours, rather than the 1 hour anticipated.  I was told that they ran into a snafu when it came to the radioactive dye that was supposed to work up to my lymph gland under my armpit.  It didn’t work as expected due to my reduction surgery scar tissue from 1999.  So, they had to do it a different way, which resulted in a larger than anticipated incision to find and obtain the proper lymph node.  No worries!  I am blessed in that I have great healing genes, so over time the scars will be very faint and hardly even noticeable.  🙂

I went home in the afternoon, and just relaxed and rested for the remainder of the day.  I know, from previous surgeries, how important it is to keep on top of the pain medications, so I have been doing just that.  So far, so good!

img_0087Thank you to everyone who has been flooding me with well wishes via email, Facebook, this blog and by sending me so many beautiful cards.  Thank you also for all of your prayers. I had an unexplainable calm going into this surgery, and I credit that to all of my prayer warriors out there (known and unknown), and God providing that peace as a result.   I can feel the love and care from all of you.  It means so much to me.  ((HUGS))