My latest scans have shown some more cancer progression. Unfortunately I had been in some pain and have felt generally unwell, so the scan results were not a huge surprise. The tumor in my liver that had been about 1 cm grew to about 1.5 cm and 2 new 1 cm spots appeared. The scans also showed a few new bone lesions in my vertebrae in 4 different spots and some rib involvement, including a “subacute pathological” rib fracture. The fracture has probably been giving me the most trouble over the past few months, although it is definitely getting a lot better as it heals.
While all of this was pretty scary to me, I get the impression that everything is still relatively small and manageable given the background of metastatic cancer. I’m not dying today. There are still things to do and memories to be made. I will continue to keep on keeping on.
As for the next steps: there is a lot. To help minimize pain and reduce further bone damage, I’m undergoing a small amount of radiation therapy and restarting the bone-strengthening osteoporosis drug I was on years ago. I’m also starting consultations with a palliative care doctor to add another leg of support. Finally, for treatment, I still have some good options. Nothing curative, of course, but some treatments that have been proven to help many others. I have a couple of clinical trials that I should be a candidate for, so that is my first choice. The benefit of the clinical trial would be 1) it would be an oral medication with seemingly fewer side effects than the next “standard of care” treatment and 2) I would probably get closer follow-up with scans and blood work and definitely have more “eyes” on my progress. If the clinical trial route doesn’t pan out this time, I will start a targeted therapy called trastuzumab or Enhertu®, which has been shown to delay progression in populations similar to mine. I will likely post a follow-up with the plan and scan results in a few months.
As my journey continues, I feel confident about two things. The first is that cancer will keep cancering. It grows and stays alive, that is what it does and now that it’s broken free and learned how to live in multiple organs under multiple treatments, I don’t think a prolonged remission is realistic for me. Second, that being said, I really believe that an actual curative treatment is close and while I think it would be a stretch to think I would live to see that day, I still have hope. I do expect my next line of treatment to work and then I know I have options after that stops working. So who knows? Never say never, and my hope is definitely still alive and well. It is hard to carry both the realism and optimism that are intertwined with the process of living with this disease, but it’s necessary. And to be here, trying these new treatments (and still running, by some miracle) is a gift that I don’t take for granted.
The past few months have been filled with contridictary feelings for me. On one hand I have been noticing all the things in life I am grateful for, all of the fun trips I’ve been on and sites I’ve seen. My daily runs continue to get more and more enjoyable as the weather improves and the green beauty of spring has sprung up in Wisconsin. All of that contentment has been counterbalanced with the ugliness of cancer. The rough days, the calls and appointments that feel never ending, and the heavy responsibility of shouldering not only my own feelings, but the sadness of loved ones.
I am always looking for positive life quotes and affirmations and one that I’ve been seeing more recently is by Walt Whitman: “Keep your face always toward the sunshine – and shadows will fall behind you.” I try to do that physically every day, and many times my emotions will follow. It is what I can do in this moment to overcome the darkness that is cancer.
My Life with Stage IV Breast Cancer 