Part 10. THE SCIENCE!
What is actually going on? What happened in the weeks and possibly months prior to January 2nd when I found a lump? I’ve had people ask what might have caused my cancer. A fair question. I’d bloody like to know. Is it hormone related perhaps? Have I got family history? Have I ever stored my phone in my bra (like there’s fucking space)? Have I regularly licked asbestos or other carcinogens in my life? No one has asked me that. Is it meat? Is it dairy? Is it gin? No to all of the above.
Triple Negative Breast Cancer is comparatively rare – around 15% of breast cancers are TNBC. It’s name stems from the fact that the cells do not respond, in growth or treatment, to the hormones oestrogen, progesterone, or to HER2 (human epidermal growth factor receptor 2 – aka SCIENCE). So treatment can’t be the same as it is for other types of breast cancer. TNBC is more likely to occur in younger women and black women – so obviously I’m keen to do my DNA test at some point and celebrate my relative youth. The most likely reason for me having TNBC grade 3 (not stage 3) cancer is that I am a woman. 1 in 8 women get breast cancer. And the more people I tell, the more people tell me how many women they know who have been through this. The ones I really really want to know about are the ones who have beaten TNBC, because that’s what I’m dealing with. That’s not to say I haven’t spoken with some seriously inspiring women about their ‘jooouuurneys’ but without being able to pin point it, I have a definite filter about what will help me and what won’t.
I pointed out the grade 3 above as it’s different to stages. Grading…is a system used to classify a malignant breast cancer tumour based upon the severity of the mutation and the likelihood that it will spread. The breast cancer cells are examined under a microscope to determine, among other factors, how closely the breast cancer cells resemble the healthy cells (called the histologic grade) and the shape and size of the tumour cells’ nuclei (called the nuclear grade) as well as how rapidly those cells divide and multiply.
When dealing with breast cancer, tumours are often graded based on a scale of one to three indicating how aggressive the cancerous cells are:
- Low grade (1) – Well-diffentiated
- Intermediate grade (2) – Moderately differentiated
- High grade (3) – Poorly differentiated
Low grade tumours look more like normal tissue under the microscope. High-grade tumours look abnormal and less like normal tissue and tend to be more aggressive.
So I have a high-grade, aggressive tumour and my lymph gland has caught creeping cells (metastasis). The good news is, my MRI came back as confirming I have no other lesions (tumours) in either breast. The CT has also confirmed no distant disease (spreading). Thank Buddha / all the gods! The odds of TNBC spreading are higher than other breast cancers, and the survival rate is lower. That’s why chemo is being done first to blast my body. Any cancer is scary. When you start digging in to yours – and when your mum digs in to every research paper there is in the whole world, it can get really scary.
BUT. Knowing all this has not changed my personal prognosis – of myself(!) – which happens to marry with the facts so far. I am aware of the science, the current research, the what-if’s, the potential to respond by shouting ‘quick run for the hills I’ll probably die’. But this is my cancer and my story. It’s not the woman over there who got secondaries in her lung, or that woman over there who had breast cancer 15 years ago. It’s me, right now, knowing what my oncology report says and working through all the steps that will be required to rid my body of cells that are attacking it. The unwanted guests at the party! It’s my body, my cells, responding to my mix of chemo drugs with my mind set, my (mainly) super healthy diet, and my medical team who are second to none. It’s a bit like delivering a baby, no two births are the same. Different bodies, circumstances, drugs, pain, and mind sets. And the mind is the key for me. It’s all going to be about my mental state, as if that’s in a good place the body will follow.
I’ve gone in to a slightly trance-like state. One that shuns all and any stress. One that blocks intense conversations unless they are absolutely necessary. My need to protect myself has flicked a switch of extreme selfishness in order that anything (i feel is) negative is told to fuck off – even if I only use my internal voice! Fortunately the positives have far far outweighed the negatives.
Best case scenario here is that I do 21 weeks of chemo (once it’s fully through my system), I have surgery to remove what’s left of the lump and the lymph, and then radiotherapy to make sure everything is totally blasted and gone. Over 3 of those 21 weeks are done already. At the end of March a marker will be inserted in to my tumour, such is the certainly that chemo will shrink it to such a degree that it’s hard to find with imaging.
TNBC can be genetic and that’s going to be checked by Guys Hospital later this month too. If I do carry the BRCA gene then surgery will look different. More likely an Angelina Jolie job. TNBC has a higher risk of recurrence, but unlike breast cancer, if you’re clear for 8 years you’re officially ‘cured’.
The terminology used on January 31st was that we are curing me. I have also been asked to enter in to a UK wide study of 3000 women with breast cancer focusing on their well being AFTER they’ve been cured. So it seems to me we’re all on the same page. I’m not going to die. Brilliant!!
So Chemo! I’ve just ticked off round 2 of 6. When I say ticked off the next 21 days are also ticking it off as I deal with the symptoms, the supplementary drugs, the picc line maintenance and the self administered immune boosting injections. Not to mention low blood pressure and possibly blood sugar adding in to the mix and flooring me. Oh and insomnia like I’ve never known!
The first 3 rounds (9 weeks) of chemo are an E C blend (more science). Epirubicin (the one that looks like two big tubes of tizer) and cyclophosphomide which is clear. The final 3 rounds are a drug called docetaxel, which can be more potent / mean. I didn’t know this but there are over 100 chemo drugs – which is why some don’t make your hair fall out and some do – depends on the drug. Information I’ve been genuinely blissfully unaware of until now.
Here’s a snapshot of what I’ve been like after EC Round 2…
When Em (March 12th chemo buddy) and I left the centre around 3.30 pm I felt OK. I felt pissed / stoned when I left with mum after Round 1 and a bit out of body. Em and I came back to mine and had tea and toasted tea cakes then mum came up to take over. She bought more home made shepherds pie with ALL the goodness in it and I ate it all. Splendid. Mum stayed. The chemo ‘hit’ kicked in just before eating as I quite suddenly looked like shit. Grey with small puffy eyes. I then started feeling it while mum and I watch TV. Eyes so tired but brain totally wired. Body aches that are there but not intense. The tingles of needing to pee but knowing you just did (in the loo obvs). Dull pain like a period is on it’s way. Thirst. Mild headache. Inability to sleep cos of steroids but a huge need to sleep by 7pm. Sweats in bed. Basically I feel like Billy in Corrie right now, only with less hair and bigger boobs. Billy has also had no fun. I had fun again with my girls Emma and Chemo Anna aka Malc and Little Al.
To top off the fact that all these symptoms are interesting to say the least but manageable – the worst is the low BP – my pre-chemo bloods were better than good with the good white cells having a massive party before Round 2. And my BP had readjusted to perfection. So the body is working.
And that’s the science bit. It’s not much of a laugh is it, but it’s good to mix things up with a few factoids and an insight in to how (relatively) minimally hideous it is to date – thanks universe.
What is quite a laugh is Emma turning in to a meerkat and craning her neck over a wall at the sight of a man in handcuffs on the chemo ward – granted it was unexpected, but cancer is indiscriminate. And me describing a woman to my mum who’d been sitting across from me as ‘the bald one’. Er, hello, GaryBaldi, most of us are!